Transgender people are a growing population with specific healthcare needs, barriers to care, and disease risk factors. Cultural competencies for working with transgender people in healthcare settings are essential to reduce barriers to care and combat the associated health disparities. Genetic counselors support their patients to understand and manage medically and personally complex life events and decisions. A genetic counselor caring for a transgender patient or a patient with a transgender relative will therefore require specific cultural competencies and medical knowledge that may not have been covered in their training. Transgender health is also a relatively young field in which new insights may quickly become fundamental. The present paper therefore provides an overview of current best practices for culturally sensitive working with transgender patients, and an introduction to the additional considerations for assessment of disease risk in transgender people. Guidance on how to ensure communication with patients and other stakeholders is inclusive and affirming of transgender identities, is offered. Medical interventions used for gender transitions are described, and their (potential) effects on cancer and cardiovascular disease risk are discussed. Furthermore, the effects of sociocultural risk factors such as minority stress are outlined. In sum, we invite the reader to consider the specific biological, psychological, and social context of the consultation. Finally, we explore culturally competent approaches to pedigree charting and physical examinations with transgender people and provide recommendations for practice.

中文翻译：

---

跨性别患者遗传咨询的考虑因素：文化能力和改变的疾病风险概况

跨性别者是一个不断增长的人群，具有特定的医疗保健需求、护理障碍和疾病风险因素。在医疗保健环境中与跨性别人士合作的文化能力对于减少护理障碍和消除相关的健康差异至关重要。遗传咨询师支持他们的患者理解和管理医学和个人复杂的生活事件和决定。因此，照顾跨性别患者或有跨性别亲属的患者的遗传咨询师将需要特定的文化能力和医学知识，而这些能力和医学知识可能未包括在他们的培训中。跨性别健康也是一个相对年轻的领域，新的见解可能很快成为基础。因此，本文概述了当前与跨性别患者进行文化敏感工作的最佳实践，并介绍了评估跨性别人群疾病风险的其他注意事项。提供了关于如何确保与患者和其他利益相关者的沟通具有包容性和确认跨性别身份的指南。描述了用于性别转变的医疗干预措施，并讨论了它们对癌症和心血管疾病风险的（潜在）影响。此外，还概述了社会文化风险因素（如少数族裔压力）的影响。总之，我们邀请读者考虑咨询的具体生物学、心理和社会背景。最后，