Transgenders and breast cancer

Transgender people go through a divergence between the gender they were designated at birth and the one they experience. In the Netherlands, there are supposed to be 2,800 people who were said to be males at birth and 5,200 born as females but identify as transgender.

Transgender can affirm their gender through hormone therapy (sex steroids) to diminish the distress and provoke the physical changes they want, for instance hair body and body type.

Bear in mind i. this context and ii. the fact that the development of some tumors of breast cancer are stimulated by sex hormones, what is the risk that these gender treatments can pose to people who undergo them?

About the research

For the last ten years there has been a significant increase in the number of cases in psychological treatment, endocrine or surgical treatment, or a mix of them. Despite this movement, data about transgender people and breast cancer is restricted.

For this research, transgender people who went to the clinic of gender in VU University Medical Center Amsterdam between 1972 and January 2016. We did not take into account people who: had never undergone hormone therapy (or the date was undefined); were underage in that period; who had made use of estrogen and testosterone during the treatment because they had regretted going through the transition.

Results

This research found high risk of breast cancer in transgender women (males at birth, identified as females) in the Netherlands compared to Dutch cisgender men (males at birth, identified as males).

Both in transgender women and in transgender men, the risk of breast cancer was lower than in Dutch cisgender women. This suggests that hormone therapy alters the risk of breast cancer in transgender people, compared to the innitial risk — considering their birth genders.

The average age of the diagnosis of breast cancer was 52 years old for transgender women and 46 years old for transgender men — both below 61 years old, average for Dutch cisgender women. The HER2 status in transgender women was higher than the expected for breast cancer in cisgender men.

A surprising fact was that the risk of breast cancer in transgender women got increased in a short period.

The risk of breast cancer in transsexuals is still low, and following the guidelines to detect breast cancer in cisgender women seems to be enough for transsexuals in hormone therapy.