At the mammogram, it seemed pretty immaterial really what I thought my gender was in that particular moment. It’s just screening a piece of body. That’s how I thought of it to myself and so I just managed to deal with it in that way. And they’re very gentle and they explained everything and you just do it. Alf
Mammograms are the best tool for detecting *chest cancer early, when it’s most treatable. A low-dose x-ray machine takes detailed images of chest tissue from different angles. A radiologist examines the images to check for any abnormalities in the tissue.
Lumps and other changes can be detected by a mammogram even if they are too small to be felt by a hand. That’s why it’s important to get screened regularly: screening means finding abnormalities early, when they are easiest to deal with.Who should get screened?
Early detection helps fight chest cancer. Your chances of getting chest cancer increase once you’re 50. So, if you’re aged 50 to 69 and you haven't had top surgery, don’t wait until you find a lump or have other symptoms: get screened by getting a mammogram every two years.
At this time, we don’t have clear recommendations about whether or how trans men who have had top surgery should be screened regularly for chest cancer. Mammograms can still be done on the chest after top surgery, or you may need a different screening test, such as an ultrasound or MRI. If you’ve had top surgery, talk to your doctor about the type of surgery you’ve had, as well as any other risk factors, to figure out your screening needs.
No matter how old you are, or whether you’ve had top surgery, become familiar with your chest and talk to your healthcare professional if you notice any changes. Many people are alive and well today because their chest cancer was detected and treated early.
The Canadian Cancer Society recommends the following chest screening guidelines:
|If you are:||You should:|
|40 to 49||
Talk to your doctor about your risk of chest cancer, along with the benefits and risks of mammography.
|50 to 69 and have not had top surgery||
Have a mammogram every two years.
|50 to 69 and have had top surgery||
Talk to your doctor about your individual risk factors, including the type of surgery you’ve had, to figure out your screening needs.
|70 or older||
Talk to your doctor about how often you should be checked for chest cancer.
Do not apply any deodorant, lotions or talcum powder on the day of the test. The metals in these products can interfere with the x-ray. It’s also helpful not to wear anything that can get in the way of the test (for example, necklaces or clothing that is difficult to remove from the waist up). If you have nipple piercings, you don’t need to remove them.
I’ve got the gender dysphoria thing going on. The discomfort of having breasts is a daily challenge. It’s always there and present in my awareness. So having a mammogram is really just an extension of that daily dysphoria I experience. And just being treated courteously and in a friendly way made all the difference. – Alf
For most people, a mammogram takes less than 10 minutes.
Screening mammograms are done in a clinic or screening centre. In smaller communities, the Ontario Breast Screening Program (OBSP) conducts mammograms on a specially equipped bus that travels from community to community. Mammograms show detailed images and views of the chest taken from different angles.
You’ll need to remove your clothing from the waist up for the test. When you have a mammogram, each side of your chest is placed between two plastic plates. The mammography unit will be adjusted to your height. A registered medical radiation technologist will place each side of your chest on one plate, one at a time. Then, the second plate will press down on your chest for a few seconds to spread out the chest tissue. Compressing the chest tissue helps make the images clearer while using as little radiation as possible. This will not harm your chest tissue.
Two x-rays are taken of each side of your chest, one from the top and one from the side. The technologist will check the quality of the images and will take more pictures if necessary. A radiologist examines the x-rays to see if there are any abnormal changes.
No, the mammogram didn’t hurt. –Alf
It hurt! It’s like when it squeezes it’s tight … youch! –Fred
You may have heard that getting a mammogram can be painful or uncomfortable. That’s because, to get the x-ray pictures, your chest tissue is placed between two compression plates, which flatten the tissue. This is done to make sure the images are clear and that the smallest amount of radiation possible is used when taking the x-rays.
As the quotes above suggest, some people find the test painful, while others don’t. You will feel some pressure on your chest for just a few seconds — it feels a lot like a tight blood-pressure cuff. If this does feel uncomfortable or outright painful, it can help to know that the discomfort should last only a few seconds. If it lasts longer than that, you can tell the technician and they can adjust the compression.
Take some time to think through what’s going to make it the least stressful for you. And then be entitled to what you want. We’re not all the same and you’re not more trans or less trans or a better dude or whatever if you want this rather than that. –Fred
For some trans men, getting a mammogram is no big deal — just one more medical test in the grand scheme of things.
For many other trans guys, the idea of going for a mammogram or the test itself can be uncomfortable or upsetting. The test, or a focus on our chests, can trigger or worsen feelings of gender dysphoria. We may feel awkward or vulnerable in changing rooms or waiting areas. It can be difficult to have to come out repeatedly, or to have to explain our identity or appearance to people who aren’t familiar with trans folk.
Here are some suggestions for things you can do to prepare yourself for the test and to make getting a mammogram as emotionally comfortable as possible:
If my doctor is sending me to a clinic he hasn’t sent trans people to before, he calls ahead and talks to someone fairly high up to say that he is sending trans people and do they need some information and blah, blah, blah? And that, coming from a physician, is very powerful. And then he used to actually write on the prescription that I’m a trans man. And some trans people would hate that but in this situation I really liked it because it means there’s a heads-up right away. –Fred
If you’re outside a major urban centre and you think you may be one of the first trans people going to this clinic, if your family doctor won’t do it, a very friendly phone call just saying, “I’m coming in and I’m a trans person and I just want to be sure people aren’t surprised by it,” or something very straightforward like that can ease the way a lot. And if you don’t feel up to doing that yourself maybe you have a family member or a good friend who would do that for you. And you should be able to tell by their response whether that clinic is a good fit. –Fred
Honestly, once you don’t use that old name that was given at birth any more, you don’t think of yourself as the person with that name. And if you’re already stressed about going through the procedure it’s the last thing you’re thinking about. And so it’s a shock if they call out that name. And then when you face that hurdle it’s more difficult. So phoning ahead and having somebody who you trust with you would help, and that’s what I’m going to do. –Alf
*A note on terminology: In the trans men sections of this website, we refer to cancer in chest tissue as cancer of the chest, and to the tissue itself as chest tissue. This is because we recognize that many trans men and people on the transmasculine spectrum do not identify as having breasts, feel ambivalent about having breasts and prefer the term “chest” on its own. Although we use this terminology where appropriate, we also recognize the fact that some trans men do have breasts.Back to top