Every October, public service announcements featuring breast cancer survivors and their families flood TV and social media to raise awareness about the illness. Most of the content features cisgender women telling stories about survival and perseverance through the diseases harrowing effects. But messaging for Breast Cancer Awareness Month typically omits or forgets the transgender community even though we are actually high-risk.

For many trans people of every gender identity, the chest or breasts are a major part of the transition. So why isnt the treatment of gender dysphoria paired with outreach and screening for breast cancer? This oversight sends what feels like a hurtful message about the value of our lives.

As insignificant as PSAs seem to some, theyve proved both influential and helpful in our countrys past. Dating back to the Civil War, government interests have leaned on public outreach. Some of the earliest PSAs aimed to sell war bonds and sway public perceptions about controversial topics. PSAs eventually evolved into ads by nonprofits about various subjects, including fire safety , drug prevention and, more recently, COVID-19 response .

As a transgender journalist who scans the news every day, Im subjected to hundreds of ads targeting my community. But Ive never seen a breast cancer PSA that spoke to me. After an extensive search, most information about breast cancer in trans people was produced by vloggers on YouTube and small nonprofits in major cities .

Occasionally, some of the larger nonprofits write blog posts about studies involving trans people or add informational pages to their sites. A video produced by Breastcancer.org was one of the few sources discussing chest cancer for trans men. Its something, sure. But the amount of prevention outreach is far from enough to match the risk.

Even when breast cancer PSAs target the LGBTQ community, transgender people are rarely mentioned. Transmasculine people and the risk of chest cancer after top surgery are discussed even less. Breast and chest cancers are a threat to the trans community because many trans people will never know they are at risk.

As the battle for gender-inclusive health care rages on, it needs to expand beyond hormones and gender-affirming surgeries. These are crucial and lifesaving treatments, of course, and need to be protected from harmful legislation but theres more to our well-being and longevity.

A 2019 study one of the first of its kind by the VU University Medical Centre in Amsterdam indicated that transgender women are 47 times more likely to develop breast cancer than cisgender men. Researchers found that feminizing hormones were likely the catalyst, since cisgender women taking similar hormone treatments for menopause experienced comparable levels of risk. Transgender men also showed increased risk compared with cisgender men but less risk than cisgender women.

Although the study only included participants from the Netherlands, it suggested a higher risk of breast cancer among transgender people globally.