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?

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