Radiology's Engagement with Transgender Breast Imaging: Review of Radiology Practice Websites and Publications

To assess engagement with transgender breast health among radiology investigators and providers, we analyzed: (1) trends in medical research regarding transgender breast health, and (2) breast imaging practices' websites, for inclusion of the word transgender and mention of services specifically for transgender patients. We viewed the analyses of both research articles and general websites as two real-world measures of engagement among the professional community, in contrast to surveys whose responses rely on the compliance of recipients. A PubMed search performed for the text words transgender breast cancer, Lesbian-Gay-Bisexual-Transgender (LGBT) breast cancer, and transgender breast imaging. Our search yielded 48 unique relevant publications from 2010-2019. While research publications regarding transgender breast health have been become more numerous since 2015, it is still a relatively small field of study. Websites were analyzed for mention of transgender breast health needs and were reviewed for gender-neutral language and design. Of the 20 breast imaging centers listed as top choices by a national consumer group in 2019, none of their websites included the term transgender. Likewise, of the 21 centers in New York City and in San Francisco listed using the Google search engine, none included the term transgender. Despite its growing importance, issues related to transgender breast imaging are not well addressed in the radiology literature or in the radiology community, even though more transgender patients are presenting to breast centers for imaging. Radiologists need to be aware of imaging recommendations for these patients and display sensitivity to specific patient concerns.