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. 2022 Feb;31(1):230-241.
doi: 10.1002/jgc4.1476. Epub 2021 Jul 23.

Barriers to family history knowledge and family communication among LGBTQ+ individuals in the context of hereditary cancer risk assessment

Bradley A Rolf  1 , Jennifer L Schneider  2 , Laura M Amendola  1 , James V Davis  2 , Kathleen F Mittendorf  3 , Mark A Schmidt  2 , Gail P Jarvik  1 , Benjamin S Wilfond  4   5 , Katrina A B Goddard  3 , Jessica Ezzell Hunter  3
Affiliations

Barriers to family history knowledge and family communication among LGBTQ+ individuals in the context of hereditary cancer risk assessment

Bradley A Rolf et al. J Genet Couns. 2022 Feb.

Abstract

Openness about identity as lesbian, gay, bisexual, transgender, queer, and other sexual orientations and gender identities (LGBTQ+) may cause strain on relationships between family members, which could lead to limited knowledge of cancer family history and reduced communication with family members. As a result, members of the LGBTQ+ community may have more difficulty accessing genetic counseling services for inherited cancer risk. We applied a mixed-methods approach to explore potential barriers to knowledge of cancer family history and family communication among participants of the Cancer Health Assessments Reaching Many (CHARM) study who self-identified as LGBTQ+. We assessed perceptions of family functioning and communication of genetic test results to family members using survey tools and supplemented these data with 20 in-depth interviews to further assess participant perspectives and experiences. LGBTQ+ participants were more likely to report unhealthy family functioning on the survey tool, and some interviewees endorsed that openness about their LGBTQ+ identity led to strained family relationships and reduced communication about their family history of cancer. Overall, this study identified barriers that may be faced by members of the LGBTQ+ community which could limit their ability to access genetic counseling services for inherited cancer risk.

Keywords: Cultural competence; LGBTQ+; family history; genetic counseling; hereditary cancer; risk assessment.

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Conflict of interest statement

CONFLICT OF INTEREST

Bradley Rolf, James V. Davis, Jennifer L. Schneider, Laura M. Amendola, Mark A. Schmidt, Jessica Ezzell Hunter, Kathleen F. Mittendorf, Gail Jarvik, Benjamin Wilfond, and Katrina Goddard declare that they have no conflicts of interest related to the work described in this manuscript.

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