Awareness: Who’s Being Reached, Who Isn’t

Last week, I discussed the fact that gendering breast cancer with pink branding has the effect of excluding many people who can potentially develop breast cancer. I also briefly touched upon the question of awareness. Most campaigns for breast cancer dominating the news and airwaves right now have ‘awareness’ in their names or missions. They claim to want to make people more aware of breast cancer.

The question I have is: Who are they trying to make more aware?

Because, currently, these campaigns seem to be primarily aimed at cis women who have an affinity for the colour pink. All of whom are quite aware of breast cancer at this point. That wasn’t always the case. Earlier generations of feminists fought long and hard for cancer awareness and education, and this is a case of a feminist campaign that worked. The groups those women were trying to reach have been thoroughly saturated by the message. Most cis women in the United States know about breast cancer, know about self exams, are aware, at least of a tangential level, of issues like the link between pollution and breast cancer. The medical community takes cancers of the breast in cis women seriously, as does the research community.

This is huge. I’m not going to undermine that. Those campaigns were critically needed because the fact is that women were dying in droves from breast cancer because it was being diagnosed far too late and minimal funding was being dedicated to research and treatment, because breast cancer was considered ‘a women’s issue’ and therefore not of interest to the scientific community. The push, the reversal, that women managed to create with aggressive awareness campaigns deserves recognition.

But now, it’s time to improve those campaigns, because there are demographics being underserved by breast cancer awareness right now. Where cis women were 30 years ago, men, some trans women, and nonbinary trans people are today. Because these campaigns have so powerfully sent a message, and have been so effectively structured around more rights, autonomy, and social equality for women, that people who need to be made aware of breast cancer are not being made aware. And they are dying of underdiagnosed breast cancer, and cancers diagnosed too late.

There’s a pretty easy way to fix this, and that’s retooling these campaigns to be more inclusive. I know people have invested a lot of time and energy in pinkifying breast cancer, but, I’m sorry, it’s time to drop the branding. It’s time to reach everyone. It’s time to film PSAs aimed at people like men, encouraging them to do self exams, to get screened for cancer, to make sure they know their family history and are aware of their risks. It’s time to make sure the medical community is providing the trans community with respectful, appropriate medical treatment, rather than discriminating against us.

Want an example of an inclusive awareness campaign? Buck Angel (site may not be safe for work for you) recently filmed a prostate awareness PSA aimed at trans women, reminding them that they need screenings for prostate cancer and disease too, even though most prostate awareness campaigns are aimed at cis men.

The PSA opens with a woman lying on an exam table, wearing a bikini. She sits up to face the camera. ‘My name’s Drew,’ she says, ‘and I’m a trans woman. For women like us, we have some special healthcare needs. This includes getting our prostates checked, ’cause women can have prostates too. Know your body. Love your body. Talk to your doctor today.’

It’s short, it’s clear, it’s to the point. It states some simple facts. And it raises awareness. Women can indeed have prostates too! And prostates need to be checked! So we should talk about that, talk about different bodies, instead of treating things like prostate cancer as something that can only happen to men (after all, not all men have prostates). I’ve long been a fan of Buck Angel’s work because of the breaking down of barriers that happens, the challenges to gender norms, and the huge amount of community service work that he does. He saw a clear area where women were not being served, and went to work to raise awareness.

Another example, brought to my attention by OuyangDan; a calender shot by male Marines promoting breast cancer research. ‘If I knew I had breasts, I would have taken better care of these puppies,’ one of the participants in the shoot said. This, people, is the consequence of a lack of awareness.

I would like to see breast cancer awareness expanded to all people, along with awareness about cancer screening in general, as there are a number of other highly prevalent cancers that people do not know enough about[1. Lung cancer, for example, is commonly believed to only be a problem if you are a smoker, which means that nonsmokers assume they don’t need to be screened or evaluated for cancers of the lung.]. And hey, did you know that men with a family history of breast cancer are at increased risk of prostate cancer? Because they are.

I often criticise ‘awareness’ campaigns because I ask, ‘what’s the point of making people more aware? Don’t you want people to do something?’ But, in the case of breast cancer awareness, there actually are populations that are not being served and need to be. Those populations do need to be made more aware, and in the process, they also need to be educated about how to screen themselves for breast cancer, how to ask for screening, and how to receive appropriate preventative care.

This also needs to paired with better training in medical school. Especially in the trans community, there are populations who are at serious risk of medical complications from untreated and undertreated conditions, solely because of gender biasing and a lack of awareness about bodies, and how they work. There are trans men who die of ovarian cancer because their doctors refuse to screen them for it and don’t consider it as a risk when those men present with symptoms, asking for treatment. There are trans women who develop prostate problems that aren’t treated. There are numerous nonbinary trans people who are read in certain ways when they walk into medical offices and don’t get the care their bodies need, just as there are intersex people who do not receive proper medical treatment for their bodies.

Awareness in the medical community needs to come hand in hand with awareness for patients. Because some of us can ask for all the breast cancer screening we want, but if our doctors decide we don’t have the right bodies, we aren’t going to get it.