October is National Breast Cancer Awareness Month, and information about self-breast exams, mammography, and risk reduction tips are all over the media. This information is critical—prevention and early detection are two of the best defenses against breast cancer. But often, breast cancer information overlooks the LGBT community and other minorities.
Sexual, gender and other minority women are more likely to experience financial, cultural, or linguistic barriers to adequate health care. This can mean fewer doctor’s visits, mammograms, and less follow-up care.
“Breast screening is part of overall health maintenance and lesbians are less likely to go for general care for a variety of reasons, like not feeling safe in health care settings,” says Dr. Jennifer Potter, Fenway’s Director of Women’s Health.
Many women in our community who identify as lesbian, bisexual, or transgender may have more risk factors for breast cancer than their heterosexual peers. Many straight, cisgender women connect with care primarily through reproductive services and receive regular screenings, including breast exams during office visits. Because LBT women might not have children or receive reproductive care, they have fewer chances to access screening services. Furthermore, some avoid medical care due to fear of discrimination or a lack of understanding on the part of medical providers.
Transgender people especially are at risk of being excluded from breast cancer awareness information—both because our understanding of breast cancer risks for trans people is limited and because most information is framed around the experiences of cisgender women. Transgender people may not perceive risk for cancer in body parts that are not embraced or have been removed or added. But transgender women and men receiving hormone therapy may be at increased risk of breast cancer.
Transgender men may also feel marginalized by many breast cancer awareness campaigns, which discuss breast cancer primarily as a women’s health issue. Transgender men may feel disconnected from their breasts, or assume top surgery protects them, and therefore neglect to do breast tissue self exams. But chest reconstruction leaves some breast tissue behind, which remains susceptible to cancer. For more information about breast cancer risks for trans men and women, read or download this brochure from our Trans Health Program (PDF).
Disparities exist among other groups as well. Although African-American women have a lower incidence of breast cancer overall, they are at greater risk of dying from it. Latina women have lower rates of breast cancer diagnosis than white women, but they are more likely to be diagnosed with large tumors and late-stage breast cancer. This group is also more likely to die from breast cancer than white women. Breast cancer rates among Asian American women have increased 1.2 % every year between 1988 and 2005, and they have yet to decline. Although the mortality rates have declined among all other U.S. racial groups, they have increased among Asian American women.
One-size-fits-all messaging sometimes fails to resonate with many of the people who are affected by breast cancer. This month should also be about recognizing that every person’s experiences with breast cancer are unique, and can vary among communities. Sensitivity to culture, gender identity, and sexual orientation should be part of the conversation.
Fenway Health offers supportive, sensitive care for everyone in our community, and this fall, we’ll begin to offer screening mammography at our health center. This means patients will have more access to these important services in a safe environment.
We also know that breast cancer awareness month is about more than screening and exams. We’ll be celebrating this month with the 14th Annual Audre Lorde Cancer Awareness Brunch, where survivors and their supporters come together to celebrate, learn about cancer related issues, and nourish mind, body and spirit.
“Audre Lorde was an African American lesbian feminist poet whose willingness to share her own experiences, including those with breast cancer, increased visibility of the challenges facing our communities. She was a role model whose eloquent words inspire women to embrace their lives as who they are,” says Potter.