Complex Medical Decision-Making for a Trans-Feminine Youth with a BRCA1 Mutation.

The risks of being a cisgender BRCA1/BRCA2 mutation carrier (BRCA1+/BRCA2+) are well documented, and recommendations to mitigate cancer risk in BRCA+ cisgender women are clear. However, there is a lack of guidance for BRCA+ transgender women. In this article, we discuss the case of a trans-feminine youth who presented at a gender clinic for medications for pubertal suppression and was identified as a BRCA1 mutation carrier. We explore principles of bioethics to consider when the potential risks of treatment are unclear. We discuss the unknown risks for a trans-feminine youth with a BRCA1 mutation and the potential benefits and risks of treatment options.