Hereditary Cancer in Transgender Women
in Transgender Women
Transgender women and other nonbinary and gender diverse people assigned male at birth who have a mutation in a breast or cancer-risk gene may have special considerations that differ from men and women.
This page covers the following topics:
Cancer risks and genes
Special considerations related to cancer risk and management may apply for transgender women with mutations in the following genes:
Cancer Type |
Genes |
Breast |
|
Prostate |
ATM, BRCA1, BRCA2, CHEK2, EPCAM, HOXB13, MLH1, MSH2, MSH6**, PMS2** |
*Research suggests that mutations in ATM increase the risk for breast cancer in people assigned male at birth, but more research is needed to confirm this link. **More research is needed to confirm a link between these genes and prostate cancer. |
|
People assigned male at birth do not have ovaries, or a uterus and are not at risk for these cancers. For most other cancers, risks and risk-management options are similar for transgender and people with the same mutation.
Visit this this section for more information about the cancer risks associated with mutations in specific genes.
Visit our Partner
In the News
Article : Breast cancer risk for transgender women with inherited mutations
There has been little research on breast cancer risk for transgender women who are at high risk for breast cancer...
Breast cancer risk and management
Breast cancer risk in transgender women depends on several factors including:
- the gene mutation
- exposure to hormones, including hormone replacement like
- factors that affect risk for people
More research is needed to better understand how these factors affect cancer risk in transgender women with mutations.
Genes associated with increased risk for breast cancer in transgender women
Limited research has focused on breast cancer risk in transgender women. Because people who are assigned male at birth generally have very little breast tissue, their risk for breast cancer is low.
Mutations in the genes , , , and have been linked to an increased risk for breast cancer for men. Trans women with mutations in these genes are likely to have a higher risk for breast cancer than trans women without a mutation, but the exact risk is unknown. Very little is known about the cancer risk of trans women with mutations in other genes that are linked to hereditary breast cancer risk.
Gender-affirming hormones
for transgender women may include the use of the hormone with or without as well as hormones to decrease testosterone. Long-term exposure to is a risk factor for breast cancer in women. Transgender women may have prolonged use of , which may increase their risk for breast cancer. Despite this, the risk for breast cancer for transgender women is lower than the risk for women. Experts consider the use of hormones for to be an acceptable option, even for high-risk transgender women.
Breast screening
Very little research has been done on the benefits of breast screening in transgender women with inherited mutations linked to breast cancer. For this reason, many experts use the guidelines for high-risk men as a basis for screening recommendations for high-risk transgender women. This includes:
- Age 35: annual breast exam by a doctor.
- Age 35: begin breast self-exams and report any changes to a doctor.
- Age 50: discuss annual breast screening with . Breast screening for transgender women at increased hereditary risk should be decided on a case-by-case basis based on age, family history, use of gender-affirming hormone therapy and the amount of breast tissue present.
cancer risk and management
Risks for cancer in transgender women are similar to those for men. The is usually not removed during gender-affirming bottom surgery. This means that risk for cancer remains even for trans women who have had surgery.
Guidelines for screening in transgender women are similar to those for men. Screening for cancer begins at age 40 and involves a Specific Antigen () blood test. Many experts also recommend a digital rectal examination that allows the doctor to feel for abnormalities in the . For transgender women who have had vaginoplasty surgery, a neovaginal exam may allow doctors to feel for abnormalities better than a rectal exam. The guidelines vary by mutation, so it's important for transgender women to know the risks and screening recommendations for their specific gene. More information about cancer risks, management and treatment can be found here.