OBSP-cancer care

Breast and chest cancer screening saves lives, but Two-Spirit, trans and nonbinary people have historically faced barriers to getting it. Unclear eligibility rules, worries about being misgendered, and a lack of inclusive information can all stand in the way. In 2023, the Ontario Breast Screening Program (OBSP) expanded its eligibility criteria to include Two-Spirit people, trans people and nonbinary people. This guide explains who can be screened, how to book, and where to find affirming resources. If you are looking for breast and chest screening in Toronto, this guide also shows you how to book at Annex Medical Imaging.

Quick Summary

  • In 2023, the OBSP expanded its eligibility criteria to include Two-Spirit, trans and nonbinary people.
  • People ages 40 to 74 who meet all OBSP eligibility criteria can be screened, and can self-refer with no doctor’s referral required.
  • Transfeminine people who have used feminizing hormones for at least 5 years in a row at some point in their life, and who are otherwise eligible, can be screened. No documentation, such as a hormone prescription, is required to prove eligibility.
  • Transmasculine people who have not had top surgery to remove breast or chest tissue, and who are otherwise eligible, can be screened.
  • Book by calling 1-800-668-9304 or contacting an OBSP location.

Who Can Be Screened in the OBSP?

The OBSP is publicly funded and serves women, Two-Spirit people, trans people and nonbinary people. Ontario Health lists the following criteria for average-risk screening. You should:

  • be between the ages of 40 and 74;
  • have no new breast or chest cancer symptoms;
  • have no personal history of breast cancer;
  • have not had a mastectomy; and
  • have not had a screening mammogram within the last 11 months.

In addition, the following applies for trans and nonbinary people. Select the tab that matches your situation.

You may be screened if you have used feminizing hormone therapy for at least 5 years in a row at some point in your life and you are otherwise eligible. You do not need to show documentation, such as a hormone prescription, to prove your eligibility.

You may be screened if you have not had top surgery to remove breast or chest tissue and you are otherwise eligible.

You may be screened if you meet all of the OBSP eligibility criteria. If you are not sure how the criteria apply to your body and history, call the OBSP site and ask. The team can talk through the questions with you. See the Ontario Health breast cancer screening page for the program’s full criteria.

What Rainbow Health Ontario says about breast and chest cancer risk

The Rainbow Health Ontario campaign Be Seen. Get Screened. puts it in everyday terms: if you have breast or chest tissue and are over 40 years of age, you may be at risk for breast or chest cancer. If you have been taking estrogen for more than 5 consecutive years and are over 40, talk to your health care provider about breast cancer screening.

Why This Matters

Rainbow Health Ontario’s campaign highlights that cancer screening saves lives, but 2SLGBTQ+ communities face preventable barriers to care, including lower screening rates and later-stage diagnoses. Making screening more welcoming does not just help individual patients. It helps entire communities get the care they need. Learn more about the Be Seen. Get Screened. campaign, which covers breast and chest, cervical, colorectal and lung screening.

What Safe and Affirming Care Looks Like

Guidance developed for OBSP sites by the Toronto Central Regional Cancer Program recommends that site staff provide safe, inclusive and affirming care for Two-Spirit, trans and nonbinary people. This includes:

  • introducing themselves with their pronouns;
  • calling all patients by the name they provided, even if it differs from what is on their screening record or health card;
  • using inclusive pronouns such as they/them until a patient shares their preferred pronouns;
  • not making assumptions about a patient’s gender or personal circumstances, and only collecting clinically relevant information in a sensitive, respectful way;
  • giving patients the chance to share their correct name and pronouns at booking, so that the information flows smoothly to the medical radiation technologist; and
  • learning about trauma-informed care and the barriers this community faces.

You deserve to be treated with respect at every step. If you have questions about how a site will support you, ask when you book.

How to Book

  1. Check that you meet the criteria above.
  2. Find a location with the Ontario Health wait times tool. Choose Breast Screening (Mammogram) Wait Times and search by city or postal code.
  3. Call to book at 1-800-668-9304 or contact a location directly. At Annex Medical Imaging, call (416) 531-1128.
  4. Share your name and pronouns if you would like the team to use them.

Resources for 2SLGBTQ+ Communities

Postcards and Posters

Rainbow Health Ontario offers Be Seen. Get Screened. breast and chest screening postcards and posters. Click Download Now and refer to postcard versions 3 and 4 and poster versions 3 and 4 for breast and chest screening.

Video: Binary and Beyond

Watch Binary & Beyond: Taking Care of Our Bodies, 2SLGBTQI+ Breast & Chest Cancer Screening in Ontario, a community-led video from the Mid-West Toronto Ontario Health Team and The Open Door Program that encourages 2SLGBTQ+ people aged 40 to 74 to get breast and chest cancer screening.

Training for Health and Social Service Teams

Trans Care BC offers free online learning on gender diversity for anyone working or volunteering in health care and social services. The course page linked below is Intro to Gender Diversity (Expanded), a free, one-hour, self-paced eLearning course that covers gender diversity terminology, common barriers to care, and strategies for creating inclusive, affirming services. Check the course page for current prerequisites, including the standard Intro to Gender Diversity course. Register for the course here.

The Eligibility Script for OBSP Staff

The Toronto Central Regional Cancer Program developed a script and supporting documents to help OBSP site clerical staff confirm patients’ eligibility respectfully. The package includes a script, scenarios, a summary flow-chart, a glossary and FAQs and supporting notes. Rainbow Health Ontario reviewed the script and provided feedback. OBSP sites can request a copy by emailing infoTCRCP@sunnybrook.ca.

Tips for family, friends and allies
  • Offer to help look up a location and phone number together.
  • Offer to go along to the appointment if the person would like company.
  • Use the name and pronouns the person uses.
  • Share the video and the postcards and posters above with your own community.

Related Reading

  • Mammography and preparation

    • Frequently Asked Questions

    When did the OBSP begin including Two-Spirit, trans and nonbinary people?

    The OBSP expanded its eligibility criteria to include Two-Spirit people, trans people and nonbinary people in 2023.

    Do I need a doctor’s note or hormone prescription to prove I am eligible?

    No. For transfeminine people, no documentation such as a hormone prescription is required to prove eligibility.

    I am transmasculine and have not had top surgery. Can I be screened?

    Yes, if you are otherwise eligible. Transmasculine people who have not had top surgery to remove breast or chest tissue can be screened in the OBSP.

    What age should I start?

    The OBSP serves people ages 40 to 74 who meet the criteria. People ages 40 to 49 are encouraged to talk with a health care provider or Health811 navigator about the benefits and harms of screening before deciding. Most people who choose screening should have a mammogram every 2 years.

    Will staff use my name and pronouns?

    OBSP site staff are encouraged to call all patients by the name they provide, even if it is different from what is on their screening record or health card, and to use inclusive pronouns until you share yours. Let the site know when you book.

    Do I need a referral?

    No, not if you are 40 to 74 and meet the criteria. You can contact an OBSP location directly or call 1-800-668-9304.

    What if I have a lump or another new change in my chest?

    Contact your health care provider right away. Screening mammograms are for people without new symptoms.

    Where can I find more information for 2SLGBTQ+ communities?

    Start with the Be Seen. Get Screened. campaign and the Binary & Beyond video.

    Key Takeaways

    • Since 2023, the OBSP includes Two-Spirit, trans and nonbinary people who meet all eligibility criteria.
    • Transfeminine people need 5 or more consecutive years of feminizing hormone therapy, with no documentation required.
    • Transmasculine people who have not had top surgery to remove breast or chest tissue can be screened.
    • You can self-refer if you are 40 to 74. No doctor’s referral is needed.
    • Safe and affirming care means using your name and pronouns and not making assumptions.
    Helpful Links and Resources

    OBSP appointment booking line: 1-800-668-9304.

    Book Your Screening Mammogram in Toronto

    Ready to book, or have questions about your eligibility? Contact Annex Medical Imaging at (416) 531-1128, or call the OBSP Appointment Booking Line at 1-800-668-9304. Learn more about mammography (OBSP) at Annex Medical Imaging.

    Book Your Appointment

    This article is for general information only and is based on information published by Ontario Health (Cancer Care Ontario) as of September 2026. It is not medical advice. Screening recommendations can change, so please confirm current details with the Ontario Health links above and speak with your health care provider about your personal situation.

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