Improving gender‐affirming care in genetic counseling: Using educational tools that amplify transgender and/or gender non‐binary community voices

Abstract

Transgender and/or gender non‐binary (TGNB) individuals face significant health care disparities, including deficiencies in provider knowledge. To address this knowledge gap for genetic counselors, we developed, implemented, and analyzed an educational intervention on gender‐affirming genetic counseling (GC) and care for TGNB patients. In partnership with the TGNB community, we designed a 5‐module (length = 146 min ± 94 min) genetic counseling‐targeted online learning program focused on gender‐affirming care (Amplify). Content included elements of gender‐affirming care, core components of gender‐inclusive GC sessions, and cancer risk assessment/management. Video testimonials featuring TGNB individuals complemented learning within each module. Educational outcomes measured included comfort working with TGNB patients (n = 2 multiple choice questions (MCQs)), impact of education on knowledge (n = 25 MCQs), and clinical self‐efficacy based on the Accreditation Council for Genetic Counseling competencies (n = 35 skills). Participants (n = 40), recruited through state and national GC organizations, completed all modules, and pre‐ and post‐education/self‐efficacy assessments. Pre‐Amplify, 65% (n = 26/40) of participants endorsed feeling ‘somewhat comfortable’ working with TGNB patients. The average knowledge score was 77.6% (SD = 11.2%) with the lowest scores related to the gender affirmation process. After Amplify, overall knowledge improvement was statistically significant with an average 16.9% (p < 0.001) increase in score. Pre‐Amplify, the average self‐efficacy score was 78.4% (SD = 15.8%) with lowest scores seen in statements surrounding information gathering of family and medical histories. Post‐Amplify, overall self‐efficacy improvement was statistically significant with an average 13.8% (p < 0.001) increase in score. Linear regression did not identify an impact of practice specialty on participants’ knowledge gains or self‐efficacy. This study shows online modules are an effective form of gender‐affirming care education for GCs. This intervention can positively improve the care practicing genetic counselors provide to patients and inform future decision‐making about the development of gender‐affirming care education for genetic counselors.

From intention to action: Assessing need and creating a JEDI toolkit for individuals teaching cancer genetics curriculum

“…It is necessary to ensure current and future genetic counselors are being taught anti‐racist practices to incorporate these approaches into their clinical rotations and professional practice. Emerging cancer genetic curriculum in the JEDI realm can also be utilized (Huser et al., 2022). Finally, programs should engage with and compensate experts not affiliated with the university to minimize internal bias.…”

Learning from our patients: Utilizing the expertise of transgender and/or gender diverse educators to build an inclusive learning cycle

“…The first iteration of this cycle, Amplify , launched in 2020 (Huser et al, 2022). TGDAB members were recruited locally and nationally through a variety of social media platforms and TGD‐focused advocacy organizations.…”

“…Of the 111 TGD individuals who responded to the initial interest form, four participated in the TGDAB for Amplify (Table S1). Content for the educational component of Amplify (online modules) explored core aspects of gender‐affirming care applicable to cancer genetic counseling practice (Huser et al, 2022). Content was developed based on a comprehensive literature review and evaluated by TGDAB members.…”

“…Additionally, several TGDAB members provided personal video testimonials about their own lived experiences. Forty GC learners completed this educational program (39 GCs and 1 GC student), and both knowledge and genetic counseling self‐efficacy (GCSE) improved with an average 16.9% increase in knowledge score and 13.8% increase in GCSE, both reaching statistical significance ( p < 0.0038) (Huser et al, 2022). GC participants also cited the inclusion of TGD perspectives in the online modules as highly valuable.…”

“…Keeping this gap in mind, we created a community‐based learning cycle in partnership with a TGD advisory board (TGDAB), with the goal of increasing GC knowledge and self‐efficacy (Caldwell et al, 2018; Keller et al, 2019) (Figure 1). We provide data on the workshop component of the community‐based learning cycle and refer readers to Huser et al (2022) and Ernst (2022) for details on the online educational modules that were developed for both iterations of the learning cycle.…”