October is Breast/Chest Cancer Awareness Month!
Breast/chest cancer is the most common diagnosed cancer in the U.S. with an expected 290,560 new cases in 2022. While there is limited data on overall rates of breast/chest cancer screenings, diagnosis, and health outcomes among LGBTQ+ individuals, a growing body of research shows that sexual minority women may be at increased risk of breast cancer due to higher prevalence of well-known risk factors—including cigarette smoking, alcohol use, obesity, and nulliparity. Additionally, research shows that lesbian women report lower rates of preventative healthcare, including mammography, compared to their heterosexual counterparts. While there is even more limited data on transgender and non-binary (TNB) individuals, some recent studies have shown that transgender patients are less likely receive breast/chest cancer screening compared to the cisgender population.
For LGBTQ+ patients, there are many barriers to accessing breast/chest cancer screenings. For example, socioeconomic factors like lack of insurance coverage and economic instability disproportionately impact LGBTQ+ patients and also make it more difficult to access all types of healthcare, including cancer screenings. Another barrier to LGBTQ+ individuals seeking breast/chest cancer screenings is the lack of affirming and inclusive breast/chest cancer awareness campaigns. Breast/chest cancer campaigns typically use terminology and visuals that are geared towards heterosexual and cisgender women without any acknowledgement of queer and TNB individuals. This can lead to many LGBTQ+, and TNB individuals especially, to not feel seen or represented and potentially not identify with the necessity for breast cancer screenings.
Lack of affirming and knowledgeable healthcare spaces is also a huge contributor to disparities in breast/chest cancer screening and outcomes. Research shows that 15% of LGBTQ+ Americans, and 30% of transgender people, postpone or avoid medical treatment—including cancer screening—due to discrimination. TNB individuals also may have specific concerns or needs around breast/chest cancer screening that are often overlooked. For trans men who experience gender dysphoria around their chest, being misgendered and having their mammary tissue referred to as “breasts” can be very distressing. For those on feminizing hormone therapy, as well as those who have had gender affirming top surgery, there may be questions about breast/chest cancer risk and screening protocol. Unfortunately, there is confusion and lack of knowledge among providers regarding breast/chest cancer screening guidance for TNB patients.
It is critical for providers to create more affirming spaces for LGBTQ+ patients to receive breast/chest cancer preventative care, treatment, and resources. Using more inclusive terminology, such as “chest” instead of “breast” or “mammary tissue” rather than “breast tissue,” may help make mammograms a bit more comfortable for TNB patients. Providers should always use terminology that patients are comfortable with and use for themselves. Additionally, providers can also help to ensure that breast cancer patient education materials depict a wide range of people, and that mammograms are not specifically labeled as women’s healthcare. Overall, it is critical that national cancer data registries collect sexual orientation and gender identity data to better understand breast/chest cancer concerns, needs, and disparities affecting LGBTQ+ communities.
The importance of getting screened for breast/chest cancer cannot be overstated. Early detection for breast/chest cancer can be lifesaving. For more information on breast/chest cancer among LGBTQ+, including resources on cancer screening for transfeminine and transmasculine individuals, you can visit the National LGBT Cancer Network here. You can also visit Howard Brown Health to get more information or speak to a provider about breast exams.