LGBTQ+ people face unique challenges within the healthcare system that can cause poorer mental and physical health because of lack of specialized care.
Lesbian, gay, bisexual, and transgender people have a greater risk of breast cancer than their heterosexual counterparts – this is not because of their sexual orientation or gender identification. The risk is linked to breast cancer risk factors that tend to be more common in these people. Examples include never having children or having them later in life, and higher rates of obesity and alcohol use.
LGBTQ+ people are also less likely to get screened than heterosexual cisgender people. This means that LGBTQ+ people experience a higher risk of dying from these cancers because the cancer is often caught in later stages due to lack of screening.
When seeking treatment for breast cancer, it is best to make your cancer care team aware of your sexual orientation.
It’s best to tell your doctor about your gender identity and your transition. This allows your health care team to
- Use your preferred pronouns and name
- Take your transition into account in determining the best treatment plan for you1
For advice on coming out to your doctor, read Coming Out to your Doctor (Human Rights Campaign).
Since there have been relatively few documented cases of breast cancer in transgender people, it is not clear whether transgender men or women are more or less at risk for breast cancer than cisgender men or women. It is also unclear whether breast cancer in transgender people is more likely to have certain characteristics than in cisgender people. As health professionals and organizations become better at caring for transgender people, more transgender people seek medical care, and more research is conducted, the state of knowledge of breast cancer in transgender people will improve a great deal.
It is not clear whether trans women have a greater or lesser risk of breast cancer than cis women. Some studies have suggested that their risk is significantly lesser; others claim that it is much higher.2
Gender-affirming hormones may add to your risk of breast cancer over time. If you have taken gender-affirming hormones for more than five years and you are between 50 and 69 years old, you should get a screening mammogram every two years. Otherwise you do not need regular screening mammograms.4 (This is because estrogen and similar hormones gradually increase the risk of breast cancer the more the breast is exposed to them).
It’s generally recommended that you have screening mammograms between 50 and 69 years of age. This is true
- even if you have had top surgery, since usually some chest tissue remains
- even if you have taken testosterone.5
In general, trans men should be screened for breast cancer in much the same way as non-trans women.
You can often still get a mammogram if you don’t have very much chest tissue. In some cases you may need to have an ultrasound or an MRI instead.6
- Living Beyond Breast Cancer, Coming Out as Transgender to Your Breast Cancer Care Team
- Breast Cancer Now (25 June 2019), Transgender women have an increased risk of breast cancer.
- Madeline B. Deutsch, editor. (2016). Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People. 2nd edition. Center of Excellence for Transgender Health, University of California, San Francisco.
- Canadian Cancer Society, Trans women and breast cancer screening.
- Canadian Cancer Society, Trans men and chest cancer screening.
- Canadian Cancer Society, Questions about breast and chest cancer screening from LGBTQ community.