{
  "abstract": "Genetic counselling in transgender patients with cancer predisposition requires careful navigation of psychological motivations, gender identity, and medical risk. We present three patients: two 18-year-old trans males at risk of familial BRCA2 and PALB2 variants, and a 20-year-old trans female with NF1. Both trans male patients expressed a desire to carry familial pathogenic variants to obtain earlier top surgery, minimising cancer risk to attain earlier gender affirming treatment. The trans female with NF1 required counselling around risk of hormone replacement therapy(HRT)-associated breast cancer and screening pathways, with limited data suggesting screening consideration after five years of HRT. Trans females with high-risk cancer predisposition may consider risk-reducing mastectomy with reconstruction to avoid HRT-associated breast cancer risk. These cases illustrate how inherited cancer risk in transgender patients intersects with identity development and evolving medical pathways. The higher rates of mental health issues and suicide in transgender populations highlights the need for careful counselling. Informed consent must address not only clinical implications but also psychological drivers, including the symbolic value assigned to genetic results. Multidisciplinary input, staged decision-making, and careful genetic counselling approaches are essential to ensure patients are supported through decisions that affect both their cancer risk and their sense of self.",
  "authors": [
    {
      "affiliations": [
        "University Hospitals of Leicester NHS Trust, Leicester"
      ],
      "name": "Titiksha Masand"
    },
    {
      "affiliations": [
        "University Hospitals of Leicester NHS Trust, Leicester"
      ],
      "name": "B Kaemba"
    },
    {
      "affiliations": [
        "University Hospitals of Leicester NHS Trust, Leicester"
      ],
      "name": "J Barwell"
    }
  ],
  "title": "P14 Psychological complexity in genetic counselling for cancer risk in transgender patients",
  "uid": "75d0ce2c-36fb-5829-9942-a83de77dda1c"
}