As a trans woman or non-binary person assigned male 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.

Our recommendation

If you are taking estrogen as part of your gender-affirming care, you may develop breasts. If you have taken estrogen for at least 5 years in total, you should be screened for breast cancer once you reach a certain age.

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 have never taken estrogen or have taken estrogen for less than 5 years in total, you do not need breast cancer screening. But knowing your body is still important. Get to know how your breasts or chest area looks and feels and tell your healthcare provider about any changes.

If you are at a higher risk for breast cancer, you may start screening at an earlier age or when you have taken estrogen for less than 5 years total. You may also 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 breasts or chest 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 breasts or chest. This includes the entire breast or chest area up to the collarbone and under the armpits, as well as the nipples. Tell your healthcare provider about any changes.

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. Trans women are more likely to have dense breasts, which 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.

I have breast implants. Can I still get a mammogram?

Yes, mammograms are safe and effective for people with breast implants. Tell your technologist that you have breast implants before your mammogram. They will need to make sure that as much breast tissue as possible is seen on the mammogram. This can be done by adjusting the mammography machine and using special techniques to move the implant out of the way and pull the breast tissue forward. They may need to take more pictures (4 instead of the standard 2) to examine as much of the breast tissue as possible. Breast implants can make mammograms more difficult to read, but they should not stop you from getting screened.