Description:
In this vignette, a patient expresses her concern that her estrogen treatments, combined with her family history of breast cancer, may increase her chances of developing breast cancer. This vignette highlighted various aspects of the health of LGBT and gender nonconforming populations and is designed to give learners the opportunity to analyze clinician-patient communication strategies. 
Learning Objectives:
By the completion of this vignette/vignette series, the learner will be able to:

Identify three strategies to engage LGBT patients in the clinical environment.
Discuss methods to sensitively approach history taking and physical examination with LGBT patients.
Describe three verbal or non-verbal strategies to identify sexual orientation and gender identity in the clinical environment.
Describe three unique risk factors for health conditions related to sexual orientation and gender identity.
Outline three techniques for tailoring health promotion strategies to the needs of LGBT patients.

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 1. What questions did the clinician ask to assess this patient’s risk for developing breast cancer? Are there any additional questions you would have asked? should be a minimum of 250 words with three references in correct APA format.
2. How effectively did the clinician address the patient’s concerns about estrogen risk? What do you think about the safety of estrogen risk? What do you think about the safety estrogen prescription in a transgender patient at high risk for breast cancer? should be a minimum of 150 words with two references in correct APA format.