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finding the guys in genetic counseling, part 2

November 18, 2009 Leave a comment

As I’ve mentioned multiple times, voices from males in the genetic counseling field are few and far between. The following study from the Minnesota training program perhaps sheds a little light on the issue, although know the caveat that the conclusions and comments stem from only a sample of 3 male students.

From the following 2007 article, Schoonveld KC, Veach PM, LeRoy BS. What is it like to be in the minority? Ethnic and gender diversity in the genetic counseling profession. J Genet Couns. 2007 Feb;16(1):53-69., a few quotes from the 3 man-students that were interviewed:

“It’s like I’m an outsider. There’s this small group of us, and I’m always the one to be singled out or excluded …”

“I do feel that I was given the opportunity to interview at more schools because I am male”

“Patients always seem to think that I’m the doctor. It’s frustrating to get the question of ‘Why didn’t you go to medical school?’ from my patients! Like I couldn’t cut it, or like genetic counseling is somehow less of a field”

“A lot of the girls [sic] see things as since I’m a guy I was let in. So they set lower expectations for me and don’t expect me to do well”

“The people who interviewed me seemed to indicate that gender might be an obstacle. I almost felt like they were trying to deter me from the field”

“There are certain preconceived notions like, “He’s a guy, he’ll need more help with the feeling stuff.” Professors/supervisors seem to expect that I’ll know more of the medical/hard science stuff. Some of the professors or the male MDs still ask why I don’t go to medical school”

“It is really helpful to have him [my roommate, who is not in the program] around to sometimes just do guy things. It’s nice to talk about concrete things versus how I feel about things. He maintains my masculine sanity”

“I feel that I might be able to understand what the father is going through better than some females would …”

In comparing the experiences of males to those of other “minority” or self-identified “underrepresented” identity groups in the field of genetic counseling, the authors discuss:

Since the males had spent most of their lives in the majority vis-a-vis their gender, their more recent minority status as graduate students might be more distressing than for the female student participants who have a history of being in the minority because of their ethnicity.

In the present study, male participants appeared to be most adversely affected by their peer relationships. One male participant stated: “[my classmates] don’t even attempt to allow me to be a part of the group, but rather assume that we are so different it is not worth it.” It is unclear if a similar disparity exists among practicing genetic counselors, as all of the male participants in this study were students. Some participants sought out organizations or environments where they were guaranteed to interact with others from a similar ethnic/cultural group, especially the males, who expressed a need to do masculine things.

These above two comments are contrasted to the authors’ initial hypothesis:

1) Individuals identifying with an underrepresented racial/ethnic group would have more negative experiences within the field than would male participants

It definitely provides an interesting view of the experience of males, individuals of underrepresented racial/ethnic groups, and the potentially expanded implications on men who are of an underrepresented racial/ethnic group.

On another note, how about the actual practice between males and females? Heh. Good luck finding literature there. I did find the following article from 1984 (!!!!): Zare N, Sorenson JR, Heeren T. Sex of provider as a variable in effective genetic counseling. Soc Sci Med. 1984;19(7):671-5. Here are their conclusions from the study, taken with a few grains of salt, given that these ‘genetic providers’ were majority of an M.D. training background…

So.. “statistically significant” differences between many genetic-medical issues, but.. wait, no difference between socio-medical issues? Wait, let’s look at those numbers.. they’re all really low anyway so how useful is that information?

What’s interesting about the above data is “relationship with other children” under soci-medical. a difference of 25 to 5.9 isn’t statistically different? Again, low numbers.. I suppose?

What I’d be most worried about are the more counseling-aspects especially “raising a child with a birth defect”, “helped with most personal concerns” … but instead those were not statistically significant. What the authors claim was statistically significant (with a p-value of 0.06? no, that isn’t..) is “failed to ask about all concerns” with males faring worse.

The authors final conclusion:

Available data suggest that women patients seen by male providers. in genetic counseling at least, are likely to receive neither as exhaustive a discussion of selected basic medical and genetic topics, nor as much discussion of the specific topics they came to counseling to discuss. as do women patients seen by female patients.

Frankly, that’s a bit ridiculous based off of this data. Really? Gonna make those arguments based on a comparison of 8.6% to 17.6%. Oh, right, they’re MDs and not genetic counselors. And.. the study is 25 years old.

finding the guys in genetic counseling

November 17, 2009 3 comments

given that i get a few hits every week or so from individuals searching for “male genetic counselors” or something or other, i thought it’d be an appropriate time to speak a bit more about how i’ve gone about getting where i am in my understanding of men in the genetic counseling field. i’ve had a few posts in the past that have addressed some of the important issues, but how did i go about absolving the myth that male genetic counselors are inept at the counseling side of GC? with experience of course!

those experiences started with my first year in my program. UofM allows its students to elect a summer rotation of their choice. my first thought that I ended up sticking with was finding a location, a clinical rotation, where I’d be able to work with a male genetic counselor and get some experience seeing how he would work. given that ann arbor didn’t have any genetic counselor men locally, i started with speaking to my directors and seeing who they knew, or who had been an alum of the program (UofM hasn’t had a guy since the early 90s…).

another step I took was to look at who was credentialed, holding the CGC desgination. these people were more likely to be practicing, vs. working in a non-clinical job (so i thought). i browsed through all the pages of ABGC diplomates, and then google’d any male-gendered names i saw to see where they worked, if it was clinical, if it was in a location in the country i wanted to travel to, etc.  yes, i browsed through all 2500+ names looking and discerning for male-gendered first names. quite a task 😛

i ended up deciding on two locations that had a cancer focus, since i also had a particular interest in pursuing a fun, interesting, and involved cancer GC rotation. sent a few emails, got back a very welcome response and a second, polite decline (that was primarily due to the medical institution not being very appropriate to students), and i was set!

as the counselor who was my student liason first impressed on me (in our very first email exchange), it’s important to know that you can learn a whole lot from the counselors who are women that work there as well… and that basically sums it all up. it’s nice to work with another genetic counselor who’s a man, but when it comes down to learning the skills of GC, whoever it is that’s a good counselor will teach you tons and tons. some of my best counseling and career advice have come from those individuals at that rotation, so I absolutely lucked out (and made some great friends & professional relationships in the process!)

anyway, that’s been my experience. going to NSGC AEC is also an awesome way to scope out who’s a guy (it’s way easy, believe me, although i’m sure you don’t need to be convinced). there might even be guys that will address the topic too! (prominent example being Jeff Kopesky’s graduate research study and presentation at this year’s AEC on undergrad guys/girls in upper-level biology courses and their interest/knowledge of the genetic counseling field!)

not to mention, a lot of the training programs have at least a token guy (if not more!) maybe that’s a good place to start too. obviously, the bigger the program, or the bigger the city, the more likely there is to be a genetic counselor dude around, but, alas. hopefully this is can help someone out there.

check-in: NSGC Atlanta 2009

November 16, 2009 Leave a comment

just returned from the NSGC Annual Education Conference in Atlanta, Georgia. was able to meet a lot of new people, hear from a lot of new people, and take in all that is the annual conference.

i have to say the best part of the conference was seeing so many of the people i’ve worked with in the past, old classmates, and all these awesome genetic counselors and speakers that i’ve heard about over the past few years in one place. slyly peering at nametags and then once i figure out they’re someone important, whispering to classmates and friends to point out the awesome gc that just ignored me by texting on their iphone… guess they’re “real” people too, right?

catching up and networking aside, it helps to see what the current interests of others in the genetic counseling field as it currently stands (well, perhaps a few months behind the times given that submissions for abstracts, speakers, sessions are done in advance). attended the pre-conference symposium on counseling for genomic medicine. what was perhaps the most interesting was hearing about current models of practice and research experiences coming from Navigenics, Coriell Institute, Duke, and the Cleveland Clinic.

other interesting sessions included longer talks about addressing the need for genetic counselor involvement in training primary care providers (specifically PAs and NPs), and learning techniques to implement effective strategies to do those (basically, cut to the chase and give them just the information they need, when they need it).

another session spoke of developing genetic awareness campaigns and the different avenues genetic counselors can integrate into creating a media-based campaign to increase the general public’s knowledge of genetics, genetic counseling, or genetics services.

smaller meetings and talks were just as useful. attending the special interest group meetings really showed me how a lot of awesome projects happen on the SIG level, and that there are tons of opportunities to be a part of NSGC and those projects, on a volunteer level.

it’s really amazing how much involvement some individuals have in this organization, and the great things that come out of it.

it was nice seeing students/recent grads from different programs, too, that i’ve heard about, communicated with while writing my Perspectives article, and through fellow classmates and friends.

Atlanta was a blast as well. got to hit up some southern home cooking at The Colonnade, get some gourmet burgers and liquid nitrogen milkshakes from Flip Burger Boutique, and explore some fun neighborhoods and bars around the city, all thanks to my former classmate’s Zipcar membership.

all-in-all, it was a great time. learn lots, meet a lot of people, eat well, and play hard. it’s all in a long-weekend’s work 🙂 oh, and got some networking in there to boot and am now rethinking/reanalyzing my interests for my future career.

let’s just say i’m very intrigued by the intermingling of common complex disease, tons of need for genetics health education that incorporates the skills i’ve learned from school of public health, and one-on-one counseling that incorporates face-to-face as well as technology in the ways it should be better utilized.

more on gender and genetic counseling

continuing the discourse on the idea of “male-ness” in genetic counseling, i find myself shocked, surprised, i don’t know. i’m not sure. read this, from Rayna Rapp in Testing Women, Testing the Fetus, 1999:

Men are scarce in the world of genetic counseling: About 5 percent of the graduates of genetic counseling programs are men, and many of those are employed in administration. As the female director of counseling services in one program put it, “men just use genetic counseling to jump into administration. If a man got hired here, he’d want my job.” Several seasoned counselors expressed great ambivalence about the capacities and limits of men in the profession. “Men aren’t sensitive to counseling issues, to the anxiety of pregnancy,” one said. “science, that’s just information; the skilled part of this job is in the female psyche. Oh, it might work here at Middle Hospital , they’re [hospital staff] well organized. But imagine him at City, where we work in an examining room, and women run around half-dressed. What would we do with a man?” Despite their consciousness of male-dominating biases affecting their own professional standing and pay, counselors are hardly immune to gender stereotypes. But the questions this counselor is raising – whether men are by nature or training less empathic than women, whether identification with similar bodies is necessary to provide the best pregnancy counseling; in other words, “Why can’t a man be more like a woman” – reverberate inside all counseling skills.

finally a frank discussion of what’s usually (in 2009) spoken in-between the lines of “I don’t know any males that are currently counseling; the ones I do know are no longer doing clinical work”, or “Most male genetic counselors tend to work in Cancer Genetics.”

why is it that there’s an opinion that men are not well suited for counseling, and on top of that, reproductive genetic counseling? why is it that these stereotypes stand, possible even today, 10 years later, so readily expressed in supposedly objective situations as what a man would do in an examining room with women half-dressed. is that not what obstetricians, gynecologists, breast oncologists and surgeons do, where the opposing criticism in those fields that were once dominated by white, affluent, males, not necessarily about appropriateness of their presence but rather gender equality?

i can see the criticism, and understandably, perhaps historically the roles of males in the field of genetic counseling are accurately reflected in such statements. however, who is it to say that it’s the male’s intentions, lack of empathic skills, and general unsuitedness to reproductive genetic counseling that pushes him to administration? is it not the influence of the higher hospital administration that allows him to be there, allows him to be chosen, and if offered, the influence of social & financial factors that would incline anyone (male or female) to refuse a promotion? are these statements not the singular opinions of one person (let’s even ignore gender here), who has both an interest in preservation of professional status and role, and perhaps an established bias (that extends to stereotype) against a particular and potential rival group to her/his position?

there are obviously many factors that influence the counselor-client relationship, and even more influences that may exacerbate miscommunication or mis-foster the counseling environment. but to pin a certain gender as universally less capable… i am unfortunately not trained to appropriately evaluate.

Rayna Rapp (so glad i picked up her work) continues:

But the vast literature on communication between counselors and clients suggests profound chasms separating their various agendas and accomplishments that are not dependent on the sex of the service provider.

sure, i’m making assumptions based on a single quotation, of an anonymous source, indirectly through the lens of the author. but it exists! it’s been spoken! it’s been published! i can’t help but wonder what my future supervisors,, colleagues, and those who interview me will think when i express my interest in reproductive genetics. will i receive the same questions, the same assumptions, the same stereotypes as those that may or may not have been pinned when i chose to apply to genetic counseling programs? i wonder.

certainly this is why research exploring the cultural and familial contexts of reproductive genetic counseling is of utmost importance. (shameless plug and ego-boost for my personal research interests…)

Perspectives Article Published!

April 20, 2009 2 comments

pgcarticletitle

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 Read more…

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pgc: it’s good!

i just heard back from the student editor for the Perspectives in Genetic Counseling newsletter. she liked my article! i’m so happy i had the chance to write this article and interview my fellow male genetic counseling trainees across the states, it was a very educational experience and i’m glad we’re finally getting our voices out there as a coherent whole. i’m not sure exactly when the article will be published, but it will most likely be in the spring edition of PGC. look out for it! we’re still working on a lot of the edits, but here’s a short excerpt:

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. Read more…

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