Prevalence of selected gynecological conditions among transgender men in Rio de Janeiro, Brazil

Background Transgender men face barriers to gynecological care, and data from Brazil are scarce. Understanding their health needs is essential to removing barriers and improving healthcare access.Objectives To assess the prevalence of gynecological conditions among trans men in Rio de Janeiro, Brazil, and examine access to care within a culturally safe clinic.Methods We conducted a prospective, observational study of 100 trans men on hormone therapy, followed for 12 months at a university-affiliated clinic. Clinical evaluations, laboratory testing, and structured questionnaires were used to determine the prevalence of gynecological conditions.Results Eighty-four percent of participants reported prior gynecological evaluation, yet only 49% had cytological testing, markedly lower than coverage in cisgender Brazilian women. At least one gynecological symptom was reported by 71%, most frequently dysmenorrhea (43.7%), dyspareunia (32.4%), and vaginal discharge (16.9%). Clitoromegaly was nearly universal (97%). Novel papillary clitoral lesions were observed, and there was one case of primary syphilis. Adherence to visits was high (99%), supported by a culturally safe clinic environment with trained and gender-diverse staff.Conclusions Gynecological conditions are common among trans men in Brazil, and uptake of preventive screening remains suboptimal. Inclusive, patient-centered services can promote retention in care, even in stigmatizing contexts.Implications Reducing disparities requires integration of transgender-specific training in medical curricula, expansion of culturally adequate clinics, and further research on determinants of morbidity in this population.