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.