Breast Care in the Transgender Individual

Abstract

Transgender individuals should be counseled on all the possible outcomes of their decisions, so they are capable of making informed choices. They must also be followed with careful consideration of these choices. More research in many areas of transgender breast care is necessary.

Provision of Patient‐Centered Transgender Care

“…Addressing health disparities in the transgender population by providing prevention and early intervention have been shown to reduce health care costs while improving general health outcomes . CNMs/CMs are especially well suited for providing ongoing primary care for transgender populations because of their skill in treating women with hormonal health needs throughout the life span . Ongoing management of hormonal administration, monitoring laboratory values, and care before or after gender‐affirming surgery may be provided by properly trained providers as a part of primary care services .…”

“…Progesterone may be used in trans men to suppress menstruation for a short time, especially if transdermal testosterone is used rather than parenteral dosing, but it is rarely used on an ongoing basis . If the uterus remains intact and contraception is desired, a progestin‐secreting intrauterine device may be used.…”

“…Postmastectomy pain in the surgical sites may be reported for trans men who choose this option for care . Guidelines for mammography screening for those who have breast tissue intact or have undergone mastectomy should be the same as for cisgender populations until further research is completed . However, more research, in the form of randomized controlled trials to determine the exact effects of long‐term cross hormone use on breast tissue, is needed to create specific guidelines for breast cancer screening in the transgender population …”

“…18 CNMs/CMs are especially well suited for providing ongoing primary care for transgender populations because of their skill in treating women with hormonal health needs throughout the life span. 21 Ongoing management of hormonal administration, monitoring laboratory values, and care before or after gender-affirming surgery may be provided by properly trained providers as a part of primary care services. 18 CNMs/CMs may increase clinical competency for transgender care by referring to transgender treatment guidelines established by the World Association for Transgender Health (WPATH), consulting or collaborating with other providers who are experienced in transgender care, or limiting care to ongoing hormone treatment.…”

Health impact of chest binding among transgender adults: a community-engaged, cross-sectional study

“…Past research has explored the effects of chest binding in regards to lactation suppression (Swift and Janke 2003) and gynaecomastia (Huber 2012), but never within transmasculine populations (Maycock and Kennedy 2014). evidence from case series and community reports demonstrate that binding may lead to a variety of negative health outcomes including pain (Nelson, Whallett, and McGregor 2009), skin excess/ptosis (Berry, Curtis, and Davies 2012;Monstrey et al 2008), bruising, fractured ribs, pneumothoraces (TransGuys 2014) and infection (Feldman and Goldberg 2006;Hudson 2004).…”