My Last Mammogram

Photo by Wendy Thomas (see notes)

Photo by Wendy Thomas (see notes)

I had my last mammogram on Monday. I put it off for four years and only made an appointment because my surgeon required it before he would clear me for top surgery (bilateral mastectomy).

I’ve had other mammograms. This one was no different except that it was the last one. I was anxious in the radiology clinic waiting room. The TV blasted the Good Morning America show and it was impossible to read the book I brought with me (Susan Orlean’s Rin Tin Tin). All the women in the room were quiet. They dressed up for their appointments, as if they were going to an interview. I felt overly self-conscious; a parody of a butch lesbian in jeans and a plaid shirt. I wondered what they would think if they knew why I was there.

FInally, the receptionist called my name and everyone turned and looked at me as I got up to go to the dressing room. I took off my shirt and binder and put on a short blue gown that opened to the front. The gown didn’t tie high enough or tight enough for my comfort level. My cleavage and I went into the next waiting room. It was filled with silent women in gowns, sitting with their arms crossed in front of their breasts. All of us hoping that we would be called next.

The technician came, and lead me to the mammography room. She took four shots, two flat and two rotated and tilted. It was painful and awkward to have my breasts inserted between two plastic plates and flattened, like tortillas in a press, while I held my breath and stood still. It took less than five minutes. They sent me home and told me I’d get the results later in the week. The worst part of the mammogram is the wait; the fear that the radiologists will find something.

I’ve had two false positives (the probability of a false positive is about 7% each time). I didn’t talk about them, even to Donna, until after I returned for follow-up tests and I got the “all clear” report. I was scared, but I didn’t want to burden her until I knew for sure. I was optimistic that the spots were just spots.

Researchers agree that having top surgery reduces your risk of breast cancer, but there is still a risk, and no one really knows what that risk is, how taking testosterone affects it, or the best way to test for it. Transgender health organizations recommend that a clinician perform an annual chest/breast tissue exam for abnormalities, and that you talk with your doctor.

During my consultation with Dr. Weiss, I asked him what he recommended. He prefers annual MRI’s, and would write a script for them. I know I will have trouble making the follow-up appointments for the MRI.

I’m relieved to be done with mammograms, just like I’m relieved to be done with menstruating. A few years back I had a partial hysterectomy (because of uterine fibroids), which ended my periods. I chose to keep my cervix because it improves sexual response (I may be stone but I’m an optimist). I chose to keep my ovaries so that I would not be suddenly thrown into early menopause or pressured to take estrogen. I didn’t want to take female hormones.

Dysphoria is not good for your health. I ignored my periods until the bleeding from the fibroids got out of control and I became anemic. I didn’t track it. Getting it was always a surprise, particularly when it became fierce and irregular. I didn’t plan for it except to always keep a stash of tampons and panty liners handy.

I hated getting my period because it was a reminder of my femaleness. It grossed me out and I never got used to it or used to using tampons. I don’t feel comfortable going back to my gynecologist and I am overdue for a pap smear and pelvic exam. I’m going to have to find a queer/trans friendly clinic. I know that dissociating from things doesn’t make them go away; it just puts me at risk for cervical and ovarian cancer. It is not a risk I want to take.

Notes: Fenway Health in Boston has a brochure on breast cancer facts for transgender men and women here. There is an interesting article summarizing current research in the Journal of Midwifery & Women’s Health here (to read it open the link and then look to the right to click on the “get pdf” icon for the article). The picture of “Mammo-Grahams” comes from Wendy Thomas of Lesson’s Learned from the Flock.

27 thoughts on “My Last Mammogram

  1. RonaFraser

    Well good on ya, because I am 47, with a mom who’s survived breast cancer twice, yet I’ve never been for a mammogram. A combo of “can’t be bothered”, “why get pain or x-rays for ‘nothing'” and “don’t wanna know”, I suspect.
    And have to share that although I am cis, my period still irritates me because I’m, like, “it’s not fair — if I don’t get to use these parts for fun [always single], I shouldn’t have to go through the disgusting part either!!”

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    1. Jamie Ray Post author

      I agree, periods are only useful as a pregnancy test.
      I have very mixed feelings about cancer screenings; there are many more false positives that true positives – and the emotional fallout from false positives, combined with the exposure to radiation, combined with the over-treatment of potentially benign tumors makes a reasonable argument for not doing it.
      In my case I tend to procrastinate for no true logical reason other than it makes me uncomfortable to do it, which is not the best reason (e.g. why I didn’t pay taxes for a few years and it was not a good situation when I decided to finally file and it cost a lot more money than if I had just done it on time).
      I didn’t realize that by keeping my ovaries I would get hot flashes (power surges) but I can handle them. As long as you are not trying to look underage and like a supermodel menopause is pretty good.

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  2. Pingback: Bounce Your Boobies | Dog Dharma's Blog

  3. perpetualtomboy

    I thing we’re pretty similar. Well, aside from the fact that I’m a straight tomboy. I’m 44 with lifelong chest dysphoria and am finally getting top surgery later this month. I also had a hysterectomy (at age 26) due to endometriosis. I was so THRILLED to get rid of my periods forever! And I’m going to be so happy to get rid of these fatty lumps on my chest. I feel like that will be enough. I’ve always felt “in the middle” and after top surgery I think my body will match that more.

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    1. Jamie Ray Post author

      When I first started thinking about top surgery, you and Butch In The South were the two blogs I found that I could relate to who discussed it from a non-transitioning perspective. I’m happy to hear that you are finally getting to do it – hope it is everything that you have been wishing for.

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  4. Lesboi

    Congrats on your last mammogram. I’m thinking I have at least one more in me. I’m a bit horrified at the idea of yearly MRI’s instead. I’d much rather have the mammogram, which I’ve never really minded since they’re so short and only mildly uncomfortable for me. My brother has to have a mammogram next week because of a lump on his chest. It’s just a precaution and I’d be very surprised if it was a serious situation. Still, I find it amusing that he has to have it done.

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    1. Jamie Ray Post author

      I think my surgeon requires them of anyone over 40; it is not an unreasonable thing to ask for. I’ve had MRI’s for knee surgery (cross country skiing accident, and then another tear on the same ligament), and I didn’t mind going through the machine (I’m not claustrophobic and I don’t have knee dysphoria).
      Hope your brother is OK, maybe at some point you will get to compare moobs with him. My brother used to tease me when I was pre-pubescent by saying “what do you want a medal or a chest to pin it on?” and I would reply “the medal.”

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  5. The Little Butch That Could (TLBTC)

    I had to have a mammogram after a doctor found a lump. Now, I’ve been to my share of specialists/doctors/hospitals for my medical issues but I swear, I never felt so out of place but so welcomed by the other women in that waiting room as we were all in the same boat, waiting on results while holding our gowns in place. It became a little cheering section. Once a woman got the news that she was free to go, we all smiled and clapped for her as she went on to change into her street clothes. Me? I was there alone and there was concern on their faces for me. I was called back for a second go around with the booby press. I was taken into the back a third time for a different test but it all turned out fine in the end. Those women in the waiting room were genuinely relieved and happy for me. I don’t think i’ve ever been so warmly welcomed by a group of women in my life. At that time social status, age, labels and other devices we use to differentiate ourselves did not matter. We were all there for the same reason filled with the same worry.

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    1. Jamie Ray Post author

      That is a great story. The clinic that I was in had the TV blaring, and no one talked. It might be a New York mind-your-own-business-and-don’t-make-eye-contact-or-I’ll-kill-you kind of thing.

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  6. The Final Rinse

    Since this is the very last mammogram, I think that it is worthy of being celebrated. Congratualtions. These little milestones are what there is to look back at, and know that you are making progress.

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      1. The Final Rinse

        I went to sleep and woke up with a big smile on my face. I think that I probably smiled through surgery too. The surgeon even commented on it later. 🙂

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  7. Valo Spiraltänzer

    Hi!
    I’m from Germany so I don’t know about the common ways of gynecological examinations in the U.S. – is it the usual way to have a mammograms for preventive medical checkup? In Germany the doctor will strobe your breasts by hand. If he finds something which bothers him, he will make an ultrasonic testing in his practice. And only if there is still something he can not identify, he will send you to a hospital to have a mammogram done. In Germany, mammograms are reduced to a minimum to keep the radiation exposure as little as possible.

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    1. Jamie Ray Post author

      Because most of our health care is privatized (for profit) different insurance companies follow different recommendations. At a minimum most recommend a mammogram every two years between 40-49, and annual mammograms after 50. However, if you have a history of breast cancer in your family, they recommend annual screenings.
      There is less concern here about the effects of radiation; the U.S. polices on food irradiation are very different from the E.U.

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  8. anexactinglife

    Happy for you to be done with them! I also had a false positive with quite a bit of follow-up, and was worried about the excessive radiation exposure. I had the opposite experience to TLBTC above – each patient in the waiting room was told to go home when the preliminary scan showed no abnormalities, and everyone was so happy for them – until me, when I was called in for another consultation (always a sign of bad news) and everyone adverted their eyes and looked queasy. All has been fine since then, though.

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    1. Jamie Ray Post author

      I’m glad to be done. The clinic always made me uncomfortable and I never knew how much of it was that particular clinic and how much was the procedure.

      It would be an interesting study to know if certain clinics or environments encourage solidarity and contact between patients or if it is a day-to-day thing depending upon who shows up (once one person breaks the ice it is easier for the next etc.).

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    1. Jamie Ray Post author

      The mammogram just came back as clean! WIth a copy to my surgeon. I find top surgery to be totally mind occupying – I guess for everyone there is a part of their transition process that is – whether it is growing facial hair, or being sir’d, or going to court for their name change. I’ll just be happy to have it over and done with and hope that some other trans thing doesn’t pop up to take its place.
      Still have to get a pap smear though.

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  9. MainelyButch

    Great blog! As you know I just had my top surgery 4 weeks ago, man! what a difference in my attitude and a hella lot less body dysphoria. I can’t tell you how happy you will be. I had to do the mammo before my surgeon would do the job too….I think I blogged about it, because they overlooked me in the waiting room as someone’s guy waiting for them…it was pretty comical, but reminds me that this living masculine of center stuff really does fuck with peoples perceptions of our gender and/or sexuality. ~MB

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    1. Jamie Ray Post author

      It is easier to joke about it afterwards. I’ve had my share of awkward moments in the waiting room too. When I’m with Donna they always assume that she is the patient…

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  10. UnknownJamie

    Hey there 🙂 I have to be honest that I haven’t followed much about trans-guys, but I appreciate your open and honest post, so thank you. I wonder if trans people on both sides meet in the middle at any point. Anyway, congratulations, and keep always being you!

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