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Research Letter
June 26, 2024

Prostate-Specific Antigen Values in Transgender Women Receiving Estrogen

Author Affiliations
  • 1Department of Urology, University of California San Francisco
  • 2Section of Urology, Veterans Affairs Health Care System, Durham, North Carolina
  • 3Department of Urology, University of California San Diego
  • 4Department of Urology, Cedars-Sinai Medical Center, Los Angeles, California
JAMA. 2024;332(4):335-337. doi:10.1001/jama.2024.9997

Among people with prostate cancer, transgender women receiving estrogen are more likely to present with high-grade disease vs cisgender men, suggesting potential delayed diagnosis.1 A possible reason for delayed diagnosis may be the absence of prostate-specific antigen (PSA) reference ranges specific to transgender women receiving gender-affirming hormones. Due to the castrating effects of gender-affirming hormones, PSA, whose production is androgen-regulated,2 would be expected to be lowered. This study determined PSA values among a nationwide cohort of transgender women without known prostate cancer receiving estrogen, the most common gender-affirming hormone.

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