Date of Award

Spring 2021

Document Type

Open Access Thesis


Genetic Counseling

First Advisor

Diane Koeller


Most cancers are sporadic, but 5-10% of all cancer is hereditary, or caused by a heritable genetic mutation. A patient’s medical history, family history, genetic test results, intact organs (e.g., ovaries) at an increased risk for developing cancer, and the availability and accessibility of interventions are used to make recommendations for cancer-risk management. In addition to basic medical care, transgender patients have healthcare needs that differ from those of cisgender patients such as expert care related to using hormones or having gender-affirming surgery, as well as unique mental health concerns. Transgender individuals may also experience a greater number of barriers to accessing care than cisgender individuals.

The purpose of this study was to explore the motivations and needs of transgender individuals who may seek cancer genetic counseling. We aimed to determine where current practices could be improved to increase comfortability and inclusivity of transgender patients. Eighty-seven transgender individuals participated in an online questionnaire that asked about their personal perspectives on comfort and preferences regarding current genetic counseling practices.

Most participants reported that they would feel comfortable sharing their pronouns, hormone therapies, and surgical history on an intake form before their genetic counseling appointment. The results suggested that comfort levels between the different current practices regarding pedigree nomenclature had no statistical differences, although most participants would not be comfortable being represented as their sex assigned at birth on a pedigree. When assessing motivations, evidence demonstrated that most participants would want to discuss how hormone and surgical therapies could impact personal cancer risk. These findings reinforce recommendations from existing literature regarding the adaptation and evolution of current practices to meet the needs of transgender patients while highlighting the need for standardized training in order to provide comprehensive, inclusive care for all patients, regardless of gender identity.

Included in

Genetics Commons