{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:34:18Z","timestamp":1790800458467,"version":"4.1.0"},"reference-count":53,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T00:00:00Z","timestamp":1686096000000},"content-version":"vor","delay-in-days":37,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hastings Center Report"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Gender\u2010affirming 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 \u201cgender\u2010affirming care\u201d that distinguish it from previous therapeutic models, such as \u201csex reassignment.\u201d Next, we sketch two historical cases\u2014reconstructive mammoplasty and testicular implants\u2014to show how cisgender patients offered justifications grounded in authenticity and gender affirmation that closely mirror rationales supporting gender\u2010affirming 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 \u201ctrans exceptionalism\u201d that produces demonstrable harm.<\/jats:italic>\n                    .\n                  <\/jats:p>","DOI":"10.1002\/hast.1486","type":"journal-article","created":{"date-parts":[[2023,6,8]],"date-time":"2023-06-08T00:29:41Z","timestamp":1686184181000},"page":"15-24","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Gender\u2010Affirming Care for Cisgender People"],"prefix":"10.1002","volume":"53","author":[{"given":"Theodore E.","family":"Schall","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob D.","family":"Moses","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,7]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11673-012-9377-8"},{"key":"e_1_2_12_3_1","unstructured":"Statements by leading medical groups are available via Transgender Legal Defense & Education Fund \u201cMedical Organization Statements \u201dhttps:\/\/transhealthproject.org\/resources\/medical-organization-statements\/ which we accessed June 8 2022."},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocab136"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.7551\/mitpress\/6352.001.0001"},{"key":"e_1_2_12_6_1","first-page":"161","volume-title":"The Science Studies Reader","author":"Hacking I.","year":"1999"},{"key":"e_1_2_12_7_1","unstructured":"We wish to thank an anonymous reviewer for this suggestion."},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.18574\/nyu\/9781479836291.001.0001"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.5749\/j.ctv75d87g"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0094-1298(20)31424-3"},{"key":"e_1_2_12_11_1","unstructured":"D.Denny \u201cAEGIS and the Renaissance Education Association: An Annotated Bibliography of Gender Dysphoria \u201d1992 AEGIS Documents II 1991-1995 box 7 folder 11 National Transgender Library Collection Gay Lesbian Bisexual and Transgender Historical Society San Francisco CA."},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/15538600802502035"},{"key":"e_1_2_12_13_1","unstructured":"This section draws onJ. D.Moses \u201cMedical Regret without Remorse: A Moral History of Harm Responsibility and Emotion in American Surgery since 1945\u201d (PhD diss. Harvard University 2020)."},{"key":"e_1_2_12_14_1","volume-title":"The Breast Cancer Wars: Hope, Fear, and the Pursuit of a Cure in Twentieth-Century America","author":"Lerner B. H.","year":"2001"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1952.02930100051011"},{"key":"e_1_2_12_16_1","unstructured":"Lerner Breast Cancer Wars 189\u201395."},{"key":"e_1_2_12_17_1","volume-title":"Diseases of the Breast","author":"Haagensen C. D.","year":"1971"},{"key":"e_1_2_12_18_1","first-page":"255","volume-title":"Venus Envy: A History of Cosmetic Surgery","author":"Haiken E.","year":"1997"},{"key":"e_1_2_12_19_1","first-page":"3","volume-title":"I Am Whole Again: The Case for Breast Reconstruction after Mastectomy","author":"Zalon J.","year":"1978"},{"key":"e_1_2_12_20_1","volume-title":"How Cancer Crossed the Color Line","author":"Wailoo K.","year":"2012"},{"key":"e_1_2_12_21_1","unstructured":"G.CantandT.Cohen \u201cThe Operation Women Never Dreamed Would Be Possible \u201dGood Housekeeping September1975 p.56; D. Wedemeyer \u201cAfter Mastectomy: The Options for Breast Reconstruction \u201dNew York Times December 9 1976."},{"key":"e_1_2_12_22_1","first-page":"11","volume-title":"Breast Reconstruction Following Mastectomy for Carcinoma","author":"Cocke W. M.","year":"1977"},{"key":"e_1_2_12_23_1","unstructured":"R. K.Snyderman \u201cReconstruction of the Breast after Surgery for Malignancy\u201d in Goldwyn Plastic and Reconstructive Surgery 67."},{"key":"e_1_2_12_24_1","unstructured":"Cocke Breast Reconstruction 27."},{"issue":"3","key":"e_1_2_12_25_1","first-page":"34","article-title":"Authenticity and Ambivalence: Toward Understanding the Enhancement Debate","volume":"35","author":"Gifford S.","year":"2005","journal-title":"Hastings Center Report"},{"key":"e_1_2_12_26_1","unstructured":"American Medical Association \u201cResolution No. 174: Refusal of Third-Party Payors to Pay for Re-constructive Surgery of the Breast to Correct Deformities \u201d inProceedings of the House of Delegates Chicago 128th annual convention (Chicago 1979)."},{"key":"e_1_2_12_27_1","volume-title":"Women\u2019s Health and Cancer Rights Act of 1997: Hearing Before the Subcommittee on Health Care of the Committee on Finance, United States Senate, One Hundred Fifth Congress, First Session, on S. 249, November 5, 1997","author":"United States Congress","year":"1997"},{"key":"e_1_2_12_28_1","volume-title":"Stigma: Notes on the Management of Spoiled Identity","author":"Goffman E.","year":"2009"},{"key":"e_1_2_12_29_1","first-page":"60","volume-title":"The Cancer Journals","author":"Lorde A.","year":"1997"},{"key":"e_1_2_12_30_1","unstructured":"Lorde Cancer Journals 62."},{"key":"e_1_2_12_31_1","unstructured":"Lorde Cancer Journals 79."},{"key":"e_1_2_12_32_1","unstructured":"J.Zinoman \u201cGoing Topless Tig Notaro Takes Over Town Hall \u201dNew York Times November 7 2014. On surgeons expressing reluctance about patients\u2019 choice to forgo reconstruction for an aesthetic flap procedure see F. Kritz \u201cSome Women Want Flat Chests after Mastectomy. Some Surgeons Don\u2019t Go Along \u201dWashington Post June 11 2022."},{"key":"e_1_2_12_33_1","volume-title":"Shaping Our Selves: On Technology, Flourishing and a Habit of Thinking","author":"Parens E.","year":"2015"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(41)90676-1"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2044-8341.1978.tb02450.x"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11673-018-9881-6"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/lasr.12575"},{"key":"e_1_2_12_38_1","first-page":"56","volume-title":"Dubious Equalities and Embodied Differences: Cultural Studies on Cosmetic Surgery","author":"Davis K.","year":"2003"},{"key":"e_1_2_12_39_1","first-page":"225","volume-title":"Cosmetic Surgery: A Feminist Primer","author":"Naugler D.","year":"2016"},{"key":"e_1_2_12_40_1","first-page":"xxiii","volume-title":"Cosmetic Procedures: Ethical Issues","author":"Archard D.","year":"2017"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1080\/15265161.2018.1531162"},{"key":"e_1_2_12_42_1","first-page":"162","volume-title":"Enhancing Human Traits: Ethical and Social Implications","author":"Little M. O.","year":"1998"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.3138\/ijfab.13.1.04"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1057\/s41271-021-00281-2"},{"key":"e_1_2_12_45_1","volume-title":"Plastic Surgery Statistics Report: ASPC National Clearinghouse of Plastic Surgery Procedural Statistics","author":"American Society of Plastic Surgeons","year":"2021"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2016.303578"},{"key":"e_1_2_12_47_1","first-page":"4193","article-title":"Writing in the Margins: Mainstream News Media Representations of Transgenderism","volume":"10","author":"Keiles J. L.","year":"2016","journal-title":"International Journal of Communication"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-015-3529-6"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2021.0952"},{"key":"e_1_2_12_50_1","volume-title":"Understanding the Well-Being of LGBTQI+ Populations","author":"National Academies of Sciences, Engineering, and Medicine","year":"2020"},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003467"},{"key":"e_1_2_12_52_1","article-title":"Gender Affirmation: A Framework for Conceptualizing Risk Behavior among Transgender Women of Color","volume":"68","author":"Sevelius J. M.","journal-title":"Sex Roles"},{"issue":"4","key":"e_1_2_12_53_1","first-page":"270","article-title":"Five Faces of Oppression","volume":"19","author":"Young I. M.","year":"1988","journal-title":"Philosophical Forum"},{"key":"e_1_2_12_54_1","unstructured":"For example the fact that cis breast augmentation isn\u2019t covered by insurance does not justify refusing to pay for trans breast augmentation."}],"container-title":["Hastings Center Report"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hast.1486","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T07:39:25Z","timestamp":1692517165000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hast.1486"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5]]},"references-count":53,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,5]]}},"alternative-id":["10.1002\/hast.1486"],"URL":"https:\/\/doi.org\/10.1002\/hast.1486","archive":["Portico"],"relation":{},"ISSN":["0093-0334","1552-146X"],"issn-type":[{"value":"0093-0334","type":"print"},{"value":"1552-146X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5]]},"assertion":[{"value":"2023-06-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}