Gynecological care and the need for breast cancer screening for transgender individuals

Transgender people have always existed, in various cultures and throughout history. However, their number have recently increased in France, especially thanks to the possibility of affirming their gender with less stigma and a gradual de-psychiatrization. This should enable them to exercise self-determination and improve their relationships with healthcare providers and, consequently, their care.
These patients may need medical support, particularly in terms of endocrinology, surgery, and even psychology if necessary. On the gynecological side, stigmatization leads to a lack of follow-up and screening. Indeed, there is a delay in care in this population, particularly due to a lack of screening, as only one-third of them is screened, compared to 65% of the cis population. These figures are even lower among transfeminine patients, as shown in American studies amongst others.
It is therefore necessary to improve the information provided to patients, since more than 70% of them are unaware of breast screening recommendations and their benefits in studies, but also to improve the training of professionals in their care. That is why we have worked to develop breast screening recommendations specific to each patient based on their personal and family history. The aim is to improve screening and prevention of breast cancer in this population, since its occurrence could theoretically contraindicate the continuation of gender-affirming hormone therapy.