“Girls”: The Gender Imbalance in GC

Happy Holidays, bloggos!

In my undergrad major, everyone had to do at least one semester in a research lab to graduate, usually for free. I did my time in a lab studying the impact of the drosophila gut microbiome on fly phenotype. Lab work was often tedious and challenging, as I had to figure out a lot of the details of my project and protocols on my own. Hard work for sure! But I wanted research experience to get a lab job, in case GC didn’t work out right away and so that I could be ready to write a master’s thesis someday. I spent about two years in that lab. One day, in the lab breakroom, I overheard someone ask, referring to the graduation lab requirement, “who would just do the one required semester?” and someone respond “sometimes there are girls who want to do genetic counseling who only stay for a semester and we have them do dishes for us”.

Shots fired, right???

There are a few problems with this statement. 1) Not all future genetic counselors are female. 2) Patronizing use of “girls” 3) Research can be a major part of a genetic counselor’s career

I was reminded of this experience this week while reading a paper by Alexandra Stern in preparation to talk about diversity in GC. I realized this topic is way too big to cover in one post, so today we’re going to focus our attention on this word “girls”– the assumption that genetic counselors are “girls”, what impact that’s had on the profession, and what we should be doing about it.

In one section of Stern’s paper, she accounts the transition into the workplace for the first graduating class of genetic counselors in 1971. Melissa Richter, the founder of the first genetic counseling program, actively sought to build the first class out of women who wanted a professional but flexible career. Two years later, as that class entered the workplace, Stern accounts that physicians saw genetic counselors as “nurse-like”, referred to them as “girls”, and apparently tried to make their job title “genetic associate”. Salaries and prestige for genetic counselors reflected this assumption that these graduates, all female and all mothers, fit somewhere on the lower rungs of the healthcare food chain.

The first class of genetic counselors started their program at Sarah Lawrence College in 1969, nearly 50 years ago, and the repercussions of these gendered begins still persist. Ninety-six percent of genetic counselors identify as female. While I don’t feel genetic counselors are as undervalued in the workplace as much as they once were, it’s hard to know how valued genetic counselors could be if we were all free of gender biases. The bigger issue now is, we’re largely missing the male perspective in the field! This field has gotten stuck in the “women’s work” sector, and it’s the job of current and future genetic counselors to get it out of that box and also show that genetic counselors of all demographics and backgrounds are professionals worthy of respect.

 

Fig. 2
Looks like even early genetic counseling students knew their way around the lab. (Stern, 2009)

This week I surveyed some applicants and students about diversity in GC, partly to find out what hesitance men had or have about entering genetic counseling as a career. Twenty-eight percent of my survey respondents were male. I asked respondents about any reasons they had ever thought the field might not be right for them. I expected at least some answers about it being a female-dominated field, or hesitance to participate in emotion-centered counseling work. Interestingly, men’s answers didn’t vary much from those of the women who responded. They mentioned compassion fatigue, cost of training, competitiveness of admission, etc. Pay was mentioned once, by a male. What that says to me is that men are not seeing genetic counseling as beneath them, and the gender balance is likely moving in the right direction soon.

It seems like much of the persistence of the gender imbalance relates to a lack of awareness of GC. I asked survey respondents what they thought could help their demographic (be it male, minority race, anything else) be more likely to pursue genetic counseling, and the responses mostly centered around this theme of awareness. Most future genetic counselors did not hear about the career prior to undergrad. For example, I heard about it in a 2nd semester freshman class about careers in genetics, a class I had to take because after I’d declared a genetics major. Now, imagine a person who comes into college interested in medicine, who might have made a great genetic counselor, but they declare a major in physiology and they never end up in careers in genetics class. The genetic counseling field misses out on wonderful men and women of all backgrounds, due to a lack of awareness of the possibility of pursuing this career.

But if both men and women miss out this way, how does this lack of education about GC contribute to the gender divide? I wondered about this for some time. I believe the answer lies in the formation of peer groups and association with people like oneself. I learned about GC as an 18-year-old freshman girl, from a young, female genetic counselor who came to speak to our class. I built that association of “genetic counselors are like me”. Combine that association with a desire to study hard and social science, and I easily developed a budding interest in the career. Over my undergrad years, I shared my genetic counseling dream with my close peers, mostly young females like me, some of whom also gained an interest in the field.

Compare that to if I’d learned about the field in high school from a textbook (or for more accuracy, looking it up on Wikipedia for some homework sheet). I’d read:

Genetic counseling is the process of advising individuals and families affected by or at risk of genetic disorders to help them understand and adapt to the medical, psychological and familial implications of genetic contributions to disease.

-Wikipedia

No references to what type of person does this work. No statements that it’s emotional or dominated by women. No implicit association with any particular group. If education about genetic counseling came around in the high school years, the idea of genetic counseling could be so endemic that everyone would know it’s a career option for them. Instead of a one-off guest speaker providing all a student knows about genetic counseling, it would be wonderful to see it be a constant part of the discussion of healthcare careers. If education on the topic doesn’t come around until halfway through undergrad, and if it comes in this sort of “side-thought” presentation, genetic counseling is going to be overlooked. Or worse, it’ll be known only as the end-goal of those girls who wash dishes for the lab.

It’s a lot to ask of high school biology teachers, so it’s up to the small but growing bunch of fabulous genetic counselors and future genetic counselors to share their passion with people from all backgrounds and demographics. Open up the discussion about genetic counseling and help everyone know they can have a place in this career field. It’s not just girls and it’s not easy, feminine, touchy-feely work. It’s a challenging and exciting career field that needs perspectives from men and women across the spectrum of life circumstances and experiences.

IT’S THE LAST BLOG POST OF 2018!! That means next week we’re cresting our way into interview offer season. I’m already so stressed. Last year it was like a ball of stress grew from the first of the year until Match Day morning, at which point I finally couldn’t even stomach solid food. This year, LET’S NOT. We’re going to have tons of good times these next few months. Applicants out there, keep coming by to celebrate good news and cope with the bad times together. And everyone else, buckle up for an exciting ride!

-Laura Cooper-Hastings

 

A Citation for the Paper I Referenced a Lot:

Stern, A. M. (2008). A Quiet Revolution: The Birth of the Genetic Counselor at Sarah Lawrence College, 1969. Journal of Genetic Counseling,18(1), 1-11. doi:10.1007/s10897-008-9186-8

 

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