Eleven months after her moth­er suc­cumbs to can­cer, Jes­si­ca Queller has her­self test­ed for the BRCA ​“breast can­cer” gene muta­tion. The results come back pos­i­tive, putting her at a ter­ri­fy­ing­ly ele­vat­ed risk of devel­op­ing breast can­cer before the age of fifty and ovar­i­an can­cer in her life­time. Thir­ty-four, unat­tached, and yearn­ing for mar­riage and a fam­i­ly of her own, Queller faces an ago­niz­ing choice: a life­time of vig­i­lant screen­ings and a com­mit­ment to fight the dis­ease when caught, or its rad­i­cal alter­na­tive — a pro­phy­lac­tic dou­ble mas­tec­to­my that would effec­tive­ly restore life to her, even as it would chal­lenge her most close­ly held beliefs about body image, iden­ti­ty, and sexuality.

Superbly informed and armed with sur­pris­ing wit and style, Queller takes us on an odyssey from the fron­tiers of sci­ence to the pri­vate inte­ri­ors of a woman’s life. Pret­ty Is What Changes is an absorb­ing account of how she reach­es her coura­geous deci­sion and its phys­i­cal, emo­tion­al, and philo­soph­i­cal con­se­quences. It is also an incred­i­bly mov­ing sto­ry of what we inher­it from our par­ents and how we fash­ion it into the stuff of our own lives, of moth­ers and daugh­ters and sis­ters, and of the sis­ter­hood that forms when women are unit­ed in bat­tle against a com­mon enemy.

With­out flinch­ing, Jes­si­ca Queller answers a ques­tion we may one day face for our­selves: If genes can map our fates and their dark knowl­edge is offered to us, will we will­ing­ly trade inno­cence for the infor­ma­tion that could save our lives?