At 25 years old, I found out that my breasts could be a ticking time bomb.

One of my family members tested positive for the BRCA1 genetic mutation, which is associated with an increased risk of breast cancer. They sounded the alarm for all of the women in our family to get tested as soon as possible. I took the test and a month later got the confirmation: I was positive, too, meaning I had up to a 72% chance of developing breast cancer at some point in my lifetime.

Up until then, I still thought of illness and death as something other people had to deal with. I was young and blessedly healthy. The BRCA1 diagnosis shoved my mortality into the present and meant that I would have painful decisions to make.

I could choose to do nothing and hope for the best, but the odds were clearly against me. I could opt to get frequent mammograms, sonograms and breast MRIs to try to catch the cancer early if it emerged. But for the best possible protection, I’d need to have prophylactic surgery.

For a long time, I couldn’t bring myself to do anything at all. Even as more family members got tested and found out they were carriers, I avoided the topic at family gatherings. It wasn’t until two years after my diagnosis that I felt strong enough to reach out to a genetic counselor, who referred me to a surgical oncologist.

Minutes into my first meeting with the surgeon, she told me matter-of-factly that the safest course of action would be to have a double mastectomy, ideally by the age of 35. I was stunned by the short timeline, and everything in me rejected the idea of surgery. In the first months after that appointment, I remember thinking more than once that I’d rather die than lose my breasts.

But at 33, I welcomed my son into the world, and I found that the transformations of pregnancy and breastfeeding made the prospect of further physical change seem less daunting. Above all, becoming a mother made staying alive a crystal clear priority. By opting to have the surgery, I’d bring my breast cancer risk to less than 1%. In my surgical oncologist’s career, she had never seen a case of breast cancer in any of the hundreds of patients for whom she’d performed the same surgery.

After one more clear mammogram in April, I decided I didn’t want to continue living under the threat of breast cancer and I consulted a plastic surgeon.

The first thing the plastic surgeon asked me wasn’t, “What do you want to do?” It was, “How are you feeling”?

He opened the door for me to talk about everything I’d been carrying for so long: the fear, sadness, anxiety and the anticipation of grief and loss post-surgery. He and his nurse practitioner addressed my emotions before they spoke a word about my body or how they might operate on it. In an era of harried 15-minute medical encounters, that unrushed hourlong conversation ― with time left open for silence, tears and questions ― felt like a little miracle.

When the conversation did shift to my surgical options, we discussed whether I wanted to elect to have breast reconstruction surgery, or forego implants and “go flat,” as they call it. I was surprised to discover how intensely I felt.

Breasts are not required to be a woman, but my breasts are an integral part of how I understand and experience my own gender identity. Not only did I associate them with beauty, but they were the most embodied manifestation of my early motherhood, as I bonded with my son through breastfeeding. I couldn’t imagine feeling truly comfortable and confident in my body without them.

I am privileged to have always felt at home in the gender I was assigned at birth, but I didn’t know how viscerally attached I was to my gender identity, and how deeply uncomfortable I would feel if my body didn’t align with my perception of that identity. That’s how it dawned on me that the term “gender-affirming care” applied to me as a cis woman.

Gender-affirming care usually refers to health care services that affirm a person’s gender identity when it conflicts with the gender they were assigned at birth. But cis people also routinely benefit from medical interventions to affirm their gender identity.

The number of annual breast augmentations in America alone tops 300,000. And that’s just one of the countless aesthetic surgeries and procedures designed to help cis women enhance or create “feminine” attributes. Some cis men get hair transplants, take steroids to help them become more muscular, or take Viagra to maintain their “masculine” virility. Trans people aren’t alone in seeking medical care that affirms their gender, but they are treated differently when it comes to obtaining it.

Implants do nothing to reduce cancer risk, and in fact carry potential dangers of their own in the form of infections and other complications. Yet breast reconstruction for cis women is considered a “medical necessity,” allowing insurance companies to cover a procedure worth tens of thousands of dollars. If the litmus test of medical necessity was only the prevention of illness and death, then implants wouldn’t qualify. But of course, living isn’t just about not dying.

When my surgeries were submitted for pre-authorization, they sailed through. Approval letters simply arrived at my house ― I never had a single conversation where I was expected to justify my decision, and I certainly never had to face the trauma of being denied.

Trans people seeking gender-affirming surgeries can face huge institutional hurdles in accessing care. Some insurance companies have accepted the clear science that shows the health benefits of gender-affirming surgeries, but not all. Even when insurers do ostensibly cover gender-affirming care, there can be byzantine red tape or denials that have to be appealed. Sometimes third parties like psychologists have to validate that a trans person is of sound mind and should be given the care they want.

All of this is happening under the cloud of antagonism towards gender-affirming health care for trans Americans. Across the country, state legislators are actively stripping people of their rights to make their own medical decisions, callously putting lives at risk out of their own fear, ignorance and bigotry. At the federal level, the House of Representatives just passed a military spending bill that included provisions to explicitly deny service members and their families gender-affirming surgeries. Just last week, Louisiana’s legislature voted to keep anyone under the age of 18 from receiving gender-affirming surgeries, puberty-blocking medications or hormone treatments.

These inequities can have profound consequences for trans people’s health. Research consistently shows that rates of depression, anxiety and suicidality are higher among trans people, and that gender-affirming surgeries show remarkable success in improving the health outcomes of those who get them. The notion that my mastectomy and elective breast implants are lauded as “brave” while trans people seeking gender-affirming care are questioned, shamed and even criminalized is not only illogical, it’s immoral.

I’m not happy about undergoing surgery. I’m scared of the pain and discomfort, and I’m sad to say goodbye to a version of my body that I have loved and been loved in. But I know that my community is going to show up for me and help me get through it, something that should be true for everyone.

Back in April, when I told my oncologist I was ready to move ahead after almost 10 years in her care, she broke out in a huge, beaming smile. A little confused, I asked her what she was so happy about.

“Now I won’t have to worry about you!” she responded. She truly valued my life and was joyful she’d have a part in preserving it. All patients, of all gender identities, deserve to know what that feels like.

Do you have a compelling personal story you’d like to see published on HuffPost? Find out what we’re looking for here and send us a pitch.