STUDY: Trans Women at Greater Risk of Breast Cancer than General Male Population


A Dutch study found that male-to-female transgender people were at a higher risk of suffering from breast cancer than males who do not undergo hormone replacement therapy.

Conversely, female-to-male transgender people are at a lower risk of suffering from breast cancer than their cis counterparts.

Although the risk of developing breast cancer is greater for males who undergo a course of hormones, biological women still have a higher likelihood of suffering from breast cancer.

Only the conventional breast cancer screening is currently necessary for trans individuals on hormones.

According to Medical Express:

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The study included 2,260 trans women and 1,229 trans men receiving gender affirming hormone treatment at a specialist clinic in Amsterdam between 1972 and 2016. National medical records were used to identify breast cancer cases.

Average age at the start of hormone treatment was 31 years for trans women and 23 for trans men. Average treatment time was 13 years for trans women and 8 years for trans men.

Of the 2,260 trans women, 15 cases of invasive breast cancer were diagnosed at an average age of 50 years and after an average 18 years of hormone treatment.

This was higher than the general male population whose gender identity matches the sex they were assigned at birth (cisgender men), but lower than the general female population (cisgender women).

In 1,229 trans men, four cases of invasive breast cancer were identified at an average age of 47 years and after an average 15 years of hormone treatment. This was lower than expected compared with cisgender women.

The researchers wrote, “This study found an increased risk of breast cancer in trans women in the Netherlands compared with Dutch cisgender men.”

It continued, “In both trans women and trans men, the risk of breast cancer was lower than in Dutch cisgender women.”

The researchers were then able to surmise that hormone treatment seems to change the risk of breast cancer.

“This suggests that hormone treatment alters the risk of breast cancer in transgender people compared with initial risk based on their birth assigned sex,” according to the researchers.

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They went on, “Current recommendations suggest that trans women and trans men who have not undergone mastectomy should be biennially screened with mammography from the age of 50 years and if they are using hormone treatment for more than five years.”

“The absolute risk of breast cancer in transgender people is still low in this study, and, more importantly, is not increased compared with cisgender women.

“We believe therefore that awareness in both doctors and transgender people is of more importance than the start of screening at a younger age or intensifying available screening, even though the median age at diagnosis in the current study was lower than in cisgender women.”

On those who have transitioned, they added: “Besides, discontinuation of hormone treatment in older transgender people can be considered, which might from then decrease the risk of breast cancer. Trans women and trans men who have not had a mastectomy are advised to undergo the same intensified breast surveillance as their close female relatives if the risk of breast cancer is increased because of a familial predisposition.

“It is important to remember that transgender people who changed their legal sex might not be automatically invited for population-based screenings, including breast cancer screening.”

On the study, the authors concluded: “the absolute overall risk of breast cancer in transgender people remains low and therefore it seems sufficient for transgender people using hormone treatment to follow screening guidelines as for cisgender people.”

As it was merely an observational study, it cannot prove cause and effect.

WebMD, referring to the study, noted the researchers highlighted some limitations of the study, including missing/incomplete data about type of hormone use, family history, tobacco and alcohol use, and body mass index.

In the UK, trans women were recently invited to take a smear test–in spite of not having a cervix.

National File reports:

Gender transitioning men, who identify as female, will be invited by the United Kingdom’s National Health Service to take tests for cervical cancer – despite not having a cervix.

Further, women who identify as male will not be offered routine anti-cancer check ups for their breasts and cervix.

Ironically, biological females who are transitioning to become men would be ineligible for these screenings, as they would be registered as male.

Canada also offers a similar service. On the Canadian Cancer Society’s website, a trans woman is used as the image on their cervical cancer page.

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