• Although CFTR modulators have transformed cystic fibrosis care, access remains limited, and real-world use may be affected by factors such as genetic eligibility, treatment adherence, and potential adverse effects.<h4>What is new</h4>• Children with CF who are genetically eligible for CFTR modulator therapy-particularly those with advanced lung disease-report higher levels of hope, more positive attitudes toward their illness, and lower perceived illness threat than ineligible peers. The gene discussed is CFTR; the disease is cystic fibrosis.