Mammograms for Trans Men: What You Need to Know

by Nikki Naser (they/them)

If you’re a trans man, one of the last places you want to be is in the reception room of a “women’s care” center waiting to get a mammogram. While mammograms for trans men are important to normalize, there is still a risk of being mistreated, misunderstood, and/or misgendered by healthcare providers.

The good news? We can help with these roadblocks to provide you with the right screening for your body at the right time. We’ll explain your risk factors and give you guidelines for when and why you need to get screened, all while taking care to make it as affirming and comfortable as possible. This is an important preventive screening, and we want to help you take this step toward a long, healthy life of living as your authentic self.

Why Mammograms for Trans Men?

Breast cancer became the most common cancer as of 2021, accounting for 12% of all new annual cancer cases worldwide, according to the World Health Organization.

When it comes to the risk of breast cancer and the necessity of mammograms for trans men, there are many factors to consider when determining your personal risk. Unfortunately, not enough research has been done to give accurate statistics about breast cancer in the trans community, but according to a resource on Breast Health for the LGBTQ Community by Susan G. Komen Puget Sound, there are two important reasons why you may still be at risk:

  • If you take testosterone, you may be at increased risk of breast cancer. Why? Your body can convert excess testosterone into estrogen, and having excess estrogen increases your risk of breast cancer.
  • Even after a transgender mastectomy, some breast tissue can remain to preserve a natural pectoral shape. If you have a chest reduction only, you will also have some degree of breast tissue, and this tissue is still at risk of breast cancer.

And if you have not chosen to or been able to have any gender-affirming top surgeries, HRT, or any other physiologically-altering treatments, then you retain the same risk for breast cancer as cisgender women.

Know Your Risk Factors

Now that you know you can get breast cancer, you should learn your risk factors. You’re at higher risk for breast cancer if you:

  • Gave birth after age 35
  • Have never given birth
  • Have never breastfed a baby
  • Are age 50 or older
  • Have a mother, sister, or daughter who has had breast cancer
  • Got your period at age 12 or younger
  • Take birth control now or have taken it within the past 10 years
  • Started menopause at age 45 or later
  • Are overweight after menopause
  • Take estrogen or hormone pills
  • Take testosterone
  • Have dense chest tissue
  • Have been diagnosed with atypical hyperplasia
  • Drink alcohol more than once a day
  • Are not physically active or do not exercise regularly

When to Get Screened

So, what if you have had a chest reduction and also have none of the risk factors listed above? Or what if you have had a bilateral transgender mastectomy but still have several risk factors?

Here are some screening guidelines for mammograms for trans men from the American College of Radiology:

If you’ve had...And you have…Then…
Major top surgery (transgender mastectomy)Any risk level (risk level does not factor significantly due to the degree of tissue removal)Perform regular self-exams and ask your physician about annual chest wall and axillary exams
A chest reduction or NO top surgery at allLow/average number of risk factorsMammograms are recommended every year or every two years once you turn 40
Intermediate risk level (especially if previously diagnosed with breast cancer or atypical hyperplasia)Annual mammograms are recommended starting at age 30
High risk (especially if you have a family history of breast cancer)Annual mammograms and MRI are recommended starting at age 25-30

A Better Experience for Trans Men at 26Health

At 26Health, we do things differently than your average healthcare center or doctor’s office. We make your visit as stress-free as possible, especially if you’re here with questions about a mammogram as a trans man.

We start with intake forms that ask about not just your legal (and perhaps dead) name and assigned sex at birth, but also your preferred name and gender identity as well as your pronouns. You won’t ever have to explain the name or sex listed on your ID.

When you get here, you won’t be sitting in a “women-only” space, which we know can cause huge amounts of anxiety to start with. Our practice is designed for everyone, and we provide many different services, from transgender health services, primary healthcare, and mental health to pediatric healthcare and adoption assistance.

The people you’ll interact with are either LGBTQ+ themselves or are LGBTQ-friendly, and they understand that this can be an overwhelming experience. They are also knowledgeable about queer issues and can answer questions specific to your unique experience and identity.

26Health will help you get the screenings you need as you continue your journey. We also provide letters of recommendation for gender-affirming surgery. Keep getting screened until you’re cleared by a doctor to stop screening, and check out our guide to safe-binding.

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