Transgender men with inherited mutations grapple with decisions about cancer risk

Like many other marginalized populations, LGBTQIA+ people face health disparities and are often overlooked when it comes to health care and research about medical conditions, and trans, nonbinary, and gender expansive people often face even higher health disparities. There are an estimated 1.5 million transgender people in the United States, and little information related to the cancer risk and cancer care in this community is available. This is especially true for people who have an inherited mutation that increases their risk of breast cancer.

For people with a BRCA mutation who are assigned female at birth, including transmasculine people, the lifetime risk for breast cancer is very high, between 50 to 75 percent. This is significantly higher than the 12 to 13 percent lifetime risk in the general female population. Risk-reducing surgery to remove breast tissue (mastectomy) is one approach that people with BRCA mutations can consider to lower their cancer risk. Little to no research has led to a lack of guidelines to help trans people make medical decisions related in this area.

Many transgender men and nonbinary people who were assigned female at birth may undergo “top surgery”—mastectomy to remove breast tissue—as part of their gender-affirming care. We review an expert viewpoint on the implications of a BRCA mutation for transgender men who undergo breast removal as part of their gender-affirming care plan.

Read more about this issue in our review.