JUNE BLOG – PRIDE GROWS HERE – SEPHIRA HEALING
A Guide to Breast and Chest Health for Women, Men, Trans, and Nonbinary People in Canada
Pam Fichtner, RMT | Breast and Chest Health Educator | Founder, Sephira Healing | Saskatoon, Saskatchewan
TL;DR – Key Takeaways
✓ Breast and chest health applies to every body – women, men, trans, and nonbinary people. Most people were never taught how to understand theirs.
✓ The biggest barrier to care for many Canadians, especially LGBTQ+ people, is fear of being judged when seeking it.
✓ Breast and chest tissue changes throughout life because of hormones, surgery, binding, and aging. Familiarity with your own body matters more than matching a textbook.
✓ This guide includes a simple, pressure-free starting point for getting to know your body. Research shows 96% of breast cancers are first identified by the person themselves – which is exactly why body familiarity matters.
✓ Sephira Healing in Saskatoon offers breast and chest massage therapy, lymphatic drainage, post-surgical recovery support, and educational programs for every kind of body.
A lot of people have questions about their breast or chest health, but they don’t ask. Sometimes they sit on those questions for years. And sometimes they wait until they can’t anymore.
When I’ve asked why, the answer is usually some version of the same thing. At some point, they felt judged, or they were afraid they would be. They felt like they didn’t know enough, like they had the wrong kind of body, or like they were a problem. A nuisance. An inconvenience. Too much to deal with.
There’s research on this. Studies looking at cancer screening across 2SLGBTQI+ communities keep coming back to the same finding. The strongest predictor of whether someone seeks care is whether they feel safe with their provider. Not how informed they are. Not how close the clinic is.
I believe every body deserves care that feels safe, respectful, and accessible. With Pride Month here, it felt like the right time to speak more openly about some of my own experiences and why this matters so much to me personally.
As someone who identifies as bisexual while also being in a heterosexual relationship, I know what it feels like to carry parts of yourself that are not always immediately visible to other people. I also have a nonbinary child, which deepened my learning and understanding even further in ways that became both personal and important to me.
The more I learned about gender identity, expression, attraction, and the experiences many LGBTQ+ people have within healthcare spaces, the more intentional I became about creating an environment where people feel safe, respected, and able to show up fully as themselves without fear of judgment or assumptions.
You don’t have to fit a particular profile or explain your body to deserve care.
Breast Cancer in Canada: An Inclusive Look at the Numbers
Breast and chest health is something many people put off. It doesn’t always feel urgent. But these numbers might make you reconsider waiting.
According to the Canadian Cancer Society’s 2026 projected estimates:
- An estimated 32,400 women in Canada will be diagnosed with breast cancer in 2026 – roughly 89 per day.
- 300 men in Canada will also be diagnosed with breast cancer this year. Most will not have known they were at risk.
- About 1 in 8 people with breasts will develop breast cancer at some point in their lifetime.
- The 5-year survival rate for breast cancer in Canada is approximately 89%. That number is tied to how early changes get noticed.
Those numbers only count the people currently being counted, which is its own issue. The Canadian Cancer Society has acknowledged that data on breast and chest cancer in transgender, non-binary, and gender-diverse people is not being collected in a way that reflects the real world.
What research does show is that 2SLGBTQI+ people face more barriers to screening. Screening rates are lower, which means cancers are often caught later. And when people can’t safely access the system, they often aren’t counted by it either. That’s part of why the data gaps exist in the first place.
Closer to home, Saskatchewan has been expanding access to screening without a doctor’s referral. As of January 2026, women aged 43 and older can now self-refer. That age is expected to drop to 40 by the end of this month, June 2026.
Why Feeling Safe Enough to Ask Is the Real Barrier
If you’ve been putting this off, you’re not alone.
People come to this late for a lot of reasons. Body shame that started young. A past healthcare experience that left them feeling dismissed. Language that never reflected their body. Or simply never being given clear, usable information in the first place.
Research across 2SLGBTQI+ communities is consistent on this. Screening rates are lower, and discrimination in healthcare is a major factor. What makes the biggest difference is having a provider who communicates well and makes people feel respected.
In practice, that means the barrier for many people is the relationship. Whether someone in that space makes them feel like they belong there.
For a lot of people in the 2SLGBTQI+ community, that hasn’t been their experience. They’ve had to assess safety before accessing care. They’ve had to explain their bodies to receive basic information. They’ve been misgendered, rushed, or made to feel like their needs were inconvenient.
When people can’t safely access care, they often aren’t counted by it either. That is part of why there are still gaps in the data.
Sephira Healing in Saskatoon was built with this in mind. Care where consent is explicit from the start, where no explanation is required, and where the people walking through the door don’t have to fit a particular picture to be welcomed.
Get to Know What Normal Breast And Chest Feels Like For You
I’ve found most people were never really taught how to understand their own breast or chest health. What they did learn was often clinical, fear-based, or built around a very narrow idea of what a body is supposed to look like. So they’re left trying to make sense of it on their own.
The questions I hear most often are things like:
• What should this actually feel like?
• What is normal for my body specifically?
• If I bind, or I’ve had surgery, or things have changed a lot, does any of this still apply to me?
• Is there a space where I can ask this without having to explain myself first?
Breast and chest tissue varies from person to person. It can feel soft or firm, lumpy or smooth, more sensitive at certain times, and different from one side to the other. All of that can fall within a normal range.
What matters most is getting familiar with your own body as it is right now.
Bodies change over time, and hormones play a big role in that. Pregnancy, postpartum, perimenopause, menopause, hormonal therapy, and aging all affect how tissue feels. A lot of the fear people carry comes from noticing something different and not knowing what it means. Change does not automatically mean something is wrong.
For people who bind or have had surgery, the picture is different again. Scar tissue can feel firm or tight and often changes for months or even years. Understanding what your body feels like now helps you make sense of those changes. There is no textbook version to match.
How to Do a Visual and Physical Breast and Chest Self-Exam
Here’s something worth knowing before anything else. Research looking at 462 breast masses found that 96% of cancers and 81% of ultrasound findings were first identified by the person themselves, not by a clinical exam or mammogram.
The approach I teach at Sephira Healing is simple and sustainable. The goal is to build a relaxed familiarity with your body so you can notice when something changes.
There are two important parts to this: a visual check and a physical check.
The visual check
Standing in front of a mirror, look at your breast or chest area with your hands on your hips, then with arms raised overhead. You’re simply looking for anything that seems new or different: changes in shape or symmetry, skin dimpling or puckering, or any change around the nipple. If you’ve had surgery, get familiar with what your body looks like now so you’ll notice when something changes.
The physical check
You can do this lying down or in the shower. The water and soap in the shower lets your fingers move more easily across the skin, which some people find helpful. Just make sure you’re feeling relaxed and ease when before you start.
- Use the pads of your fingers to get a feel for your breast or chest tissue. Note – don’t use the tips of your fingers. The pads cover more surface area and are more sensitive to texture changes.
- Work through the whole area in a spiral pattern, starting at the nipple and moving outward. Cover from your collarbone down, across to your armpits, and all the way to the lower edge of your breast or chest tissue. Put one arm over your head to access the side near the armpit.
- Use varying pressure (light, medium, and firm) as you go. Different pressures pick up different things.
- Gently check your nipples for any discharge.
- Notice what you feel. Not to diagnose anything. Just to get a sense of what’s normal for you right now. Soft spots, firmer areas, any tenderness. This is just information.
Timing
If you menstruate, the best time to do this is a few days after your period ends, when hormonal changes have settled and tissue is in a more typical state. If you don’t menstruate, choosing a consistent day each month works well.
A few things worth knowing as you go
• One side feeling slightly different from the other is common and usually normal.
• Tenderness that comes and goes with your cycle or with hormonal changes is usually not a concern.
• If you have scar tissue from surgery, it can feel quite firm or dense. Getting to know how yours feels specifically is important.
• If you bind, checking on days you’re not binding is easiest, but even a quick check through lighter fabric gives you a sense of what’s there.
• If you find something that feels harder than the surrounding tissue, that’s worth noting. A lump will usually feel harder than other parts of the area, though people with dense or cystic tissue may experience lumps that feel different.
If you’ve never done anything like this before, or if the idea of touching that part of your body brings up difficult feelings, that’s worth knowing about yourself too. A lot of people carry complicated relationships with their breast or chest area. That’s not unusual, and it’s part of what the work that Sephira Healing addresses.
If you’d rather be guided through this, you can learn more about hands-on and educational support here: https://www.sephirahealing.ca/treatment-options.
What to Watch for in Breast and Chest Health
When you know what your body normally feels like, you'll notice when something is genuinely different.
Things to pay attention to:
• A new lump or thickened area that wasn’t there before
• Changes in shape, size, or how one side compares to the other
• Skin dimpling or changes in texture
• Nipple changes or discharge
• Persistent pain in one area that doesn’t go away on its own
If something feels different and doesn’t settle, it’s worth following up with a healthcare provider. Most changes turn out to be nothing. And for the ones that do need attention, catching them earlier means having more options. Canada’s breast cancer 5-year survival rate of approximately 89% reflects that. Knowing your body is just the practical part of it.
You don’t need to be certain something is wrong to ask about it.
Breast and Chest Health Questions for Specific Situations
What do lumps in the breast or chest area mean?
A lot of lumps are completely benign. Many are related to normal tissue changes, hormonal shifts, or cysts. What’s worth paying attention to is whether something is new or changing, and whether it resolves on its own. Getting familiar with your body over time is more useful than trying to evaluate any single moment against a checklist.
What should people know about breast and chest health after surgery?
Scar tissue from mastectomy, lumpectomy, top surgery, or reconstruction can feel firm, tight, or quite different from what’s around it. It often keeps changing for a year or more after surgery. Gentle care and body awareness matter here. Breast and chest massage therapy and lymphatic drainage support can make a real difference in both physical comfort and feeling reconnected to that part of the body. Pam works with post-surgical bodies regularly and understands the specific ways tissue changes after different procedures.
Does breast and chest health apply to people with implants?
Yes. Having implants changes how tissue feels, and staying familiar with your body still matters. You can learn what’s normal for you specifically and notice when something shifts. That familiarity is part of good self-care regardless of surgical history.
Is binding bad for breast and chest health?
Binding is an important part of daily life for a lot of people, and breast and chest health care needs to include that without judgment. There are things worth being mindful of: breath restriction, skin irritation, and muscle tension. Giving the body breaks when possible and paying attention to discomfort helps. Pam addresses binding specifically as part of her practice because it’s part of the real picture of breast and chest health for many people she works with.
How do hormones affect breast and chest tissue?
Hormones have a significant effect on breast and chest tissue throughout life, through menstrual cycles, pregnancy, perimenopause, menopause, and hormonal therapy. If tissue feels different than it used to, more tender or dense or active, that often has a hormonal explanation. Having language for that shift can replace a lot of unnecessary worry. Pam’s Healthy Breast Foundations program covers hormonal changes as a core thread, because it’s one of the things most people were never taught clearly. Contact for details.
Can men get breast cancer?
Yes. In Canada, an estimated 300 men will be diagnosed with breast cancer in 2026. Most will not have known they were at risk. Men have breast tissue, and male breast cancer is underdiagnosed largely because awareness is so low. Body familiarity matters for anyone with tissue in that area.
Where to Start
Breast and chest health doesn’t have to be something you approach with dread or obligation.
A lot of people have avoided this part of their body for a long time, for reasons that make complete sense. Body shame, past experiences, language that left them out, or simply never having had a useful conversation about it. That's a really common place to be.
Getting started doesn’t require having it figured out. It can just look like:
• Trying the simple check-in described in this guide
• Reading through the program options at Sephira Healing to see what resonates
• Reaching out to ask a question, even if you’re not sure what you need yet
Sephira Healing is showing up at Pride this month in Saskatoon. We’ll be doing some demonstrations and would be happy to answer more questions there.
Additional Resource
One resource that really helped me better understand the differences between gender identity, gender expression, biological sex, and attraction was the Genderbread Person. I found it to be a simple and approachable visual explanation for concepts that can sometimes feel overwhelming or confusing when the language is new.
The resource explains that:
• gender identity is how someone experiences themselves internally
• gender expression is how someone presents themselves outwardly
• biological sex refers to physical characteristics someone is born with or develops over time
• attraction refers to who someone is emotionally, romantically, or physically drawn to
One thing I appreciated about the resource is that it recognizes these experiences can exist on spectrums rather than rigid boxes. Language and understanding continue to evolve over time, and most people are learning as they go.
You do not need to understand every term perfectly to treat people with kindness and respect. Curiosity, openness, compassion, and willingness to listen go a long way in helping people feel safe and welcomed.
I’ve added more about this on my website if you’d like to explore it further.
https://www.sephirahealing.ca/the-hub/my-blog/what-ive-learned-about-gender-identity-expression-and-attraction
Frequently Asked Questions About Breast and Chest Health in Canada
Does breast cancer affect 2SLGBTQI+ people differently?
LGBTQ+ people aren’t at higher biological risk, but they face more barriers to screening and care, so cancers tend to get caught later. The Canadian Cancer Society has acknowledged that data on breast and chest cancer in transgender, non-binary, and gender-diverse people is currently incomplete.
What is breast and chest health, and is it different from breast health?
Breast and chest health is a broader term that covers everyone with tissue in that area, regardless of gender identity, surgical history, or anatomy. It was intentionally expanded in clinical settings to include trans and non-binary people, people who have had mastectomies, and anyone who doesn’t identify with the word “breast.” Sephira Healing uses this language as standard.
What is the survival rate for breast cancer in Canada?
Approximately 89% at five years, according to the Public Health Agency of Canada. That number is higher when changes are caught early, which is why body familiarity and timely follow-up matter.
What should someone do if they notice a change in their breast or chest?
Follow up with a healthcare provider. Most changes won’t be cancer, but early awareness gives you more options if something does need attention. You don’t need to wait until you’re certain something is wrong.
Can people in Saskatchewan self-refer for a mammogram?
As of mid-2025, Saskatchewan women aged 45 and older can self-refer for a screening mammogram without a doctor’s requisition. The province is working toward lowering that age to 40 by June 2026. Awareness of the change has been low, and health advocates have called on the government to communicate eligibility more actively.
What does breast and chest massage therapy involve?
Breast and chest massage therapy is specialized, consent-based therapeutic work that supports the health of breast and chest tissue. It can address pain, tightness, lymphatic congestion, scar tissue, and disconnection from the body after surgery or trauma. At Sephira Healing, it is always paired with education and body awareness so clients leave understanding their own body better.
Where can I find inclusive breast and chest health care in Saskatoon?
Sephira Healing, founded by Pam Fichtner, RMT, offers specialized, trauma-aware breast and chest massage therapy, lymphatic drainage, oncology massage care, and post-surgical recovery support in Saskatoon, Saskatchewan. The practice welcomes people of all genders and identities. No explanation or justification is required to receive care. See all services at https://www.sephirahealing.ca/treatment-options
Sources
All statistics and claims in this post can be verified through the sources listed below. If any information has been updated since publication, please contact us so we can keep this resource accurate.
- Canadian Cancer Society – Breast Cancer Statistics (2026 Projected Estimates) cancer.ca/en/cancer-information/cancer-types/breast/statistics
- Public Health Agency of Canada – Breast Cancer
canada.ca/en/public-health/services/chronic-diseases/cancer/breast-cancer.html -
Canadian Cancer Survivor Network – LGBTQ+ People and Breast Cancer
survivornet.ca/cancer-type/breast-cancer/lgbtq-information -
ScienceDirect (2023) – Participation, Barriers, and Facilitators of Cancer Screening Among LGBTQ+ Populations
doi.org/10.1016/j.ypmed.2023.107451 -
CBC News Saskatchewan (January 2026) – Experts Shocked by Mammogram Misinformation in Saskatchewan
cbc.ca/news/canada/saskatchewan/experts-shocked-mammogram-misinformation-saskatchewan-9.7041168 -
CMAJ Open (2019) – Breast Cancer Risk and Breast Screening for Trans People: An Integration of 3 Systematic Reviews
cmajopen.ca/content/7/3/E598 -
CA: A Cancer Journal for Clinicians (2025) – Breast Cancer in a Transgender Man
acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.70021 -
Canadian Medical Association Journal (2026) – Projected Estimates of Cancer in Canada in 2026
cmaj.ca/content/198/14/E526 -
Huang N, et al. (2022) – The Efficacy of Clinical Breast Exams and Breast Self-Exams in Detecting Malignancy or Positive Ultrasound Findings
ncbi.nlm.nih.gov/pmc/articles/PMC8942605 -
Healthline – Breast Self-Exam: Preparation, Procedure, and Risks (medically reviewed by Valinda Riggins Nwadike, MD, MPH; updated July 2024)
healthline.com/health/breast-lump-self-exam
