I am a certified genetic counselor specializing in breast and ovarian cancer risk evaluation. For patients who have never had a cancer diagnosis, cancer risk evaluation can help patients better understand how their family health history, genetics, surgeries, medications, and personal health risk factors influence the risk of developing cancer. When the risk of cancer is better understood, decisions can then be made regarding managing cancer risks. For some patients, learning of a significantly increased risk of cancer may help obtain insurance authorization for gender affirming care. If a risk is elevated, no care is denied (e.g. hormones will not be discontinued), but discussion of how the risk is influenced will be held to allow for informed decision making. For patients who have had a cancer diagnosis, genetic counseling and testing can help better inform the causes of the cancer and risks for other types of cancer moving forward.