Transgender and gender-diverse (TGD) individuals experience significant health care disparities across the oncology spectrum of care. Systemic barriers, past harmful health care experiences, the sociopolitical climate and other impediments to accessing health care combine to influence these disparities. TGD individuals undergoing gender-affirming mastectomy ("top surgery") face unique challenges related to breast cancer risk assessment and screening. Currently, a patient can undergo top surgery without understanding how that procedure will affect their lifelong breast and chest cancer risk—and, critically, without knowing whether they carry predispositions that could fundamentally reshape their surgical decisions.
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