Transgender People and 'Sex-Specific' Cancers: What's the Risk?

Patient Expert
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Can a transgender man who has undergone gender-affirming surgery get breast cancer or ovarian cancer? What about transgender people and prostate cancer, or testicular cancer? When asking these questions about transgender populations and cancer risk, the answer is often, “It depends.” How do you know if you, a family member, or friend needs to worry about these cancers?

First off, it’s important to know that there have yet to be any long-term studies focusing on cancer risk in transgender populations. Thus, any conclusions about these cancers in transgender individuals is surmise — albeit informed surmise.

According to Children’s Hospital Los Angeles (CHLA), the National Institutes of Health is currently funding a large study that will evaluate the long-term effect of various medical treatments for transgender youth (including hormone blockers and cross-sex hormone treatment) at four different medical centers.

But given that most of these cancers are more common in older people, it could be decades before enough data are collected to present a true picture of cancer risk in transgender populations.

Breast cancer

Numerous studies show that some cisgender women (meaning women whose gender aligns with the sex they were assigned at birth) who take estrogen-based hormone replacement therapy raise their breast cancer risk. We also know that all humans can get breast cancer, regardless of sex.

Transgender men who were assigned female at birth will retain their original breast cancer risk, unless they undergo breast-removal surgery (top surgery). As with cisgender women undergoing double prophylactic mastectomies (a surgery that reduces the risk of breast cancer by about 90 percent), trans men who undergo this surgery will also reduce their risk of breast cancer — though not entirely eliminate it, since some breast tissue will always remain.

Bottom line: All transgender individuals are at varying degrees of breast cancer risk. If you’re a transgender person, be aware of breast/chest lumps and armpit lumps, even after top surgery; and consider regular breast cancer screening. Ask your doctor what screening schedule they recommend for you.

Ovarian cancer

Ovarian cancer is much less common than breast cancer. It’s not regularly screened for, and its symptoms are vague; as a result, it’s much more deadly than breast cancer.

Transgender men who retain their ovaries should be aware that they may still be at risk for ovarian cancer. Even if ovaries have been removed, you should still be aware of potential symptoms.

Transgender people who never had ovaries don’t need to worry about ovarian cancer.

Bottom line: Transgender men should be aware of the possibility of ovarian cancer (especially if ovaries are still present); and should understand potential symptoms.

Prostate cancer

Transgender women remain at risk for prostate cancer, especially because surgical removal of the prostate isn’t usually recommended due to urinary incontinence and other after-effects.

Transgender people who never had a prostate gland aren’t at risk for prostate cancer.

Bottom line: Transgender individuals should discuss their risk of prostate cancer with their doctor, taking into account family history and other known risk factors. If advised, transgender women should be screened regularly for prostate cancer.

Testicular cancer

There are no reports of transgender women getting testicular cancer after gender-affirming surgery. Thankfully, testicular cancer is very rare; only about 8,800 American cisgender men were diagnosed with it in 2017, according to the American Cancer Society.

Transgender people who never had testicles can’t be diagnosed with testicular cancer.

Bottom line: Transgender women should be aware that testicular cancer is a risk, but an incredibly small one: Only one case of testicular cancer in a trans woman has ever been reported.

Remember: Cancer risk in transgender populations cancer risk is an area where more research is needed. If you’re concerned about cancer, talk to your health care team. They can help guide you in making decisions about routine screenings and more.

See more helpful articles:

Top 10 Breast Cancer Risk Factors

Ovarian Cancer: Are You at Risk?

Prostate Cancer Risk Factors

Testicular Cancer