Research has shown that lesbian, gay, bi-sexual, and transgender people have routinely experienced the isolation of exclusion and intolerance in the medical setting. Even when cost is not a factor, previous or feared insensitivity, ignorance, or outright disdain from health care personnel often prevent sexual minorities from seeking routine health screenings. Lambda Legal reports that 56% of LGB and 70% of transgender or gender-nonconforming patients experienced some type of discrimination in the healthcare setting. With statistics like these, it’s no surprise that the LGBT community doesn’t utilize preventive services at the same rate as their straight cohorts. Simply put, no matter how “free” health screenings are, if you don’t feel welcome, you won’t utilize the services.
Breast cancer does not discriminate. It can happen to anyone, regardless of gender, gender identity, or sexual orientation. However, it’s important to note that some members of the LGBT community can have a higher probability for developing breast cancer due to certain risk factors. As mentioned above, members of the LGBT community are notably less likely to have routine cancer screening of any kind compared to the straight community. Lower rates of cancer screening put LGBT people at greater risk of late diagnosis, which significantly reduces the chance of successful treatment and survival.
Lesbians and Bi-Sexual Women
Lesbian and bi-sexual women have a greater risk of breast cancer (National LGBT Cancer Network). This is not because of sexual orientation, but because of certain breast cancer risk factors related to personal behaviors. Studies have shown that lesbians and bi-sexual women are more likely to have these risk factors which increases the risk for developing breast cancer:
- Late or no pregnancy. (Having the first pregnancy after age 30 or never having a full-term pregnancy.)
- Drinking alcohol.
- Cigarette smoking.
Currently, there are no cancer screening guidelines specific to lesbian and bi-sexual women, so it is advised to follow The American Cancer Society recommendations for women regardless of sexual orientation:
- Women ages 40 to 44 should have the choice to start annual breast cancer screening with mammograms if they wish to do so.
- Women age 45 to 54 should get mammograms every year.
- Women 55 and older should switch to mammograms every 2 years, or can continue yearly screening.
Transgender Men and Women
Breast cancer has also been reported in the transgender community, in both male-to-female (MTF) and female to male (FTM) individuals. The National LGBT Health Education Center recommends:
- Transgender women over 50 years old who have had hormone therapy for 5 or more years should get mammograms annually.
- Transgender men taking testosterone may also be at increased risk for breast cancer. Transgender men who have not had chest reconstructive surgery should get mammograms annually starting at 50 years old. Some breast tissue will remain after chest reconstruction and this remaining tissue is still susceptible to breast cancer. Transgender men who have had top surgery still need annual chest exams by a health care professional. (Fenway Health)
Gay men have no increased risk of breast cancer as compared to straight men. The American Cancer Society recommends breast exams by a healthcare professional for screening men with a strong family history and/or a genetic predisposition for breast cancer. Mammograms are usually only done if a lump is found.
Any person, regardless of sexual orientation or identity, with a family history or genetic predisposition of breast cancer may need to begin breast exams and/or mammograms earlier. Talk with a health care provider about your risk for breast cancer and the best screening plan for you.
Mammogram Trailer at Pride
Roger Maris Cancer Center (RMCC) in Fargo is a local pioneer in delivering equitable and inclusive care for the LGBT community. This year, RMCC and the Edith Sanford Breast Center (ESBC) will have their mobile mammogram trailer at F-M Pride at Island Park. LGBT-friendly and affirming staff and volunteers will be available to answer questions and provide pamphlets on breast health and screening for the LGBT community. RMCC and ESBC will also offer mammograms on site! Appointments are approximately 15 minutes, starting at 11AM and ending at 4PM. Mammograms will need to be prescheduled by calling Sanford centralized scheduling at 701-234-7100. Insurance is accepted. If you do not have insurance or cannot afford your co-pay, Sanford will work with you to get mammograms covered by the Women’s Way program for North Dakota residents or The Sage Cancer Screening Program for Minnesota residents.