Turning lessons into action: Building an inclusive oncology care for transgender and gender-diverse people- Pavia & Milano framework.

Italy remains one of the lowest-ranking Western European countries in terms of rights and protections for transgender and gender-diverse (TGD) individuals, with serious consequences for equitable healthcare access. In response to these disparities, and thanks to the initiative and support of the advocacy group Salute Donna Odv Salute Uomo, a multidisciplinary team organised a series of public conferences in Pavia and Milan in 2024. These events brought together healthcare professionals, researchers, LGBTQIA+ organisations, and patient advocates to define practical strategies for more inclusive cancer care. The outcome is a shared framework presented in this manuscript, aimed at enhancing cultural competence and institutional responsiveness in oncology services for TGD patients.