Gendered ageism among women undergoing mastectomy across two life stages: early adulthood and later life in Pakistan.

This qualitative study examines how gender and age shape breast cancer and mastectomy experiences among women in Pakistan. Using critical phenomenology and drawing on 12 in-depth interviews with women across two distinct age groups (early adulthood and later life), the study identifies three key themes regarding age- and gender-based inequalities that shape women's access to care. These inequalities are produced not only within the healthcare system but also through social and familial structures: [1] From Surveillance to Neglect: Age-Stratified Gatekeeping and Delayed Diagnosis, [2] Sacrificial femininity and internalized ageism, [3] Mastectomy as age-stratified embodied threat. Findings show that men act as financial and moral gatekeepers, limiting women's healthcare access, especially for young married women regarded as reproductive assets. Older women experience internalized ageism, viewing their bodies as less worthy of care. Although participants reported no age-based discrimination from healthcare providers, their accounts highlighted that gendered ageism operates strongly in pre-clinical family and community contexts, determining who is allowed to seek care and when. The study demonstrates that the most critical barriers to timely breast cancer treatment are not biomedical but social, cultural, and age gendered.