Science
I had to man up and get a mammogram
I show up for my appointment. A nurse asks me to get undressed from the waist up and put on a gown with the opening in front. For the life of me, I can’t figure out the correct way to tie the gown’s tassels. When I mention this feat of incompetence to the technologist inside the examining room, she tells me I could’ve just taken off my shirt. The nurse, she says, is “not used to male patients for mammograms.”
Thus began my first of what will be many regular mammogram screenings, screenings that, as a man, I never expected I’d need. I guess that nurse didn’t expect it either.
Let’s be clear, the breast cancer statistics for women are downright frightening: One in eight women will be diagnosed with breast cancer in their lifetime. For men, it’s only 1 in 726. Looking at those numbers, it’s obvious and even reasonable to understand why breast cancer is treated as a greater health threat for women. But much of the culture surrounding the disease seems ensconced in a gendered mold, including those pink awareness ribbons, pink merchandise, wigs, sisterhood and the general idea that men don’t have breasts in the first place, so why on earth would they have to worry about getting breast cancer?
In fact, some of us do have to worry. Breast cancer in men isn’t so rare that it hasn’t affected a few male celebrities, like KISS drummer Peter Criss, actor Richard Roundtree (star of “Shaft”), and famous by association, Beyoncé’s father, Mathew Knowles. Despite these high-profile diagnoses, the perception of breast cancer as a threat to men’s health has struggled to go mainstream.
Cheri Ambrose founded the Male Breast Cancer Global Alliance more than a decade ago after learning her friend’s husband received a breast cancer diagnosis. She looked on the internet for some information about it. “And to my surprise, there was nothing out there for men,” she tells me. “It was crickets.”
Dr. Aditya Bardia is a UCLA breast cancer oncologist who’s been in the field for 15 years and, in that time, has treated over 20 men. He says that men should watch out for lumps, pain, discomfort or nipple inversion. “If you have any of that, get it checked out with an ultrasound,” says Bardia. “Otherwise, if a man is only at average risk, then a mammogram is not necessary. But if he has BRCA and a family history, then a mammogram is recommended.”
The genetic risk factor
Those major risk indicators are what ushered me into my own cancer prevention safari. My mother was diagnosed with breast cancer in 2000, and my grandmother was diagnosed around a decade earlier. Add to this the fact that I have an Ashkenazi background, and I’m about as at-risk for breast cancer as any man can be.
To get a more accurate genetic indicator of cancer risk, my mother encouraged me to get my DNA tested for the BRCA1 gene mutation. Sure enough, I tested positive for BRCA1, and now my doctors and I are on high alert not just for breast cancer but also linked cancers like prostate and pancreatic cancer. (While it’s not public record if Richard Roundtree was BRCA1 positive, he survived his bout with breast cancer only to pass away decades later from pancreatic cancer, suggesting that he possibly carried the gene mutation.)
The mammogram experience
After testing positive for BRCA1, the geneticist I spoke with emphasized that my biggest new health concern would be prostate cancer, so I was a little bit surprised when my general practitioner gave me a referral for my first mammogram. I had no idea what to expect.
This is where I have to say that the scope of what I don’t know about women’s health is probably wider than I’d care to admit. My first exposure to the realities of what a mammogram procedure actually entails came from watching the pilot episode of “Girls5eva.” We first meet Sara Bareilles’ character while she’s in the middle of getting one, latched in somewhat medieval fashion to a mechanical vice that towers high over her head. I knew uncomfortable breast squeezing was involved; I just didn’t realize a machine did all the work. “Girls5eva,” if you’re unfamiliar, is not an old show, which means I’ve been unaware for most of my life how a mammogram actually works.
Still, as I headed to my appointment, I wondered, because I’m a man, how my own mammogram would differ from the one I saw Sara Bareilles getting on TV. It turns out, it wasn’t very different at all.
After getting rid of that gown, the technician positioned me chest-forward against her own mechanical vice. I was instructed to hold my breath while the machine gave me two tight squeezes on the left and two tight squeezes on the right, each squeeze lasting a few seconds. Yes, this was uncomfortable, but comparatively breezy as far as medical procedures go — simple, brief and noninvasive. My greatest irrational fear was that the machine might squeeze far tighter than necessary and I’d just be stuck there in immense pain until someone unplugged the cord. Of course, that did not happen. Actually, nothing else happened. I was in and out of the building in under 15 minutes.
The results? “No significant masses, calcifications or other findings are seen in either breast.” Good to know.
Navigating, and breaking down, the gender stigma
The mammogram itself was a piece of cake, yet I have to acknowledge that there were times on this journey of cancer risk self-discovery when I felt like a tourist prying into someone else’s health narrative. It wasn’t just the incident with the gown, or the geneticist assuring me that prostate cancer would be my major BRCA-related concern. While filling out a required questionnaire before scheduling my mammogram, I had to answer questions like, “Have you had an entire breast removed?” and “Does your bra size exceed 42DD?” I answered no, but if there had been an “N/A” option, I would’ve gone with that instead.
Bardia acknowledged the disconnect. “Because it’s relatively rare for men, guidelines and management for men are informed by the guidelines and management for women,” he tells me.
In a different context, some people could misinterpret these gendered hiccups as microaggressions. I don’t personally feel that way, but I’m trying to be fair, taking into account both the overwhelming impact breast cancer inflicts on women’s bodies in much greater numbers and the stigmatic pain points that men might be experiencing in their own breast cancer journeys.
Let’s face it: The stigma for men is real and it has consequences. “Even though it’s much more rare, the mortality rate for men is 19% higher for breast cancer than for women,” says Ambrose. “That’s because of lack of awareness and, I think, the stigma.”
A big part of that stigma, Ambrose believes, is the unfortunate proliferation of associating breast cancer with the color pink. “Pink is not a cure,” she says. “Sadly, it’s become a moneymaker for everyone during October, and not just the breast cancer organizations. People are making pink bagels, pink pens and even little pink ducks. People are making money off of it. And honestly, it’s not pink, it’s not fluffy, it’s not a happy disease. It’s breast cancer. And anyone going through it, male or female, or any gender, the pink ribbon is definitely stigmatizing.”
Even Mathew Knowles has publicly fiddled with the true name of his diagnosis, opting instead for the not-quite-accurate “chest cancer” and also “male breast cancer,” which falsely implies a masculine version of the disease.
But I can’t help but wonder if some of the stigma comes from other places as well. In parts of America, the idea of a man doing anything that can be perceived as feminine is politically charged. I also don’t need to point out that we live in a time of aggressive transphobia, which factors heavily in today’s divisive politics. For some political leaders, there’s nothing scarier than the possibility of sharing a public restroom with a woman who was born a man. Even drag queens can’t read books to children at the library without getting political blowback. Under this societal construct, how are men supposed to take seriously a disease that bears the name of a body part so associated with the opposite gender?
Then again, Peter Criss spent his entire career wearing makeup to look like a glam kitty cat, but if that didn’t stop him and his KISS bandmates from earning Kennedy Center Honors last year from our current president, then I don’t think it should stop anyone from heeding Criss’ advice to take charge of our own health.
I’m grateful to not feel bothered by this perceived stigma. I can understand it, but I can also roll with the feminized aspects. I guess if I’ve learned anything from this experience, it’s that everyone has breasts — just different kinds and all of them prone to disease. After all, what part of my body went into those mechanical vices during my mammogram?
In the days after my appointment, I saw a few friends I hadn’t seen in a while. When they asked what was new, I told them I’d just had my first mammogram. Some of them, men and women, thought I was kidding, but I assured them it was no joke.
I share this anecdote with Ambrose and she dives right in, “You helped spread awareness and break down the stigma,” she says, with some gratitude I wasn’t expecting. “That’s what each person who tells their story does.”
Science
What’s in a Name? For These Snails, Legal Protection
The sun had barely risen over the Pacific Ocean when a small motorboat carrying a team of Indigenous artisans and Mexican biologists dropped anchor in a rocky cove near Bahías de Huatulco.
Mauro Habacuc Avendaño Luis, one of the craftsmen, was the first to wade to shore. With an agility belying his age, he struck out over the boulders exposed by low tide. Crouching on a slippery ledge pounded by surf, he reached inside a crevice between two rocks. There, lodged among the urchins, was a snail with a knobby gray shell the size of a walnut. The sight might not dazzle tourists who travel here to see humpback whales, but for Mr. Avendaño, 85, these drab little mollusks represent a way of life.
Marine snails in the genus Plicopurpura are sacred to the Mixtec people of Pinotepa de Don Luis, a small town in southwestern Oaxaca. Men like Mr. Avendaño have been sustainably “milking” them for radiant purple dye for at least 1,500 years. The color suffuses Mixtec textiles and spiritual beliefs. Called tixinda, it symbolizes fertility and death, as well as mythic ties between lunar cycles, women and the sea.
The future of these traditions — and the fate of the snails — are uncertain. The mollusks are subject to intense poaching pressure despite federal protections intended to protect them. Fishermen break them (and the other mollusks they eat) open and sell the meat to local restaurants. Tourists who comb the beaches pluck snails off the rocks and toss them aside.
A severe earthquake in 2020 thrust formerly submerged parts of their habitat above sea level, fatally tossing other mollusks in the snail’s food web to the air, and making once inaccessible places more available to poachers.
Decades ago, dense clusters of snails the size of doorknobs were easy to find, according to Mr. Avendaño. “Full of snails,” he said, sweeping a calloused, violet-stained hand across the coves. Now, most of the snails he finds are small, just over an inch, and yield only a few milliliters of dye.
Science
Video: This Parrot Has No Beak, But Is at the Top of the Pecking Order
new video loaded: This Parrot Has No Beak, But Is at the Top of the Pecking Order
By Meg Felling and Carl Zimmer
April 20, 2026
Science
Contributor: Focus on the real causes of the shortage in hormone treatments
For months now, menopausal women across the U.S. have been unable to fill prescriptions for the estradiol patch, a long-established and safe hormone treatment. The news media has whipped up a frenzy over this scarcity, warning of a long-lasting nationwide shortage. The problem is real — but the explanations in the media coverage miss the mark. Real solutions depend on an accurate understanding of the causes.
Reporters, pharmaceutical companies and even some doctors have blamed women for causing the shortage, saying they were inspired by a “menopause moment” that has driven unprecedented demand. Such framing does a dangerous disservice to essential health advocacy.
In this narrative, there has been unprecedented demand, and it is explained in part by the Food and Drug Administration’s recent removal of the “black-box warning” from estradiol patches’ packaging. That inaccurate (and, quite frankly, terrifying) label had been required since a 2002 announcement overstated the link between certain menopause hormone treatments and breast cancer. Right-sizing and rewording the warning was long overdue. But the trouble with this narrative is that even after the black-box warning was removed, there has not been unprecedented demand.
Around 40% of menopausal women were prescribed hormone treatments in some form before the 2002 announcement. Use plummeted in its aftermath, dipping to less than 5% in 2020 and just 1.8% in 2024. According to the most recent data, the number has now settled back at the 5% mark. Unprecedented? Hardly. Modest at best.
Nor is estradiol a new or complex drug; the patch formulation has existed for decades, and generic versions are widely manufactured. There is no exotic ingredient, no rare supply chain dependency, no fluke that explains why women are suddenly being told their pharmacy is out of stock month after month.
The story is far more an indictment of the broken insurance industry: market concentration, perverse incentives and the consequences of allowing insurance companies to own the pharmacy benefit managers that effectively control drug access for the majority of users. Three companies — CVS Caremark, Express Scripts and OptumRx — manage 79% of all prescription drug claims in the United States. Those companies are wholly owned subsidiaries of three insurance behemoths: CVS Health, Cigna and UnitedHealth Group, respectively. This means that the same corporation that sells you your insurance plan also decides which drugs get covered, at what price, and whether your pharmacy can stock them. This is called vertical integration. In another era, we might have called it a cartel. The resulting problems are not unique to hormone treatments; they have affected widely used medications including blood thinners, inhalers and antibiotics. When a low-cost generic such as estradiol — a medication with no blockbuster profit margins and no patent protection — runs into friction in this system, the friction is not random. It is structural. Every decision in that chain is filtered through the same corporate profit motive. And when the drug in question is an off-patent estradiol patch that has negligible profit margins because of generic competition but requires logistical investment to keep consistently in stock? The math on “how much does this company care about ensuring access” is not complicated.
Unfortunately, there is little financial incentive to ensure smooth, consistent access. There is, however, significant financial incentive to steer patients toward branded alternatives, or simply to let supply tighten — because the companies aren’t losing much profit if sales of that product dwindle. This is not a conspiracy theory: The Federal Trade Commission noted this dynamic in a report that documented how pharmacy benefit managers’ practices inflate costs, reduce competition and harm patient access, particularly for independent pharmacies and for generic drugs.
Any claim that the estradiol patch shortage is meaningfully caused by more women now demanding hormone treatments is a distraction. It is also misogyny, pure and simple, to imply that the solution to the shortage is for women’s health advocates to dial it down and for women to temper their expectations. The scarcity of estradiol patches is the outcome of a broken system refusing to provide adequate supply.
Meanwhile, there are a few strategies to cope.
- Ask your prescriber about alternatives. Estradiol is available in multiple formulations, including gel, spray, cream, oral tablet, vaginal ring and weekly transdermal patch, which is a different product from the twice-weekly patch and may be more consistently available depending on manufacturer and region.
- Consider an online pharmacy. Many are doing a good job locating and filling these prescriptions from outside the pharmacy benefit manager system.
- Call ahead. Patch shortages are inconsistent across regions and distributors. A call to pharmacies in your area, or a broader geographic radius if you’re able, can locate stock that your regular pharmacy doesn’t have.
- Consider a compounding pharmacy. These sources can sometimes meet needs when commercially manufactured products are inaccessible. The hormones used are the same FDA-regulated bulk ingredients.
Beyond those Band-Aid solutions, more Americans need to fight for systemic change. The FTC report exists because Congress asked for it and committed to legislation that will address at least some of the problems. The FDA took action to change the labeling on estrogen in the face of citizen and medical experts’ pressure; it should do more now to demand transparency from patch manufacturers.
Most importantly, it is on all of us to call out the cracks in the current system. Instead of repeating “there’s a patch shortage” or a “surge in demand,” say that a shockingly small minority of menopausal women still even get hormonal treatments prescribed at all, and three drug companies control the vast majority of claims in this country. Those are the real problems that need real solutions.
Jennifer Weiss-Wolf, the executive director of the Birnbaum Women’s Leadership Center at New York University School of Law, is the author of the forthcoming book “When in Menopause: A User’s Manual & Citizen’s Guide.” Suzanne Gilberg, an obstetrician and gynecologist in Los Angeles, is the author of “Menopause Bootcamp.”
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