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

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


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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Communication
  • Female
  • Genetic Predisposition to Disease
  • Homosexuality, Female* / psychology
  • Humans
  • Neoplasms* / genetics
  • Risk Assessment
  • Sexual and Gender Minorities*