Gender‐Affirming Care for Cisgender People

TLDR

Gender‑affirming care is typically discussed only in the context of transgender medicine. The authors aim to trace historical shifts in transgender medicine to identify core components of gender‑affirming care that distinguish it from earlier models. They trace historical shifts, illustrate the cases of reconstructive mammoplasty and testicular implants, and examine objections to their analogy. The article finds that gender‑affirming care is largely provided to cisgender patients, reveals policy disparities between cis and trans patients, and attributes these disparities to trans exceptionalism that causes harm.

Abstract

Gender-affirming care is almost exclusively discussed in connection with transgender medicine. However, this article argues that such care predominates among cisgender patients, people whose gender identity matches their sex assigned at birth. To advance this argument, we trace historical shifts in transgender medicine since the 1950s to identify central components of "gender-affirming care" that distinguish it from previous therapeutic models, such as "sex reassignment." Next, we sketch two historical cases-reconstructive mammoplasty and testicular implants-to show how cisgender patients offered justifications grounded in authenticity and gender affirmation that closely mirror rationales supporting gender-affirming care for transgender people. The comparison exposes significant disparities in contemporary health policy regarding care for cis and trans patients. We consider two possible objections to the analogy we draw, but ultimately argue that these disparities are rooted in "trans exceptionalism" that produces demonstrable harm..