Like many trans people, Jennifer Trefzger credits gender-affirming care with saving her life. Only this time, it’s in more ways than one.

As the 31-year-old recently told Pride, routine blood work that was part of her transition-related care led to a diagnosis of colon cancer, which had likely gone untreated for nearly a decade.

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“It’s kind of scary,” Trefzger said. “Had I not transitioned, who knows when I would have been diagnosed. It was already stage 4. The symptoms started before my transition. So, I can’t imagine what would have happened if I didn’t transition.”

“Well, I can,” she said. “I’d likely be dead.”

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Long before transitioning, Trefzger sought medical care as a teenager for persistent rectal bleeding. At just 16, she had never had sex, but according to Pride, her doctor assumed that the bleeding was the result of anal sex. Traumatized by her doctor’s invasive questions, she spent years ignoring her symptoms.

“That experience made me dismiss my symptoms and never talk about it again,” she explained. “I don’t even know how often I was bleeding. I just stopped checking.”

After Trefzger came out as trans, she began hormone replacement therapy, and in 2017, her endocrinologist noticed abnormally low iron levels and red blood cell morphology in her routine bloodwork. Her doctor ordered a colonoscopy, which detected a tumor. Trefzger was told the cancer had advanced to stage 4 and that she had a 15 percent chance of survival. But after undergoing a colectomy and 12 rounds of chemotherapy, she was declared cancer-free.

But the cancer had metastasized — something Trefzger didn’t find out until she survived a stroke during facial feminization surgery. Subsequent scans showed cancerous nodules in her lungs, and she underwent further surgeries and chemotherapy before once again being declared cancer-free in 2021.

Trefzger told the outlet she knows of other trans people who were diagnosed with cancer only after starting gender-affirming care. “We’re a marginalized community. Intentionally or not, doctors will dismiss us. Just like other marginalized communities,” she said. “People will die. Whether it’s cancer, autoimmune, or other serious conditions.”

LGBTQ+ people, and transgender people in particular, are disproportionately likely to experience stigmatization and discrimination when seeking medical care. Pride cites a 2024 Kaiser Family Foundation survey that found LGBTQ+ adults are twice as likely as non-LGBTQ+ adults to report negative experiences while receiving health care. Those experiences can discourage queer and trans people from seeking out routine medical care.

“We know that transgender and gender diverse patients often avoid routine primary and preventive care due to prior discrimination or dismissal,” Dr. Anne Marie O’Melia, a pediatrician, child and adolescent psychiatrist, and eating disorder specialist, told Pride.

But O’Melia explained that trans patients receiving gender-affirming care are more likely to have a doctor who respects their identity, pronouns, and body, leading them to be more forthcoming about worrisome symptoms.

“Routine gender affirming care does more than adjust hormone levels,” Dr. O’Melia said. “It creates a consistent, trusting relationship with the health system, and that is often what allows other medical and psychiatric conditions to be recognized early.”

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