Breast Cancer awareness and prevention in 2SLGBTQIA+ people

Breast cancer can affect anyone. Whether you consider yourself to have breasts, a chest, or a torso, breast cancer concerns you. 

While most cases of breast cancer impact cis women or people assigned female at birth, this disease can affect anyone regardless of age, sex, gender identity, or sexual orientation. 

Early detection of breast cancer is typically associated with a higher survival rate and better quality of life. This is why it is crucial that everyone understands the risks of breast cancer and learns more about the importance of early detection for prevention.  

Note that the term “chest” is used as often as possible throughout this page instead of “breasts”. The area of the body where the breast tissue is found and in which a mass could develop (the region beneath the collarbone to the bottom of the rib cage and under the armpit) is referred to as the chest or breast area. We acknowledge that many people do not think of themselves as having breasts and that this term can lead to gender dysphoria. We are aware of the issue, but for the sake of simplicity and in order to be descriptive, we have maintained the use of the terms “breast cancer” and “breasts” throughout the website when describing this area. 

While the terms “assigned female at birth” and “assigned male at birth” refers to a gender with which a person may not necessarily identify, these terms are used only when the sex assigned at birth is relevant to breast cancer.  

We invite you to contact us if you have any suggestions on how to make our content more inclusive. 

Incidence of breast cancer in 2SLGBTQIA+ individuals

Data on breast cancer in sexually- and gender-diverse people is limited in most regions of the world, but particularly in Quebec. However, we know that, in Canada, 1% of breast cancer cases affect cis men. There is currently no breast cancer research that presents incidence rates based on sexual orientation, although person-level risk may vary depending on different factors such as lifestyle. According to U.S. and Dutch studies, the incidence of breast cancer in trans women is 4/100,000 per year and around 4-6/100,000 in trans men, compared to 170/100,000 per year in cis women. While breast cancer has been detected in intersex people, little data is available on the subject. 

Am I at risk of developing breast cancer?

Everyone is at risk of developing breast cancer. Breast cancer is multifactorial, meaning that several risk factors contribute to the development of the disease. However, it is possible to develop breast cancer even if you have no known risk factors. 

It should be noted that few studies have specifically examined the risk of breast cancer among 2SLGBTQIA+ people, but several risk factors apply to the entire population regardless of sex, race, gender identity, or sexual orientation. 

Breast cancer risk factors:

  • Being a cis woman or having been assigned female at birth 
  • Being older 
  • Having a personal or family history of breast cancer 
  • Having been exposed to radiation (e.g., radiotherapy in the chest, neck, or armpit areas) 
  • Having atypical hyperplasia 
  • Being a carrier of a genetic mutation or disorder associated with breast cancer (e.g., BRCA1, BRCA2, etc.) 
  • Use of long-term feminizing hormone therapies (hormonal contraceptive, hormone therapy, treatment to reduce the effects of menopause) 
  • Late first full-term pregnancy (after age 30) or no full-term pregnancy 
  • First menses at a young age (before age 12) or late menopause (after age 55) 
  • Alcohol consumption 
  • Being overweight/obese, especially after menopause 
  • Being sedentary and/or physically inactive 
  • Smoking or being exposed to second-hand smoke 

For more details on each risk factor, see the “Screening and risk factors” section of our website. 

Gender-affirming surgeries and prolonged hormone therapies could influence the level of risk in trans and non-binary people or in anyone choosing to undergo these medical procedures. 

Long-term feminizing hormone therapy

– Feminizing hormones may increase the risk of breast cancer due to the effect of estrogen on the growth of breast cells. 

– Additionally, recent U.S. mammography studies have found that, in trans people who used feminizing hormone therapy for a period of at least five years, especially at high doses of estrogen, breast tissue appeared dense and very dense, which may increase the risk of breast cancer and make mammogram images for breast cancer screening more difficult to interpret. 

– The risk of breast cancer increases with prolonged hormone therapy use and is significantly greater if treatment is continued for at least five years. However, these hormones can also be beneficial to your health and well-being. It is therefore recommended that you discuss these risks with a healthcare professional. 

Gender affirmation surgery 

– Some people choose to undergo breast surgery, such as total bilateral mastectomy (completely removing the breasts) or breast reduction, as part of their gender affirmation process. Breast surgery reduces the risk of breast cancer, as the amount of breast tissue is decreased. However, it should be noted that even in cases of total mastectomy, the risk of breast cancer is not eliminated because some breast tissue may remain. 

– Some people choose to have their ovaries removed as part of their gender affirmation process. These surgeries reduce the risk of breast cancer because they lead to a decrease in estrogen. The risk of breast cancer is also not eliminated for people who have undergone these surgeries, as breast tissues have nonetheless been exposed to estrogen beforehand. 

– It is crucial to discuss your risk of breast cancer with your doctor if you have had one or several of these surgeries. 

How do I limit my risk?

Adopt healthy lifestyle habits to minimize your risk of breast cancer: 

  • Engage in physical activity (150 minutes of moderate physical activity or 75 minutes of vigorous activity per week) 
  • Limit sedentary activities (sitting or lying down for extended periods of time) 
  • Limit alcohol consumption 
  • Adopt a healthy and varied diet 
  • Do not smoke (or quit smoking) and limit your exposure to second-hand smoke 

For more details, see the section “How can I reduce my risk of breast cancer?” on our website. 

Knowing your risk and discussing it with your doctor: 

Knowing your risk factors and minimizing them as much as possible is a good way to prevent breast cancer. Unfortunately, many of the risk factors outlined above cannot be changed. 

It is important that a doctor assesses your personal risk to determine whether you should take specific preventative steps: 

  • Discuss the pros and cons of hormone therapies and how to adapt treatment based on risk levels.  
  • Share your family history and the relevance of being referred to genetic counselling. 
  • Depending on your genetic risk, discuss options for preventive (prophylactic) surgery, but also appropriate screening strategies (age, frequency, other medical examinations).

Certain gender transition- or affirmation-related issues could affect trans or non-binary people’s risk of breast cancer. Thus, some questions may be relevant to discuss with your doctor if you are trans or non-binary: 

  • Have you had breast surgery? If yes, was it breast reduction, a bilateral mastectomy (partial or total), or other? 
  • Have you had surgery that affects your hormone levels, such as an oophorectomy (removal of the ovaries) or a radical hysterectomy (removal of the uterus and ovaries)? 
  • Are you taking feminizing hormones (estrogen, progesterone) as part of your gender transition? If so, when did you start? 
  • At what age did you begin transitioning? 

Early detection best practices

1) Observe your chest/breasts:

Observing your chest or breasts is a simple and effective way to detect breast cancer early on. It is a preventive practice that involves noticing the chest’s appearance through touch (to identify the presence of lumps, differences in breast size, changes in texture, etc.) and visual observation (changes in size, swollen lymph nodes, presence of bumps or depressions, changes in colour or texture, nipple discharge, etc.). Regularly observing your chest enables you to better understand your body and take note of any unusual and persistent changes that may require medical attention. It is therefore important to know the signs typically associated with breast cancer and be on the lookout for any changes in your breasts. 

The main signs of breast cancer:

The most classic sign of breast cancer is a painless lump or swelling in the breast. 

Other possible signs of breast cancer include: 

  • Change in the size or shape of the chest or breasts 
  • Appearance of dimples or folds in the skin of the chest or breast 
  • Redness, swelling, or increased warmth in the chest or breast 
  • Persistent itching 
  • Inverted nipple (turned inward) 
  • Presence of a scab on a nipple or a flaky, peeling nipple 
Breast Cancer in 2SLGBTQIA+ People

The presence of these signs does not necessarily mean that you have breast cancer, but it is essential to consult a healthcare professional immediately if you notice any of them.

Special considerations for gender dysphoria:

Interacting with one’s chest or breasts can trigger or worsen gender dysphoria in many trans or non-binary people. 

It is possible to minimize these feelings when observing one’s chest in different ways, such as: 

  • While in the shower 
  • While lying down in the dark, before going to sleep, for example 
  • By asking a trusted partner to help 

Chest observation can be a sensitive and difficult issue for many gender-diverse people. Do not hesitate to consult people who have experience on the subject if the thought of your chest risks causing feelings of gender dysphoria or discomfort. Resources, such as helplines from 2SLGBTQIA+ organizations, are available. More information is provided below. 

2) Follow breast cancer screening recommendations: 

Screening mammography: 

  • Screening mammography is a simple test to detect the presence of tumors in breast tissue. It is possible for both cis and trans people to have mammography performed, regardless of breast size. However, it is recommended to inform the technician if you have breast implants in order to carry out the necessary protocol. Mammography is currently recommended for cis women aged 50 to 74 in the Quebec Breast Cancer Screening Program (PQDCS), depending on the gender registered with the RAMQ. 
  • There is still no worldwide consensus on screening recommendations for people who are trans or non-binary, or whose gender does not correspond to the sex assigned to them at birth. However, some organizations have attempted to develop recommendations based on studies of breast cancer in trans people. 
  • In Quebec, the CHUQ has issued breast cancer screening guidelines for cis and trans people: LIGNES DIRECTRICES DÉPISTAGE CANCER DU SEIN Centre des Maladies du Sein- CHU de Québec –U Laval (depistagesein.ca). (Available in French only).

Possible barriers to early breast cancer detection in 2SLGBTQIA+ people

While there is no research on the potential barriers to early breast cancer detection in sexually- and gender-diverse people in Quebec, studies conducted elsewhere in the world have documented some of these barriers.

Lack of data and awareness-raising among 2SLGTBQIA+ people:

2SLGBTQIA+ people may be less likely to look out for and recognize signs of breast cancer, given that few studies have focused on breast cancer in sexually- and gender-diverse people, meaning that little prevention efforts are geared toward increasing their awareness of breast cancer risks. Breast cancer in this community tends to be detected and diagnosed later, which reduces survival rate and quality of life of 2SLGBTQIA+ patients. 

Lower average age of 2SLGBTQIA+ people:  

The 2018 Statistics Canada census indicates that 30% of 2SLGBTQIA+ people were 15–24 years old (compared to 14% for the cis heterosexual population). Due to their young age, 2SLGBTQIA+ people might feel less concerned about the risk of and screening for breast cancer. 

2SLGBTQIA+ people’s fewer interactions with the healthcare system:  

U.S. studies, as well as studies published by the House of Commons Standing Committee on Health (2019), indicate that sexually- and gender-diverse individuals are more likely to experience discrimination based on gender identity or sexual orientation in the health system, even when taking income and insurance coverage into account. These discriminatory experiences lead 2SLGBTQIA+ people to rely on the healthcare system less frequently than their cis heterosexual counterparts, which hinders breast cancer screening and reduces chances of survival, given that breast cancer is detected at a later stage. 

Considering these possible barriers and the importance of breast cancer prevention and early detection, the Quebec Breast Cancer Foundation’s aim is to raise awareness in all communities affected by the disease, regardless of sex, gender identity, or sexual orientation. 

We would like to thank Les mots pour la causeEnsemble pour le respect de la diversité and Interligne for helping to review the content of this page.

breast Cancer Foundation Resources:

Information about breast cancer development, progression, diagnosis, and treatment applies to the general population.

The Foundation also offers several support resources to everyone. 


1 855 561-PINK

Psychosocial support services for people affected by breast cancer:


Resources for 2SLGBTQIA+ people and sources with more information on breast cancer in this population:

Interligne helpline:

514 866-0103 (Montreal),
1 888 505-1010 (elsewhere in Quebec, toll-free)


Together for the respect of diversity:

Ensemble | pour le respect de la diversité (ensemble-rd.com) (Available in French only)  

Divergenre s  :

Divergenres (Available in French only)

Institut pour la santé trans  (Institute for Trans Health) :

provides a list of trans-affirmative healthcare professionals in Quebec

Accueil | L’institut pour la santé trans (santetranshealth.com) (Available in French only) 

Gay and Grey Montréal :

Social group for 2SLGBTQIA+ seniors in Montreal and surrounding areas


Canadian Cancer Survivor Network:

LGBTQ+ Information – Canadian Cancer Survivor Network 

Action santé travesties et transexuelles du Québec (Quebec Transvestite and Transsexual Health Action) :


211 Greater Montreal (211qc.ca

Canadian Professional Association for Transgender Health: