Transgender and nonbinary (TG/NB) individuals may engage in cancer genetic counseling for a variety of reasons, including to assess risk and obtain recommendations for cancer prevention and early detection. Barriers to TG/NB individuals engaging in cancer genetic counseling include concerns of feeling marginalized or not understood. The results of testing may affect decisions about gender-affirming care, including surgical decisions and hormone use. Nurses can provide anticipatory guidance and psychosocial support and work toward changes that make care more inclusive.