As a trans man or non-binary person assigned female at birth, do I need to get screened for breast cancer?

Trans, non-binary and gender-diverse people face significant barriers to accessing healthcare and are less likely than cisgender people to be screened for cancer. Barriers that can make participating in cancer screening challenging for people in the trans community include:

transphobia and discrimination
limited healthcare provider knowledge about issues affecting trans people (such as gender dysphoria)
a lack of trans-specific resources
concerns about physical and emotional safety

But getting screened for cancer is an important part of regular medical care for everyone because the earlier cancer is found, the better the outcome and treatment options will be.

People of all genders can get breast cancer, so it’s important to be aware of your breast or chest health. To find the right screening approach for you, talk to your healthcare provider about the types of surgery you’ve had, whether you’re taking hormones, the benefits and limitations of breast cancer screening, and your personal risk. Many trans men and non-binary people prefer to use the word “chest” when they refer to that part of their body. Talk to your healthcare provider about the words you prefer to use.

Our recommendation

If you haven’t had any chest surgery, or if you’ve had a chest reduction, you should be screened for breast cancer once you reach a certain age, even if you are taking testosterone.

If you are 40 to 74 years old, have a mammogram every 2 years.
If you are 75 or older, talk to your healthcare provider about whether having a mammogram is right for you.

If you are at a higher risk for breast cancer, you may start screening at an earlier age or get screened more often. Your personal risk for breast cancer may depend on your family history, certain gene mutations or prior radiation therapy to the chest, neck and armpit area.

Not every province or territory offers mammograms through an organized program or by self-referral for people in their 40s. We are advocating to ensure that women and trans, non-binary and gender-diverse people at average risk have fair and timely access to breast cancer screening, no matter where they live.

Your healthcare provider should help you understand the benefits and limitations of cancer screening. They should affirm your gender and perform any tests in a way that reduces your discomfort and any feelings of gender dysphoria you may have as much as possible. Bringing a trusted friend or loved one with you to your appointment may also help you feel more comfortable. And if you don’t feel comfortable, you are allowed to leave and book another appointment with a different provider.

Know your body

You should be aware of what is normal for your chest or breasts even if you get regular screening or examinations by a healthcare provider. Many people find their own breast cancer by noticing changes in the look and feel of their bodies.

You can become familiar with your breast tissue by looking at and feeling your chest or breasts. This includes the entire chest or breast area up to the collarbone and under the armpits, as well as the nipples. Tell your healthcare provider about any changes.

I have had a mastectomy as part of gender-affirming chest surgery. Should I still get a mammogram?

Talk to your healthcare provider about the right screening approach for you. They may do a physical examination of the chest and lymph nodes in the underarm area (called the axilla) to feel for any lumps, hardening, tenderness or pain in the area.

Researchers are still trying to determine the best way to screen for breast cancer in trans men and non-binary and gender-diverse people who have had a mastectomy (surgery to remove all of the breast) as part of gender-affirming care. If you have had a mastectomy, it can be harder to screen for breast cancer with a mammogram. More research is needed on other screening approaches like MRI or ultrasound to make an evidence-informed recommendation. Some breast tissue is still left after surgery, so knowing your body is important.

Does chest binding increase my risk of breast cancer?

There is no evidence to suggest that chest binding increases your risk of breast cancer. It’s important to be aware that wearing a binder for a long time could result in other risks like pain and skin irritation in the chest area, fungal infections or difficulty breathing. It’s helpful to take off your binder when you sleep so your chest has more room to breathe.

I'm told I have dense breasts. What does this mean and should I still get a mammogram?

Dense breasts have more connective tissue and are a risk factor for developing breast cancer. Dense breasts can make it harder to detect breast cancer and can increase the risk of false negative mammogram results. You should still get mammograms even if you have dense breasts.