Prostate cancer has been documented in transgender women, although the prevalence is lower in transgender women than in cisgender men.64 Screening should follow guidelines as for cisgender men; however, if a prostatic-specific antigen (PSA) test is carried out in a transgender woman with a low testosterone level, the upper limit of normal should be reduced to 1.0 ng/mL (rather than 2.0 ng/mL as in cisgender men).65 This evidence concerns the gene KLK3 and prostate carcinoma.