National Breast/Chest Cancer Awareness Month
During Breast/Chest Cancer Awareness Month, it’s important to remember that while everyone with breast or chest tissue is at risk of developing cancer, the rates vary significantly and depend on a number of factors. Cisgender women bear a far greater burden than cis men, with even greater disparities among the mortality rates for lesbians, bisexuals, and women of color – due in large part to factors such as lack of health insurance, distrust of the medical system and other barriers to care. Risk for trans women and trans men likely falls somewhere in between depending on hormone use and surgical history. For cisgender females, experts do not fully agree on screening recommendations.
The U.S. Preventive Services Task Force recommends a screening test every 2 years for women ages 50-74. The American College of Obstetricians and Gynecologists recommend a mammogram annually from the age of 40. The American Cancer Society recommends the option of mammography annually to women 40-45, annual mammography for all women 45-54, and annual or every two year mammogram for women over the age of 55.
Due to the lack of sufficient data collection on sexual orientation and gender identity (SOGI), there are less specific screening recommendations for people of trans experience. Recommendations for breast/chest screening vary depending on a person’s weight, age, presence of breast tissue, family history, and length of time using hormones. The World Professional Association for Transgender Health (WPATH) recommends screening every 2 years for trans masculine people assigned female at birth who have breasts, as well as for those who have had top surgery, depending on the amount of tissue left. At this point there is not a similar recommendation from WPATH for transwomen, but The Fenway Institute in Boston recommends that transgender women over the age of 50 who have undergone HRT for 5 or more years should get a mammogram annually.
With all of these recommendations, you should take into account your family history and other factors, and discuss what’s best for you with your provider.
Aside from screenings, you can reduce your risks by eating well, talking about stress, getting exercise, taking good care of yourself and the people you love, and talking with your medical provider about your risks. When LGBTQ people take care of ourselves and one another, we triumph over homophobia, biphobia and transphobia. As one of our namesakes, Audre Lorde, wrote in The Cancer Journals: “I do not wish my anger and pain and fear about cancer to fossilize into yet another silence, nor to rob me of whatever strength can lie at the core of this experience, openly acknowledged and examined… imposed silence about any area of our lives is a tool for separation and powerlessness.”