Screening Mammography Utilization among Transgender and Gender Diverse Individuals: Insights from a Large Single Institution Center.

Abstract

Few consensus guidelines exist regarding screening mammography recommendations for transgender and gender diverse (TGD) individuals. Our study aimed to assess the utilization of screening mammograms in a large cohort of TGD individuals at a single institution and the factors influencing mammogram uptake. Retrospective cross-sectional study. 800 TGD individuals actively engaged in care at a transgender medicine and surgery urban center. We conducted a retrospective analysis of a database of TGD patients (N = 4052) actively engaged in gender-affirming care in a specialized center for transgender health in a large urban healthcare system. We included all individuals who were age 40 or older at the time of data collection (N = 800) and conducted chart reviews on use of screening mammography and results. Of the 800 TGD individuals over age 40, 532 were recorded male at birth, and 268 were recorded female at birth. Among those aged 50 and above, 136 out of 382 (36%) had a screening mammogram, whereas among those aged 40-49 years old, 72 out of 418 (17%) had a screening mammogram. Twenty-five percent (28/88) of those who underwent chest masculinization surgery had a screening mammogram, while 34.2% (94/275) of those who underwent chest feminizing surgery had a screening mammogram. Twenty-one out of the 208 (10%) of mammograms performed had a BI-RADS category greater than or equal to 3 or greater on diagnostic mammograms. In our single-center large cohort of TGD individuals, we found a low percentage of screening mammography use. In those 50 and above, an age cohort with clear guidelines for screening, only 36% had any screening mammogram, and Hispanic ethnicity, chest masculinizing, and chest feminizing surgery were significant predictors for getting any screening mammograms. Our findings suggest the need for increased compliance with screening guidelines in TGD individuals, consistent with those for cisgender women.