Of course, in order to have the issue and be queer/trans, more mutations than these are needed, however, in terms of mental health or other physical health issues that will respond to treatment, these are the relevant genes:

https://www.snpedia.com/index.php/Rs1801131

A is normal, C is bad.

https://www.snpedia.com/index.php/Rs1801133

C is normal, T is bad.

Recently, I figured out this one may also be relevant in some people:

https://www.snpedia.com/index.php/Rs1802059

G is normal, A is bad.

Search on your genetic testing site for your "raw data" and then look up these snps.

Having two bad copies is worse than just having one. In the first two, you can be anything from 0/4 bad to 4/4 bad, and the more bad, the more it acts as an amplifier on the other bad snps in Meyer-Powers syndrome.

I have had a few isolated cases so far still produce 0/4 bad of the MTHFR gene (but yet have nearly all the conditions in the syndrome), and so far, they seem to have A,A on RS1802059 which seems to create the same outcome but via a different pathway.

If you have "the syndrome" or you clinically at least seem to have a lot of the things on the list, a trial of methylated B vitamins is not unreasonable.

If you feel "wired" upon starting the supplement, you likely had deficient levels of methylated B vitamins that are now being corrected and so neurotransmitter synthesis is cranked up higher than it should be. This can cause insomnia for a week or so (happened to me and some other patients). Stick with it. It seemed to settle out after about a week or so. I kept the increased energy and decreased need for adderall, but eventually started sleeping normally again.

This so far is the cheapest/best supplement I've found that fits the needs of most people:

https://www.amazon.com/Jarrow-Formulas-B-right-Supports-Cardiovascular/dp/B0016003Z0/ref=sr_1_3?keywords=b+right&qid=1683052446&sr=8-3&th=1

Edit: WARNING - some people upon starting treatment have a reaction. There are two different types of reaction:

1. Niacin flush - you feel almost sunburnt and hot for an hour or so. Can treat with an aspirin tablet. It likely will not happen more than once. (I got one on my first dose).
2. Mania/Wired feeling. The sudden surge in neurotransmitter synthesis takes a little while to settle down, and some people get insomnia for a few days and feel like they are on a stimulant. (Also happened to me). I'm now 3 weeks in though and no longer feel any "change" after taking it.