Knowledge and perceptions of the genetic counseling profession among a national cross-sectional sample of U.S. adults.

Awareness of the genetic counseling (GC) profession may influence access to genetic services, yet awareness among the U.S. population is unknown. A survey of U.S. adults was conducted using age- and sex-based quotas. Participants were asked if they had heard of the GC profession and to describe what genetic counselors (GCs) do. After reading a brief description of what GCs do, participants were asked the likelihood they would request to see a genetic counselor if they were concerned about a genetic condition. We used descriptive statistics to characterize the population, logistic regression to determine factors related to awareness of the GC profession, and ordinary least squares regression to identify which factors correlated with likelihood of seeking GC services. Thematic analysis was used to code open-ended responses. Among the final sample of 543, the majority were White individuals (79.7%) with an average age of 46.5 and median income between $60,000 and $69,999. Although 20% indicated they had heard of the GC profession, further analysis of the qualitative follow-up question suggested only 13.4% understood the role of GCs (CI 10.6%-16.3%). Factors positively and significantly correlated with knowledge of the GC profession included identifying as White or female and having higher educational attainment or higher science knowledge after controlling for income, age, and political views. Approximately 45% of respondents indicated they would likely or very likely seek GC if concerned about a genetic condition. Biological sex, age, religious affiliation, science knowledge, and awareness of the GC profession were significantly correlated with likelihood of seeking GC services while controlling for race, income, educational attainment, and political views. Curiosity/interest, the perception of benefits, and trust in GCs were all major themes that emerged to explain reasons for seeking an appointment with GCs. Lack of awareness, lack of perceived benefit, and lack of trust in GCs or greater trust in other healthcare providers were reasons for not wanting a GC appointment. Despite the 50-year existence of the GC profession, awareness remains low and negative attitudes exist.

An examination of attitudes toward bisexual people at the intersections of gender and race/ethnicity.

People report more negative attitudes toward bisexual than gay/lesbian individuals, but little is known about attitudes at the intersections of gender and race/ethnicity. We examined whether attitudes toward bisexual people differed depending on: 1) target gender identity (man, woman), gender modality (cisgender, transgender), and race/ethnicity (White, Black, Hispanic); and 2) participant gender identity (man, woman) and race/ethnicity (White, person of color). As part of a cross-sectional survey, 552 participants rated their feelings toward 12 bisexual targets who varied in gender identity/modality and race/ethnicity. A repeated-measures ANOVA indicated that participants rated bisexual men more negatively than women, transgender individuals more negatively than cisgender individuals, and Black/Hispanic individuals more negatively than White individuals. However, differences based on target gender identity and race/ethnicity were only observed for cisgender targets, and most effects were only observed for male participants. Efforts to improve attitudes toward bisexual people must account for heterogeneity based on target/participant characteristics.

"Be Prepared if I Bring It Up:" Patients' Perceptions of the Utility of Religious and Spiritual Discussion During Genetic Counseling.

As debates continue about the relevance of religion to health care, research is needed to guide decisions about whether genetic counselors (GCs) should routinely address religious and/or spiritual (R/S) issues with their patients. We conducted an online survey to gauge patient perspectives on this issue. Among the 70 respondents, frequencies of closed-ended responses and thematic analyses of open-ended responses revealed multiple patient concerns related to R/S discussions with GCs. Although 60 respondents reported being R/S, only a small minority would want to discuss R/S issues if it meant less time discussing medical information. Most respondents also expressed opinions that: 1) genetic counseling should be about science; 2) GCs are not qualified to discuss R/S issues; 3) other outlets are available to meet the needs of patients who want R/S counseling; and/or 4) R/S discussions are more likely to be acceptable if patients broach the topic or in specific circumstances (e.g., when patients are facing end-of life issues). Overall, responses suggest routine or comprehensive R/S assessments or discussions are not necessary and that GCs would be best equipped to help all their patients if they were prepared to listen, be supportive, and make referrals when R/S issues arise in clinic.

The Last Bastion of Sexual and Gender Prejudice? Sexualities, Race, Gender, Religiosity, and Spirituality in the Examination of Prejudice Toward Sexual and Gender Minorities.

Prior research has reported that many Americans hold prejudicial attitudes toward sexual and gender minorities. Most of this research analyzed attitudes toward target categories in isolation and not in relation to attitudes toward heterosexuals. In addition, most previous research has not examined attitudes of members of sexual and gender minority categories toward other categories. While some research has examined the influence of religiosity on attitudes toward sexual and gender minorities, none of these studies has examined religiosity while also examining the influence of spirituality. In this article we drew on insights from queer theory to examine attitudes toward heterosexual, gay, lesbian, bisexual, and transgender individuals, as well as individuals who practice polygamy, among college students. Three samples gathered over a four-year period (2009, 2011, 2013) at a private, nonsectarian, midsized urban university in the Southeastern United States were used. We found that heterosexuals had the most positive rating, followed in order of rating by gay/lesbian, bisexual, and transgender individuals, and then those who practice polygamy. Regression analyses revealed gender and race were significant predictors of attitudes toward various sexual and gender categories. Holding a literalistic view of the Bible and self-identifying as more religious were related to more negative views toward sexual minorities, while self-identifying as more spiritual was related to more positive views.

Extending religion-health research to secular minorities: issues and concerns.

Claims about religion's beneficial effects on physical and psychological health have received substantial attention in popular media, but empirical support for these claims is mixed. Many of these claims are tenuous because they fail to address basic methodological issues relating to construct validity, sampling methods or analytical problems. A more conceptual problem has to do with the near universal lack of atheist control samples. While many studies include samples of individuals classified as "low spirituality" or religious "nones", these groups are heterogeneous and contain only a fraction of members who would be considered truly secular. We illustrate the importance of including an atheist control group whenever possible in the religiosity/spirituality and health research and discuss areas for further investigation.

Genetic counselors' religiosity & spirituality: are genetic counselors different from the general population?

Although there is evidence that the religious beliefs of genetic counselors (GCs) can induce internal conflict in at least some genetic counseling scenarios, empirical research on the religiosity of GCs is limited. This study compares genetic counselors to a representative sample of the adult U.S. population on multiple religiosity measures. After controlling for several sociodemographic factors the percentage of GCs who report having a religious affiliation is similar to the general U.S., but GCs are less likely to affiliate with conservative Christian religions and are more likely to be Jewish. GCs are significantly less likely than the general U.S. population to: believe in god, attend religious services, pray, and believe in an afterlife even after controlling for relevant sociodemographic factors. Despite the lower levels of religiosity, a majority of GCs do report themselves to be moderately to highly spiritual. We explore potential reasons for religiosity differences as well as possible implications in the context of the GC scope of practice.

Views on abortion: a comparison of female genetic counselors and women from the general population.

While literature characterizing individual genetic counselors' abortion attitudes is sparse, the National Society of Genetic Counselors takes a clear stance for reproductive autonomy. To determine genetic counselors' views, this study compared (1) genetic counselors' abortion attitudes to those of women from the general population and (2) genetic counselors' professional abortion attitudes to their personal abortion attitudes. Genetic counselors were invited to complete an online survey. Response rate was 44.3% (709/1,601). Compared to women from the general population, female genetic counselors were significantly more likely to agree abortion should be an option in all cases (p < .001). Controlling for other possible confounders, regression analyses revealed that being a genetic counselor, religious service attendance and age were significantly predictive of abortion attitudes. Although the vast majority of genetic counselors agree that abortion should be available, they are significantly less likely to personally consider abortion under all circumstances presented (p < .001), and the percentage of genetic counselors who would consider terminating in the case of a severe birth defect is similar to studies of other women.