Changes during transition

How Transition Can Affect your Chest

Social Transition

Social transition is when you change your gender expression to match your gender identity. If you are a trans man, you may prefer your chest to look flatter. Some trans men and non-binary people use chest binding to do this. Chest binding is done using a special vest called a binder or other tight clothing. If you choose to bind your chest make sure you do it safely and comfortably. Our friends at Brook have good advice about chest binding where you can read more.

Medical Transition

Medical transition is when you take hormones to affirm your gender identity. Some transfeminine and non-binary people take the hormone oestrogen to develop a typically female body. Taking oestrogen will make your breasts grow. It is normal to feel some discomfort when your breasts grow. Tell your doctor if you are having bad pain.

Breast cancer screening is for anyone between the ages of 50 and 70 who has breasts, either because of naturally-occurring oestrogen or oestrogen hormone therapy. If you are taking oestrogen you will probably not need breast screening in the first two years of taking it. After that, you should think about having your breasts screened (mammogram) for signs of breast cancer. You can read more about screening here. If you are medically transitioning, make sure you get to know your new normal by checking your chest every month. Our Self-Checkout will guide you through the process of checking your chest.

Surgical Transition

Surgical transition is when you have surgery to match your gender expression to your gender identity. Not all trans people choose to have surgery. In the chest area, there are two common types of surgery you might have:

Breast implants – some trans women choose to have breast implants. Here you can read our information about breast implants.

Top surgery (bilateral mastectomy with chest reconstruction) – some trans men and non-binary people choose to have top surgery. The aim is to create a flatter, more masculine or gender-neutral chest and to remove female breast tissue. If you have had top surgery, once everything has healed, you will need to get to know what is normal for you now by checking your chest every month. Make sure you check areas that still contain breast tissue. This might include under your armpits and up to your collarbone, and your nipples. If you have had top surgery, talk to your surgeon about how to check your chest.

Risks

Chest binding: There is no evidence that chest binding increases your risk of breast cancer. There is a risk of skin sores, so it is important to bind safely and comfortably. Our friends at Brook have more information on chest binding.

Hormone therapy: The best research we have at the moment shows that the risk of breast cancer in trans women is about three times lower than it is for cisgender women. The risk is still much higher than for cisgender men. Trans men have a five times lower risk than cisgender women, but this is still higher than for cisgender men. In trans women, the risk of breast cancer increases during hormone treatment. It is not fully understood how transition increases breast cancer risk for trans women, but we know oestrogen can help breast cancer cells to grow. It therefore seems likely that taking oestrogen-based hormone therapy is part of the reason for the increased risk. Some trans women also take the hormone progesterone. There is now evidence that progesterone can increase the risk of breast cancer in cisgender women.

Breast implants: There are risks with all surgery, and there are risks with all implants (prostheses). However, breast implants do not increase your risk of breast cancer. We have more information about breast implants.

Top surgery: There are risks with all surgery, but the risk of breast cancer is reduced after top surgery. This is because most of your breast tissue is taken away by top surgery. Also, hormone therapy to make a person more masculine reduces the oestrogen in your body. This may explain the lower risk for trans men compared with cisgender women. Keep in mind that there may still be breast tissue around the nipple, up to the collarbone and under the armpit, where breast cancer could start. If you have had top surgery you still need to check your chest every month. Talk to your GP if you have any unexpected changes to your chest. For example, any new changes to your chest after everything has healed from surgery.  Read more here about transitioning for trans men.