Pathology The Facts

The Royal College of Pathologists of Australasia (RCPA) Fact Sheets are in an easy to read format to inform the general public on the risks and benefits of pathology testing, and assist in providing an understanding of the important role pathology plays in the delivery of health care.

The Fact Sheets involved a number of stakeholders including the Consumer Health Forum of Australia; Royal Australian College of General Practitioners, Royal Australasian College of Physicians; Lab Tests Online; Pathology Associations Council; and the Department of Health and Ageing.

The Royal College of Pathologists of Australasia (RCPA) strongly advocates for patient safety and supports the continued dialogue between patients and health practitioners in relation to pathology testing.

When gender can make a difference to a pathology result, laboratories will provide ‘normal ranges’, as part of your report. These are provided in a binary way, displayed as either male or female reference intervals.

The ‘normal ranges’ are established by taking the results of large numbers of healthy people and calculating what is typical for them. Factors such as age, muscle mass, organ size, gender and ethnicity can affect results. For this reason, it is advisable to disclose your gender identity and gender assigned at birth.

Talk to the person giving you a referral. You may like to ask:

  • Are there different normal ranges for males and females for any of these tests?
  • Are variations in these ranges likely to be the difference between a normal or abnormal result for me?
  • Are the results likely to be used to determine the care I receive?

Your referrer can assist you in navigating this process by requesting:

  • Male and female reference ranges be provided with the report
  • State on the referral form if you were male or female assigned at birth
  • Extra assistance with interpretation of test results

Your referring doctor or health practitioner can contact your pathology laboratory and request to speak with a pathologist for further guidance.

Some of the pathology tests where gender can make a difference to the result include:

  • Full blood count (FBC) including haemoglobin (Hb), red cell count (RBC), haematocrit (HCT), ferritin (anaemia), platelets
  • Lipid profile: high density lipoprotein (HDL) cholesterol
  • Creatine kinase (CK)
  • Troponin I (TnI)
  • Kidney function tests: Creatinine [clearance], estimated glomerular filtration rate (eGFR)
  • Hormones: sex hormones testosterone, oestradiol; also luteinising hormone (LH), follicle stimulating hormone (FSH)
  • Urea (blood urea nitrogen, BUN), electrolytes and creatinine
  • Uric acid/urate
  • Liver Function Tests (LFT) – Alkaline phosphatase, Transaminases (AST, ALT), Gamma-Glutamyl Transferase (GGT)

For more information on these specific tests, please visit:

It is crucial that your pathology laboratory knows which gender you were assigned at birth to ensure reports assist your doctor in providing appropriate treatment, to enable the best possible outcomes.

Transgender Patient Information for Laboratories and Clinicians

The RCPA encourages laboratories to make information reference limits available to clinicians. Particularly for tests with sex-specific reference limits. In addition clinicians can:

  • Contact the laboratory to obtain male and female reference ranges
  • Include on the referral form the gender information most appropriate for requested tests
  • Requesting extra assistance with interpretation of test results from the laboratory if needed

For laboratory pathologists, please refer to our position statement on Pathology Testing for Transgender and Intersex Individuals – Statement of Best Practice for Medical Pathology Laboratories.

Additional Resources

The Health and Well-Being of Transgender Australians: A National Community Survey

Transgender transition testing

Pathway: Pathology testing for the trans community

Reference Intervals and what they mean

Reading your results

RCPA Transgender Patient Information Flyer

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