Gendered and nongendered language in genetic counseling

Language is essential to genetic counseling. Genetic counselors use language to accurately communicate complex medical phenomena and support patients' understanding and wellbeing. This qualitative descriptive study explored how practicing genetic counselors used gendered and non-gendered language in patient interactions and the motivations behind their word choices. Thirty genetic counselors completed surveys distributed through the National Society of Genetic Counselors' (NSGC) listserv and promoted at a regional genetic counseling conference. Purposive sampling was used to select ten participants for subsequent semi-structured interviews. Interviews were completed individually over Zoom and analyzed using inductive content analysis. Most participants were white, cisgender, heterosexual women, with an average age of 32.6 years and 8.4 years of clinical experience. Analysis revealed six key categories: (1) tailoring for patient needs and comprehension, (2) scope of practice, (3) perceived benefits and risks, (4) emotions matter, (5) responsibility for change, and (6) the electronic medical record. This study found that participants aspire to use gender-inclusive language routinely but in reality primarily do so with patients who identify or were perceived as transgender or nonbinary (TGNB) or lesbian, gay, bisexual, transgender, and/or queer/questioning (LGBTQ+). Rather than striving for consistency between patients, genetic counselors prioritize tailoring language to individuals. Factors influencing language choices included patient age, health literacy, and perceived political views. Barriers to inclusive language included fear of damaging rapport, inexperience or discomfort using non-gendered language, and uncertainty about whether related conversations fell within their professional scope. Many felt that professional organizations should lead advocacy efforts for TGNB patients on behalf of the field. Overall, while genetic counselors aim to be empathetic and inclusive, the field must critically examine how language choices impact care for all patients.