Perspectives Article Published!
It finally got published! So much work into this 🙂 Continue on to read the whole article:
Perspectives from Male Genetic Counseling Trainees, ‘Y’ Not?
With contributions from Beau Amadeus Crabb, BA (University of Colorado, Denver), Jeff Kopesky, BS (University of Minnesota), Christopher Lauricella, BS (University of Pittsburgh), Justin Leighton, BS (Arcadia University), Dr. Kunal Mahesh Sanghavi, (Boston University), Ian A.A.D. Wallace, BS (Boston University), Spencer Michael Wood, BS (University of South Carolina), and Jamie Zdrodowski, BS (Northwestern University)
Imagine being a male researching genetic counseling as a potential career, and realizing from Professional Status Surveys that only 4% of respondents share your gender. A mere 50 males exist in the field to serve as gender-concordant role models1. Furthermore, a 2005 published survey of all enrolled students in training programs revealed only six male respondents, 2.6% of the sample, in a research article no less aptly named, “Who are the Next Generation of Genetic Counselors.”2
Sure, these statistics might seem striking to individuals who believe there is an inherent difference between the way males and females practice genetic counseling, though in reality, this may not be the case. However, my interviews for genetic counseling programs seemed to suggest otherwise. Much to my frustration, I remember the need to justify, at each interview, every permutation of the same question regarding my gender relative to the predominantly female field of genetic counseling. From that point on, I vowed to explore the issue of gender and to what extent it was truly a concern over the course of my training at the University of Michigan.
I now believe that the perception of an underlying difference between genders and gender disproportions are issues that only trainees and professionals in genetic counseling observe. Our clients, who are the primary purpose of our discourse, may fail to notice the imbalance. As any other good student in science, however, I needed more data.
To explore this, I questioned a few of my fellow male trainees in various programs. Did they have experiences where gender compromised their ability as genetic counseling interns to appropriately counsel their clients? Has gender even been an issue? What do other male genetic counseling students have to say?
Why do I want to work with all females?
A theme that immediately surfaced in my colleagues’ responses involved questions posed to us even before we matriculated – either during the interview process or while inquiring about programs in genetic counseling. “During each of [my interviews], without variation, I was asked to discuss how I felt going into a predominately female field. I was asked how I felt my gender could affect schooling and further down the road, my career,” says Spencer Wood of the University of South Carolina, Greensboro.
He continues, “To be honest, I really had only given it much thought probably a month earlier, and almost solely due to the fact that I saw this question coming.”
Jamie Zdrodowski of Northwestern University remembers, “Just about every person I interviewed with asked at least one question about being a guy going into this field.” Upon reflecting the question back to his interviewers, “No one had an answer other than to say that it doesn’t really matter, just something different.”
If no difference exists, why was this emphasized for these students when it should really be a null point? Was there, in fact, a clinical impact when a genetic counselor happened to be male rather than female that I failed to notice?
To patients, why does a genetic counselor’s gender matter?
To our benefit or not, it seems that other factors often preclude a client’s comfort with the gender of their genetic counselor. Opinions that surfaced from this exploration were that our clients’ general lack of knowledge of genetic counseling often meant they were unaware that the field was predominantly female. Beau Amadeus Crabb of the University of Colorado, Denver states, “I don’t think many people outside of the profession know about the disproportionate gender distribution. Clients that I work with have little understanding of genetic counseling, so they tend not to have any preconceived notions about a genetic counselor.”
In the prenatal setting, patients often recognize that “many doctors are male… so [clients] don’t see it as strange at all that we [genetic counselors] are guys,” says Zdrodowski.
However, not all clinical situations are completely gender-neutral. Ian Wallace from Boston University has experienced “patients from certain cultures [who] prefer to talk to another woman about pregnancy or female-related issues.” Commenting on an experience he had with a female client of Lebanese descent, Wallace continues, “Interestingly, while [she] would not converse with me regarding her pregnancy or medical history, her accompanying husband would only talk to me and would not speak to the female [genetic counselor] in the room.”
It is unclear whether such an example is solely the result of the provider’s gender, but it is apparent that many cultural factors also play into how our clients respond to gender.
And of our male genetic counseling supervisors?
Justin Leighton at Arcadia University had the opportunity to have both male and female supervisors in a clinical rotation. He comments, “From my experiences with them and with patients, I can honestly say that I did not notice any difference in their interactions with patients.”
My rotation with both male and female supervisors mirrors those of Justin’s opinions. The University of Michigan allowed me to travel to a summer rotation site of my choosing, and with that ability, my main concern was to explore this potential, underlying difference between male and female genetic counselors. I decided to choose my rotation solely based on the availability of a male genetic counselor to be one of my supervisors. I soon realized this was not necessary.
Although I observed scant differences in mannerisms, accountable by individual counseling styles, I gained an incomparable and valuable rotation experience from both my male and female supervisors alike during this rotation. Indeed, I couldn’t find a difference and, fortunately, learned a lot more about genetic counseling in general.
“It also makes it near impossible to go absent unnoticed.”
If there is little gender significance in the clinical setting, do our roles as males in genetic counseling training programs warrant the degree of questioning we receive during interviews?
“Usually it is in the context of a discussion about gender differences, and I am expected to speak for the entire male gender,” says Crabb. He continues, “There were multiple times when our teacher was discussing gender differences and had to preface her statement with, ‘Now we all know Beau wouldn’t do this or say this’ then proceed to discuss the failings of the male gender.”
Christopher Lauricella of the University of Pittsburgh recalls, “The only times where I feel singled out is during classes, because I am the only guy in many of them. Not that it’s a negative thing. It also makes it near impossible to go absent unnoticed.”
“Men in genetic counseling will bring to the table perspectives and first-hand expertise on what makes men tick,” says Wood. “Male patients often require different strategies, have different issues, make decisions differently, and perceive risk … differently.”
“If anything, being a male allows you to bring different aspects to the field,” says Jeff Kopesky of the University of Minnesota.
“No one has really commented on my gender,” says Zdrodowski, “aside from jokingly pointing out that I have never had an amnio, and I don’t really know what it’s like to have breasts.”
His clients are correct: we will never understand what it is like to experience the sensation of an amniocentesis or the connection a woman’s breasts may have with her identity, but the tenets of our genetic counseling training do not require personal experience for us to do our job effectively and empathetically. Let’s remember that many of our female counterparts have never had an amniocentesis, been faced with the decision to pursue prophylactic surgery, had the experience of being pregnant, becoming a parent, or losing a child. Male and female genetic counselors alike must use empathy to connect with their clients.
Therefore, what we truly bring to the table as males is an understanding of ourselves within our social and physical environments, which is equally significant to the experiences of any other individual in our training programs.
Cease and Desist
These results may not be surprising, but from what I can tell, the concern of a gender bias is purely an artifact of demographics, regardless of which specialties we, as male genetic counseling trainees, choose to pursue.
As future genetic counselors, we perceive our contributions as males to clinical practice as no less than, nor significantly different from, those of our female role models and colleagues. As such, let us encourage other men to pursue their interests in genetic counseling and cease creating barriers to interviewing males regarding their intention to enter this field.
Kopesky concludes, “My training focused on preparing me to be the best genetic counselor, not the best male or female genetic counselor.” If our training programs are already taking this position, why suggest to interested male applicants that there may be differences between male and female genetic counselors?
My advice to other males wishing to pursue genetic counseling: don’t let a profession pursued predominantly by women deter you. They may ask you questions to justify your intentions beyond the average applicant, and there may be comments regarding your gender, as well as being singled out in casual conversation throughout training, but the end result is no different. The skills we gain as males are just as valuable, and we will become great genetic counselors, whether we have Y chromosomes or not.
1. Parrott S, Del Vecchio M. 2006 Professional Status Survey, National Society of Genetic Counselors, Inc. 2007 (from www.nsgc.org)
2. Lega M, McCarthy Veach P, Ward E, LeRoy B. Who are the next generation of genetic counselors? A survey of students. J Genet Counsel. 14:395-407. 2005.