50,285 people in the UK were diagnosed with breast cancer in 2011. Considering the UK has a population of 64 million, and there are approximately 7 billion people in the world, it stands to reason that (relying on my dodgy maths and non-existent medical knowledge) around about 5.5 million people develop breast cancer every single year. This is kind of a big deal. Breast cancer does not only affect women. Everyone is at risk, whether they’re gay, straight, trans, cis, male, female or none of the above. It appears that the most common contributing factor is old age, and none of us can escape that!
While it may seem bad enough to be a cis woman diagnosed with breast cancer, the journey is all the more confusing and disorientating for those in the trans community. Almost no research whatsoever has been conducted on the risk of breast cancer in trans individuals, whether male or female. This seems fairly shocking, considering gender reassignment surgery frequently contains at least some manipulation of the breast tissue. Most trans medical funding goes on HIV, mental health and substance abuse so as a result, there is little support or information out there for trans individuals who may be worried about the disease. I’m going to break down what I’ve found out for both trans men and women, in the hope that at least someone will finish this article more knowledgeable and better equipped to deal with what could be happening to their body.
So let’s start with trans men:
You’re in luck! If you have had top surgery, a large amount of your breast tissue will have been removed, thereby reducing your risk of breast cancer. However this does NOT mean that the risk is entirely eradicated; there will be some breast tissue remaining in the chest wall after surgery, which could cause problems. This puts you at a higher risk than cis men, but luckily not as high as cis women. At a moderate level, testosterone intake can help reduce the risk, as long as it is not too high, in which case excessive testosterone may be converted into oestrogen by the body, having the opposite effect.
Another slight issue found in groups of trans men is a reluctance to self-check. Due to many of these men never having emotionally assimilated their breasts, or never having associated with certain parts of their body that were physically present at birth, the idea of regularly checking could be a complete anathema. It’s important to persevere however, or at least talk to your doctor about it, as you must be aware of your body and keep an eye out for signs of a problem.
Now onto trans women:
Again, the risk certainly seems to be lower than with cis women. It is not negligible however, and protracted exposure to hormones (as in Hormone Replacement Therapy) could place you in a slightly higher risk group than cis men. Thankfully though, there is as yet no evidence that breast implants raise the risk factor (yay), however they can make it harder to see the cancer on a mammogram. If you talk to your doctor about this though, they’ll be better equipped to deal with this issue.
I hope this doesn’t all sound too ‘doom-and-gloom’. Take solace in the words of Dr Maddie Deutsch, director of the transgender health program at the LA Gay & Lesbian Center, who confirms that the risk of breast cancer really is relatively low. It is just important that you keep checking. Regular chest/breast exams and mammograms are ideal and perhaps could save your life.
Sadly, for some members of the trans community, particularly abroad, reliable healthcare can perhaps be harder to come by than it is for others. There are a variety of reasons for this. Some doctors (understandably, given the dearth of research) lack knowledge in this area. What’s more, trans individuals often fall victim to stigma (not so understandably), sometimes from the very medical professionals they turn to for support. In addition, trans people often belong to other economically or socially marginalised groups – there is a disproportionately high number of BME, HIV-positive and young people in the trans community – making effective healthcare harder to come by.
Despite all of that, there is still hope. There are certain things that YOU can do, regardless of your gender, sexuality or age that could help to keep you safe:
- Choose a healthcare provider that makes you feel at ease. If you are trans, try to find someone who you are comfortable talking openly with about all your issues (and all your body parts).
- Know your risk! Find out about your family history so you can judge whether you should be more wary of breast cancer, or any other cancer for that matter.
- Have a mammogram annually, particularly when you hit middle age. They are uncomfortable, but surely worth it if you find something wrong!
- Know how your breasts (or torso) normally look and feel and report any changes, regardless of how small or seemingly insignificant, to your healthcare provider.
- Live healthily! Make sensible lifestyle choices and you will be happier AND less at risk of disease.
If you want to learn more about breast cancer, come along to some of the Cambridge Pink Week events, from Friday 27 February. We are committed to raising funds and awareness for this disease, and would love for you to help us out.
Check out our website at www.pinkweek.co.uk
See you soon!
Rowan Douglas (Sub-Editor)