Born and raised female, Casey Sexton worked hard to identify as male.
He changed his name. He took testosterone treatments. He saved up for surgery to remove his breasts. When he hit the jackpot at Dejope Casino in 2010, he paid for the $6,500 operation, Wisconsin State Journal reported .
Then, last year, as Sexton was finally living as a transgender man, he got a diagnosis perhaps feared most by women: breast cancer.
“I thought, ‘You’ve got to be kidding me,'” said Sexton, 54, of Madison. “Out of all the things I could get, I get that?'”
His ordeal highlights some of the challenges transgender people and their doctors face when it comes to health care — from a hesitancy to seek care and denials of insurance coverage to concern over how to safely balance hormones in the body.
Sexton’s praise for the care he received at UW Health underscores its designation as one of 303 LGBTQ care-affirming facilities in the 2017 Healthcare Equality Index by the Human Rights Campaign.
“They treated me with respect,” he said. “They welcomed me.”
Having most of his breast tissue removed in his transition to a male identity decreased Sexton’s risk for breast cancer but didn’t eliminate it, said Dr. Mark Burkard, his oncologist at UW Health. His testosterone treatments may have lowered his risk in one way but increased it in another, Burkard said.
Sexton didn’t have his ovaries removed, as some transgender men do, which would have further lowered his risk, Burkard said.
Sexton’s breast cancer, diagnosed in April 2016, was relatively aggressive, having spread to many lymph nodes. After eight rounds of chemotherapy, three surgeries and more than a month of radiation, he is recovering.
He’s on a drug to prevent a recurrence of breast cancer, which has given him menopausal hot flashes — something his testosterone treatments had blocked.
Breast cancer in men is not unheard of. Of the 255,000 people expected to be diagnosed with breast cancer this year in the United States, nearly 2,500 of them will be people born male, according to the American Cancer Society.
It’s not clear how often transgender men, who are born female, get breast cancer, but their risk is likely lower than for women, Burkard said.
“Casey is particularly unlucky because his risk should have gone down and yet he developed breast cancer,” he said.
Sexton, who grew up in Middleton before the concept of transgender people became mainstream, said he didn’t feel female even as a young child.
“I always felt like I was a boy,”…