Chest Changes
Chest changes during transition
This page is for people who are trans or non-binary, and anyone who wants to know about changes during transition. Everyone has breast tissue and people of all genders can get breast cancer. We use the term ‘chest’ on this page, and ‘breast’ when we need to be clinically accurate, for example when we talk about breast cancer.
During transition, there might be some changes to your chest. There are different types of transition that might affect your chest. They are:
- Social transition
- Medical transition
- Surgical transition
You may be going through some, all or none of these. It is your choice what you do with your body. All bodies are different, and every person’s transition is unique.
How transition can affect your chest
Everyone is different and knowing your normal is a process, but you can start here for the need-to-know on all the bits you need-to-know.
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. Brook have good advice about chest binding here.
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, but 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, due to either 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 regularly. The CoppaFeel! Self-Checkout can guide you through the process of checking your chest.
Surgical Transition
Surgical transition is when you have surgery to affirm your gender identity. Not all trans and non-binary people choose to have surgery. In the chest area, there are two common types of surgery you might have:
- Breast implants – some trans women and non-binary people choose to have breast implants. You can read more information about chest checking with breast implants here.
- 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 your new normal by checking your chest regularly. Make sure you check areas that still contain breast tissue. This might include tissue under your armpits and up to your collarbone, and your nipples. For more information on the symptoms to check for read our chest checking guidance.
Cancer 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. Brook have more information.
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. CoppaFeel! have more information all about breast implants here.
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 regularly check your chest. Talk to your doctor if you have any unexpected changes.
This information was written in partnership with CoppaFeel!