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Abstract
Healthcare inequalities in minority groups are well-documented; this includes patients who are lesbian, gay, bisexual, transgender, queer or other sexual orientation or gender identity minorities (LGBTQ+). In 2012, Glessner et al. published a study: Are Genetic Counselors and GLBT Patients "on the same page"? an Investigation of Attitudes, Practices, and Genetic Counseling Experiences that surveyed genetic counselors about their attitudes, practices and experiences with GLBT patients. Since this study, a positive shift in the cultural opinion and increased social acceptability of the LGBTQ+ community has occurred. This community's legal achievements include the repeal of "Don't Ask, Don't Tell" in the military, the legalization of same-sex marriage in June 2015 by Supreme Court ruling and the establishment of other protections against discrimination at state levels. Despite these accomplishments, discrimination persists against the LGBTQ+ community. This study surveyed genetic counselors about their attitudes, practices, experiences and education regarding this minority population to investigate change in attitudes, practice and education since Glessner et al.'s 2012 study. An online survey was distributed through the National Society of Genetic Counselor's listserv, to which 228 genetic counselors responded, of which 182 surveys were complete and analyzed. A greater percentage of genetic counselors in 2018 profess a lack of experience in working with patients who are LGBTQ+ (51% vs 44% in 2012) and worry about offending patients or saying the wrong thing (42% vs 26% in 2012). At first, this seems at odds with the significant increase in academic instruction for LGBTQ+ patient care (from 17% of respondents in 2012 to 62% of respondents in 2018, p<0.0001). However, a greater understanding of this patient population could result in genetic counselors being aware of the limitations of their knowledge and the chance to be potentially offensive. Demographic information from genetic counselors shows the occupation has made fractional progress in diversifying in race and gender. Additionally, there is an increase in the number of genetic counselors identifying as LGBTQ+. The most significant change in genetic counselor demographics was the increase in genetic counselors who identify as bisexual (from 4 out of 213 in 2012 to 29 out of 182 in 2018). Information from this study can be used to identify professional practice gaps among genetic counselors and to direct future research for the improvement of LGBTQ+ patient care.
