More than 1.5 million individuals in the United States identify as transgender. Transgender individuals have lower rates of health care utilization and higher rates of health care discrimination than cisgender patients. With a growing interest in providing comprehensive and compassionate care to the transgender community, there has been a concurrent increase in research on transgender health. However, lack of long-term data limits understanding the effects of hormone therapy on cancer risk factors in this population. This is particularly relevant for patients with hormonally mediated cancers and those at elevated risk from hereditary breast and ovarian cancer syndromes. Few cancer-screening and management guidelines currently exist for this population. Specific practices guided by the nuances of gender identity and gender-affirming care are essential to improve clinical management and to avoid further alienating a population that is already marginalized from the health care system. This commentary summarizes screening, management, and surveillance strategies devised for cisgender patients to offer corresponding recommendations tailored for transgender BRCA mutation carriers. In doing so, it highlights critical unanswered questions pertaining to the care of these patients. To address these questions, we must prioritize this population and adopt more inclusive frameworks in medicine and research.

中文翻译：

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为 BRCA 突变的跨性别患者制定乳腺癌和妇科癌症指南。

在美国，超过 150 万人认定为跨性别者。与顺性别患者相比，跨性别者的医疗保健利用率较低，医疗保健歧视率较高。随着对向跨性别社区提供全面和富有同情心的护理的兴趣日益浓厚，对跨性别健康的研究也在同步增加。然而，缺乏长期数据限制了对激素治疗对该人群癌症风险因素的影响的理解。这与激素介导的癌症患者以及遗传性乳腺癌和卵巢癌综合征风险升高的患者特别相关。目前针对这一人群的癌症筛查和管理指南很少。以性别认同和性别确认护理的细微差别为指导的具体做法对于改善临床管理和避免进一步疏远已经被医疗保健系统边缘化的人群至关重要。本评论总结了为顺性别患者设计的筛查、管理和监测策略，为跨性别 BRCA 突变携带者提供相应的建议。在这样做的过程中，它突出了与这些患者的护理有关的关键悬而未决的问题。为了解决这些问题，我们必须优先考虑这一人群，并在医学和研究中采用更具包容性的框架。为顺性别患者设计的监测策略，为跨性别 BRCA 突变携带者提供相应的建议。在这样做的过程中，它突出了与这些患者的护理有关的关键悬而未决的问题。为了解决这些问题，我们必须优先考虑这一人群，并在医学和研究中采用更具包容性的框架。为顺性别患者设计的监测策略，为跨性别 BRCA 突变携带者提供相应的建议。在这样做的过程中，它突出了与这些患者的护理有关的关键悬而未决的问题。为了解决这些问题，我们必须优先考虑这一人群，并在医学和研究中采用更具包容性的框架。