Cancer genetic counselors' experiences with transgender patients: A qualitative study

J Genet Couns. 2019 Jun;28(3):641-653. doi: 10.1002/jgc4.1092. Epub 2019 Feb 5.

Abstract

It is becoming increasingly common for people to openly identify as transgender, yet there is little research in the field of genetic counseling regarding this community's unique medical needs. Transgender patients are likely to present with issues that cross genetics and gender-related care in a cancer genetic counseling session, and empiric data about these differences is needed to provide adequate care. In order to investigate what specific health topics and concerns are addressed in cancer genetic counseling sessions with transgender patients, 21 cancer genetic counselors who have seen transgender patients were interviewed. Through inductive analysis, six themes emerged: (1) documentation systems are not inclusive or clear; (2) genetic counselors feel unprepared for these sessions; (3) gender affirming hormones impact risk assessment; (4) genetic testing affects gender affirming surgical decisions; (5) transgender patients present at younger ages to clinic; and (6) pathogenic variants allow for insurance coverage for gender affirming surgeries. This study's findings point to opportunities for the field of genetic counseling to enhance services for transgender patients by reporting distinctive situations that may arise in clinic with these patients and providing training recommendations for genetic counselors.

Keywords: cancer screening; cultural competence; gender identity; gender reassignment procedures; genetic counseling; hereditary cancer syndromes; transgender.

MeSH terms

  • Adult
  • Counselors / psychology*
  • Emotions
  • Female
  • Genetic Counseling
  • Genetic Testing
  • Humans
  • Insurance Coverage
  • Male
  • Qualitative Research
  • Transgender Persons*