Navigating identity and professional life: A qualitative study of LGBTQ+ genetic counselors' workplace experiences

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) healthcare professionals frequently navigate complex dynamics related to their professional identities, including disclosure, advocacy, and experiences of minority stress. This qualitative study explored how LGBTQ+ genetic counselors manage their professional identities, including decisions about disclosure, advocacy and representation, and encounters with discrimination, within workplace and broader sociopolitical contexts. Twelve LGBTQ+ genetic counselors practicing in the United States participated in semi-structured interviews about their workplace experiences and identity management processes. Using a constructivist framework and reflexive thematic analysis, we conceptualized three overarching themes: (1) Navigating disclosure-Environmental signals and professional outness; (2) The burden and opportunity of being "The LGBTQ+ Expert"; (3) Enduring microaggressions and workplace disillusionment. Participants described ongoing assessments of risk and benefit in disclosure decisions, balancing authenticity with professionalism, and navigating institutional and sociopolitical pressures. They reported that advocacy and visibility often brought both pride and additional labor, and that microaggressions and performative inclusivity contributed to chronic disillusionment. These findings underscored the importance of understanding disclosure dynamics and implementing strategies to promote inclusion, belonging, and equity for LGBTQ+ professionals in genetic counseling.