Transitioning

Transitioning is the process whereby people change their gender identity and live in the opposite gender to the sex they were assigned at birth. This can have important implications with regard to breast cancer risk and detection. 

Transgender women are those whose sex assigned at birth was male and now live as female. Many transwomen take oestrogen tablets to allow their bodies to have a more female appearance and some have genitalia surgery as well to enhance this. However increasing the oestrogen levels in the body will increase the individual risk of developing breast cancer compared to that of cis men As such transgender women taking oestrogen tablets should have screening mammograms once they reach 50 years old. However, only those whose gender recorded on their GP records as female will be called for an NHS breast screening mammogram. Transgender women will therefore only be called for this screening if they have changed their gender marker at the GP from male to female. This is very easy to do and no doctor’s letter, diagnosis or medical report is needed. 

Transgender men are those whose sex assigned at birth was female but now live as a male. Many transgender men take the male hormone testosterone to allow their bodies to have a more male appearance and some have surgery to remove their breasts – known as TOP surgery- as well as genitalia surgery. After TOP surgery the risk of breast cancer will be significantly reduced although there will still be a very small amount of breast tissue left to maintain a male breast contour. Transgender men therefore still need to be breast aware and do regular checks. Screening mammograms are not needed however and in order not to be called for a screening mammogram, transgender men need to change their gender marker at the GP surgery to be removed from the screening programme. Those that have not had TOP surgery will however still require screening mammograms once they reach the age of 50. These appointments can be re-scheduled to the end of the clinic to prevent someone feeling uncomfortable attending.