This leaflet is for you if you are transgender (trans) or non-binary. It is important you read the information in this leaflet to help you decide about taking part in screening.
If you are a health professional you may find this leaflet helpful.
If you live in Wales, we will invite you for screening based on your:
It is important to know that you will be invited for screening based on how you are registered with your doctor and not based on the sex you were assigned at birth.
We aim to treat everyone with dignity and respect. It is important that we address you in the correct way. Let us know if you feel we can improve your experience of screening.
We have provided contact details throughout this leaflet. You can contact us in Welsh or English. It will take us the same amount of time to answer you, whichever language you choose.
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Breast Screening |
Will I be invited? | Yes, if you are registered with your doctor as female | Do I need to be screened? | Yes, if you have breasts |
| Cervical Screening | Will I be invited? | Yes, if you are registered with your doctor as female | Do I need to be screened? | No, as you do not have a cervix |
| AAA Screening | Will I be invited? | No, if you are registered with your doctor as female | Do I need to be screened? | Yes, as biologically you are 6 times more likely to develop an AAA |
| Bowel Screening | Will I be invited? | Yes | Do I need to be screened? | Yes |
| Diabetic Eye Screening | Will I be invited? | Yes, only if you have diabetes | Do I need to be screened? | Yes, if you have diabetes |
| Antenatal Screening | Will I be invited? | No | Do I need to be screened? | No |
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| Breast Screening | Will I be invited? | No, if you are registered with your doctor as male | Do I need to be screened? | Yes, if you have breasts |
| Cervical Screening | Will I be invited? | Yes, but let us know first, if you are registered with your doctor as male | Do I need to be screened? | Yes, if you have a cervix |
| AAA Screening | Will I be invited? | Yes, if you are registered with your doctor as male | Do I need to be screened? | See 'Things you need to know about AAA screening' below, which will help you decide |
| Bowel Screening | Will I be invited? | Yes | Do I need to be screened? | Yes |
| Diabetic Eye Screening | Will I be invited? | Yes, only if you have diabetes | Do I need to be screened? | Yes, if you have diabetes |
| Antenatal Screening | Will I be invited? | Yes, if you are pregnant | Do I need to be screened? | Yes, if you are pregnant |
Who: Some people aged from 50 up to 70 (and over 70 if you ask)
When: Every three years
Test: Mammogram (breast X-ray)
You will receive your first invitation before your 53rd birthday.
If you are invited for breast screening or have asked for this to be done at the hospital, it is important to attend.
Breast screening can save lives by finding breast cancer early.
Contact Breast Test Wales
If you are registered with your doctor as female, you will be invited for breast screening.
If you are not registered with your doctor as female, you will not be invited for breast screening.
If you have not had chest reconstruction (top surgery) or still have breasts, we recommend that you go for breast screening.
You will need to talk to your doctor to arrange a referral at a hospital or breast clinic. This will not be carried out by Breast Test Wales.
We may invite people who do not need to have breast screening. If this applies to you or you are not sure, contact Breast Test Wales who will be able to help you.
Let Breast Test Wales know if you would like your appointment at the beginning or end of the clinic or if you would prefer to be screened at your nearest breast screening centre.
If you wear a binder, private changing rooms are available so that you can remove this before having your breast X-ray.
If you are worried about going for breast screening or if breast cancer runs in your family speak to your doctor. If you find talking to your doctor difficult you may want to get support from someone you trust to do this for you.
Taking part in screening is your choice. If you do not want to be invited for breast - screening you will need to contact your nearest breast screening office, who will explain how you can opt out of breast screening.
It is important to get to know how your breasts look and feel. We understand that this may be difficult. However, it is important as it will help you notice any changes that are different. Although uncommon, people assigned male at birth can get breast cancer, so it is important that everyone is breast/chest aware.
If you notice any changes, talk to your doctor without delay.
For more information, visit: phw.nhs.wales/breast-screening
Who: Anyone aged 25 to 64 who has a cervix
When: Every five years
Test: Cervical screening (smear) test
If you have a cervix it is important for you to attend your cervical screening.
Cervical screening (smear) test can save lives by preventing cancer from developing in the cervix (the neck of the womb).
Contact Cervical Screening Wales
If you are registered with your doctor as female, you will be invited to make an appointment for cervical screening.
It is important to attend if you have a cervix. If you do not have a cervix, you do not need to attend. Let your doctor or Cervical Screening Wales know so that you do not receive further invitations.
If you are not registered with your doctor as female, you will not be invited for cervical screening.
If you are registered as male and have a cervix, it is important that you are screened. To do this, let your doctor or Cervical Screening Wales know.
If you or your doctor let Cervical Screening Wales know, they can automatically invite you each time you are due to have cervical screening and tell you your results.
We may invite people who do not need to have cervical screening as they do not have a cervix. If you do not have a cervix, you will need to let your doctor or Cervical Screening Wales know so we do not send you further invitations.
We understand that you may be worried about going to a cervical screening appointment. You may want to contact your doctor’s surgery to ask if you can have your appointment at the beginning or end of the clinic.
If you are a trans man taking long-term testosterone, your screening test may be uncomfortable or painful. You may want to:
We know this can be an anxious time as there may be physical changes to your body, particularly to your genital area. If you are worried about having your cervical screening test, contact your doctors’ surgery or Cervical Screening Wales. If you find talking to your doctor difficult you may want to get support from someone you trust to do this for you.
Taking part in screening is your choice. If you do not want to be invited for your screening test you should contact Cervical Screening Wales, who will explain how you can opt out of cervical screening.
Nearly all cervical cancers are caused by a virus called human papillomavirus (HPV). This is a very common virus that most people will come into contact with at some time during their lives. Only certain types of HPV cause cervical cancer. These are called high-risk types. Cervical screening tests for high-risk HPV.
HPV is spread by skin-to-skin contact. For HPV in the cervix, this is through sexual contact. This can be by having sex, oral sex, or through genital touching or sharing sex toys. In Wales, HPV vaccinations are offered to everyone aged 12 to 13. The vaccine could prevent 7 out of 10 cases of cervical cancer in the future. However, it is possible to develop cell changes despite having had the vaccine. People who have been vaccinated and have a cervix should still have screening.
You should tell your doctor if you have any of the following, even if your previous screening test did not find high-risk HPV.
For more information, visit: phw.nhs.wales/cervical-screening
Who: Some people aged 65(and over 65 if you ask)
When: One-off test
Test: Ultrasound
AAA (abdominal aortic aneurysm) screening can save lives by finding a swelling (aneurysm) of the aorta (main blood vessel) in the abdomen.
Contact Wales Abdominal Aortic Aneurysm Screening Programme
If you were assigned male at birth, you are six times more likely to have an AAA than someone who was assigned female at birth.
A ruptured AAA is less common in a person assigned female at birth, on average this happens 10 years later than in a person assigned male at birth.
If you are registered with your doctor as male, you will be invited for AAA screening.
If you were assigned female at birth you can choose whether or not you would like to attend for screening.
If you are not registered with a doctor as male, you will not be invited for AAA screening.
If you were assigned male at birth it is important for you to be screened. You will need to contact your nearest screening office to arrange a suitable appointment.
AAA screening involves having an ultrasound scan of your abdominal aorta. You will not need to undress but you will have to lift up your top. If you wear a binder, the screener may be able to do the scan without you having to remove this.
Let the Wales Abdominal Aortic Aneurysm Screening Programme know if you would like your appointment at the beginning or end of the clinic.
If you are worried about going for AAA screening or if AAAs run in your family speak to your doctor. If you find talking to your doctor difficult you may want to get support from someone you trust to do this for you.
Taking part in screening is your choice. If you do not want to be invited for AAA screening you will need to contact your nearest screening office, who will explain how you can opt out.
An AAA can happen to anyone but it is most common in people assigned male at birth and aged 65 or over.
You are more at risk of developing an AAA if you:
There are usually no signs and symptoms of an AAA. The easiest way to find an AAA is by having a simple ultrasound scan of the abdomen.
For more information, visit: phw.nhs.wales/aaa-screening
Who: People aged 50 to 74
When: Every two years
Test: Poo sample kit completed at home and returned by post
Bowel screening can save lives by finding bowel cancer early.
Contact Bowel Screening Wales
Everyone aged 50 to 74 will be invited to take part in bowel screening every two years.
A bowel screening test kit and information pack will be sent to you in the post when you are due for screening.
The test kit is quick and easy to use and only one small poo sample is needed.
The test looks for tiny amounts of blood in your poo which you may not be able to see. This may be a sign of bowel cancer.
If blood is found in your sample, you will be referred for further tests. This may involve you having a colonoscopy.
A colonoscopy is where a small flexible camera is inserted into your back passage (bottom) to look at the lining of your bowel.
If you have had gender reassignment surgery you may find having a colonoscopy more uncomfortable. You may want to talk to your screening nurse or doctor about this before having the test. If you find talking to your doctor difficult, you may want to get support from someone you trust to do this for you.
Taking part in screening is your choice. If you do not want to be invited for bowel screening you will need to contact Bowel Screening Wales, who will explain how you can opt out.
You may feel well even if you have early bowel cancer. Bowel cancer is more common as you get older. You should tell your doctor if you have any of the following.
For more information, visit: phw.nhs.wales/bowel-screening
Who: Everyone over 12 years with diabetes
When: Every one or two years depending on their risk of diabetic eye disease
Test: Photographs of the eye
Eye screening can prevent you from losing your sight as it can find retinopathy (damage to the back of the eye) at an early stage.
Screening saves sight.
Contact Diabetic Eye Screening Wales
Everyone aged 12 or over who has diabetes and is registered with a doctor will be invited for diabetic eye screening every one or two years depending on their risk of diabetic eye disease.
Diabetic eye screening looks for retinopathy (damage to the back of the eye), which can lead to sight loss if not treated. It is important to take part in diabetic eye screening even if your eyesight seems fine to you. Finding retinopathy early means it can be treated, and this can help prevent sight loss. Taking part in screening is your choice. If you do not want to be invited for your diabetic eye screening test you should contact Diabetic Eye Screening Wales, who will explain how you can opt out of screening.
You should tell your doctor or optician if you have any of the following.
For more information, visit: phw.nhs.wales/diabetic-eye-screening
Who: People who are pregnant
When: During pregnancy
Test: Blood tests and ultrasound scans
You will be offered antenatal screening tests during your pregnancy, to check your health and the health of your baby.
If you have any questions about antenatal screening, you can talk to your midwife.
If you are pregnant, you will be offered antenatal screening tests.
You will be offered antenatal screening tests during your pregnancy to check your health and the health of your baby. A midwife will explain the different tests you can have as part of your routine antenatal care.
Screening may involve ultrasound scans and blood tests. These tests will be offered at different stages during your pregnancy. You can choose whether or not to have these tests.
If your screening test suggests a problem, you may be offered more tests and ultrasound scans.
If you have any questions about antenatal screening you can talk to your midwife. For some people talking to a health professional may be difficult. You may want to get support from someone you trust to do this for you.
For more information, visit: phw.nhs.wales/antenatal-screening
It is important that everyone is treated with dignity and respect. If you feel that you have not been treated in this way, or if you want to share your experience with us, visit the feedback pages on the programme websites.
Everything you tell us will be treated in the strictest confidence.
Visit the Information for people who are transgender or non-binary page on the programme's websites.
Wales GIC: Cav.Wgs_enquiries@wales.nhs.uk
Public Health Wales Screening Division: phw.nhs.wales/screening
Stonewall Cymru: stonewallcymru.org.uk
Unique Transgender Network: uniquetg.org.uk
Gender Identity Research and Education Society: gires.org.uk