Breast Cancer Awareness Month takes place every October and serves as a way to honor the over 42,000 people who die from the disease every year. Cancer doesn’t discriminate and, upwards of over 21,000 LGBTQ+ people will be diagnosed with breast cancer in the next year.
In fact, LGBTQ+ people are at an increased risk of developing the disease due to lifestyle differences. For example, individuals who smoke or drink alcohol increase the risk of breast and other cancers, and LGBTQ+ people statistically drink and smoke more than their heterosexual counterparts.
In addition, individuals who give birth are at a lower risk of developing breast cancer and same-sex couples are statistically less likely to have biological children. However, the biggest reason for the increased risk in queer-identifying people is the lack of access to inclusive health care, according to the University of Pittsburgh Medical Center (UMPC).
“LGBTQIA+ people don’t receive cancer screenings as often as cisgender straight people,” the report from UMPC reads. “Regular breast cancer screenings include breast exams, mammograms, and MRI scans. These screenings can find cancer and pre-cancerous cells early. Cancer is easier to treat and has better outcomes when found early.”
Some of the hurdles…
A 2022 study showed transgender people were half as likely to get breast cancer screenings than cisgender people, as well as were less likely to have a primary care provider. A separate study found screening rates among trans and nonbinary people ranged from two to 50 percent. The reasons found in the study ranged from stigmas to a history of poor treatment from health care workers. In other words, if someone had a negative experience with a doctor or found themselves in a non-affirming situation, that patient was less likely to return for further treatments.
“Even if an LGBTQIA+ person hasn’t had a bad experience, they might fear how a healthcare provider will treat them,” UPMC officials said in a statement. “One study from 2021 found that LGBTQIA+ people had the greatest distrust of the health care system. The rates of distrust were highest in Black LGBTQIA+ women.”
In addition, 70 percent of radiologists are “unsure” what the guidelines are for screening a transgender patient for breast cancer. That same study also revealed 65 percent of radiologists don’t offer breast cancer screenings for transgender men and only 13 percent of radiologists noted patients’ gender or sex assigned at birth in their treatments.
Guidelines for screening trans patients for breast cancer
There are three things doctors must consider when screening a trans or nonbinary patient for breast cancer: the sex that doctors assigned a person at birth, whether they use hormones and if their other risk factors include a family history of breast cancer or genetic cancer syndrome.
A trans woman who doesn’t use hormones and doesn’t have a family history will not have to undergo a breast cancer screening. However, if the patient does have a family history of breast cancer or is over the age of 40 and has used hormones for at least five years, a screening that could include a mammogram is highly recommended.
Trans men who undergo top surgery may not have to submit themselves for a mammogram, but doctors do recommend evaluating the risks based on each patient’s medical history. Trans men who have NOT had top surgery do need to undergo breast cancer screenings.
Breaking down the barriers
LGBTQ+ people — especially trans people — have a higher risk of death from breast cancer than cisgender, straight people. Not only are queer folks statistically less likely to get a diagnosis early in the disease’s progress, but they are also less likely to receive care as quickly as heterosexual patients.
A 2021 study found treatment delays were most common in queer Black women, with Black queer women being upwards of five times more likely to have a delay in receiving treatment for breast cancer.
There are many organizations working to help break down the healthcare barriers for breast cancer treatment in queer and trans people. These organizations include National LGBT Cancer Network, CancerCare and their LGBTQIA+ support groups, The Fenway Institute, CoppaFeel!: Resources for Trans and Non-Binary People with Breast Cancer, Family Caregiver Alliance: LGBT Caring Community Online Support Group, The National LGBT Cancer Project, Young Survival Coalition Virtual Hangout for LGBTQIA+ Survivors, CancerCare LGBTQ+ Support Group – Women Caregivers, Queering Cancer and Live Through This.