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.. (shrink)