Do genetic ancestry tests increase racial essentialism? Findings from a randomized controlled trial

The Landscape of Direct-To-Consumer Genetic Testing in Reproductive Health Contexts: An Analytical Framework of Stakeholders and Their Competing Motivations

We propose a theoretical framework that identifies (a) the different categories of stakeholders and (b) the normative values that drive their attitudes toward direct-to-consumer genetic testing, with an emphasis on the reproductive health contexts. We conducted a literature search using varied combinations of search terms, including direct-to-consumer genetic testing, decision-making, reproductive health, and policy. Using a grounded theory approach to existing literature and in combination with a narrative review, we present a systematic framework of five categories of stakeholders (i.e., genome-driven stakeholders, industry-driven stakeholders, history-driven stakeholders, value-driven stakeholders, and social justice-driven stakeholders) that shape the public's discourse. Moving beyond the dialectical ethics that have governed the public discourse, we also identify the normative values and interests that motivate different stakeholders' attitudes and decision-making through theoretical sampling under the grounded theory. We investigate the competing and conflicting values within the same category of stakeholders. For example, despite being industry-driven stakeholders, medical professionals' attitudes are driven by concerns about standards of care; in contrast, health insurance companies' concerns are centered on profit. We further explore the tensions between these stakeholders that impact their strategic alliances and pose challenges to the practices of direct-to-consumer genetic testing. Finally, we examine how these stakeholders and their corresponding values may shape future development and policies of direct-to-consumer genetic testing in the context of reproductive health.

Conflating race and ancestry: Tracing decision points about population descriptors over the precision medicine research life course

Responding to calls for human genomics to shift away from the use of race, genomic investigators are coalescing around the possibility of using genetic ancestry. This shift has renewed questions about the use of social and genetic concepts of difference in precision medicine research (PMR). Drawing from qualitative data on five PMR projects, we illustrate negotiations within and between research teams as genomic investigators deliberate on the relevance of race and genetic ancestry for different analyses and contexts. We highlight how concepts of both social and genetic difference are embedded within and travel through research practices, and identify multiple points across the research life course at which conceptual slippage and conflation between race and genetic ancestry occur. We argue that moving beyond race will require PMR investigators to confront the entrenched ways in which race is built into research practices and biomedical infrastructures.

Getting it right: Teaching undergraduate biology to undermine racial essentialism

How we teach human genetics matters for social equity. The biology curriculum appears to be a crucial locus of intervention for either reinforcing or undermining students' racial essentialist views. The Mendelian genetic models dominating textbooks, particularly in combination with racially inflected language sometimes used when teaching about monogenic disorders, can increase middle and high school students' racial essentialism and opposition to policies to increase equity. These findings are of particular concern given the increasing spread of racist misinformation online and the misappropriation of human genomics research by white supremacists, who take advantage of low levels of genetics literacy in the general public. Encouragingly, however, teaching updated information about the geographical distribution of human genetic variation and the complex, multifactorial basis of most human traits, reduces students' endorsement of racial essentialism. The genetics curriculum is therefore a key tool in combating misinformation and scientific racism. Here, we describe a framework and example teaching materials for teaching students key concepts in genetics, human evolutionary history, and human phenotypic variation at the undergraduate level. This framework can be flexibly applied in biology and anthropology classes and adjusted based on time availability. Our goal is to provide undergraduate-level instructors with varying levels of expertise with a set of evidence-informed tools for teaching human genetics to combat scientific racism, including an evolving set of instructional resources, as well as learning goals and pedagogical approaches. Resources can be found at https://noto.li/YIlhZ5. Additionally, we hope to generate conversation about integrating modern genetics into the undergraduate curriculum, in light of recent findings about the risks and opportunities associated with teaching genetics.

Guidelines for genetic ancestry inference created through roundtable discussions

The use of genetic and genomic technology to infer ancestry is commonplace in a variety of contexts, particularly in biomedical research and for direct-to-consumer genetic testing. In 2013 and 2015, two roundtables engaged a diverse group of stakeholders toward the development of guidelines for inferring genetic ancestry in academia and industry. This report shares the stakeholder groups' work and provides an analysis of, commentary on, and views from the groundbreaking and sustained dialogue. We describe the engagement processes and the stakeholder groups' resulting statements and proposed guidelines. The guidelines focus on five key areas: application of genetic ancestry inference, assumptions and confidence/laboratory and statistical methods, terminology and population identifiers, impact on individuals and groups, and communication or translation of genetic ancestry inferences. We delineate the terms and limitations of the guidelines and discuss their critical role in advancing the development and implementation of best practices for inferring genetic ancestry and reporting the results. These efforts should inform both governmental regulation and self-regulation.

Impacts of Learning One’s Own Genetic Susceptibility to Mental Disorders

Genomic research is rapidly advancing, and personalized genetic risk information about various mental disorders is likely to become readily available for many individuals. Although genetic profiling is intended to improve individually tailored treatments, knowing one’s genetic risks or lack thereof can have unintended consequences. Upon learning that they have elevated genetic risks for a mental disorder (e.g., depression), people may become more pessimistic about their prognosis and misremember their symptoms as being more serious because they misconceive genes as immutable and defining of their identity. Upon learning that they are not genetically predisposed to a mental disorder (e.g., alcohol use disorder), people may underplay the downstream ramifications of the symptoms even when they are currently experiencing those symptoms. Possible interventions to counteract these problems and suggestions for future research are also discussed.

Recommendations on the use and reporting of race, ethnicity, and ancestry in genetic research: Experiences from the NHLBI TOPMed program

How race, ethnicity, and ancestry are used in genomic research has wide-ranging implications for how research is translated into clinical care and incorporated into public understanding. Correlation between race and genetic ancestry contributes to unresolved complexity for the scientific community, as illustrated by heterogeneous definitions and applications of these variables. Here, we offer commentary and recommendations on the use of race, ethnicity, and ancestry across the arc of genetic research, including data harmonization, analysis, and reporting. While informed by our experiences as researchers affiliated with the NHLBI Trans-Omics for Precision Medicine (TOPMed) program, these recommendations are applicable to basic and translational genomic research in diverse populations with genome-wide data. Moving forward, considerable collaborative effort will be required to ensure that race, ethnicity, and ancestry are described and used appropriately to generate scientific knowledge that yields broad and equitable benefit.

Ending genetic essentialism through genetics education

Genetic concepts are regularly used in arguments about racial inequality. This review summarizes research about the relationship between genetics education and a particular form of racial prejudice known as genetic essentialism. Genetic essentialism is a cognitive form of prejudice that is used to rationalize inequality. Studies suggest that belief in genetic essentialism among genetics students can be increased or decreased based on what students learn about human genetics and why they learn it. Research suggests that genetics education does little to prevent the development of genetic essentialism, and it may even exacerbate belief in it. However, some forms of genetics education can avert this problem. In particular, if instructors teach genetics to help students understand the flaws in genetic essentialist arguments, then it is possible to reduce belief in genetic essentialism among biology students. This review outlines our knowledge about how to accomplish this goal and the research that needs to be done to end genetic essentialism through genetics education.

Human biological variation and the "normal"

Anatomically modern human being is a relatively young species (~300 000 years old) with small amounts of genetic variation contained within them. The vast majority of its existence was spent in Eastern Africa, migration out of the region began around 100 000 YBP. Sub-Saharan African populations have the greatest amount of human genetic variation. However, migration allowed populations to accumulate genomic variation associated with living in the arctic, higher altitudes, disease resistance, living on high fat or starchy foods, surviving toxic arsenic-rich environments, lactase persistence, changing skin pigmentation, gaining thicker hair, and changing height and body mass index. Understanding these aspects of human evolution forces us to reconsider our notion of the "normal." Thus, normal for our species includes having dark melanic skin, brown eyes, and brown tightly curled hair. Derived features include lighter skin (~10 000 YBP), blue eyes (~6000 YBP), and blond straight hair (~6000 YBP). Yet in reality, "normal" has no meaning for a species that inhabits such a broad geographic range. Natural selection and genetic drift have genetically differentiated human populations in ways that impact our morphological and physiological traits. The genomic differentiation is small and does not allow any unambiguous classification of human populations into biological races. Despite these now well-established facts of human variation, significant confusion associated with Eurocentric notions of the normal still persist in both the lay public and various professions such as biomedical research and clinical practice.

Measuring Race and Ancestry in the Age of Genetic Testing

Will the rise of genetic ancestry tests (GATs) change how Americans respond to questions about race and ancestry on censuses and surveys? To provide an answer, we draw on a unique study of more than 100,000 U.S. adults that inquired about respondents' race, ancestry, and genealogical knowledge. We find that people in our sample who have taken a GAT, compared with those who have not, are more likely to self-identify as multiracial and are particularly likely to select three or more races. This difference in multiple-race reporting stems from three factors: (1) people who identify as multiracial are more likely to take GATs; (2) GAT takers are more likely to report multiple regions of ancestral origin; and (3) GAT takers more frequently translate reported ancestral diversity into multiracial self-identification. Our results imply that Americans will select three or more races at higher rates in future demographic data collection, with marked increases in multiple-race reporting among middle-aged adults. We also present experimental evidence that asking questions about ancestry before racial identification moderates some of these GAT-linked reporting differences. Demographers should consider how the meaning of U.S. race data may be changing as more Americans are exposed to information from GATs.

New poetics of postcolonial relations: global genetic kinship in Zadie Smith's White Teeth and Amitav Ghosh's The Calcutta Chromosome

Conceptions of genetic kinship have recently emerged as a powerful new discourse through which to trace and imagine connections between individuals and communities around the globe. This article argues that, as a new way to think and represent such connections, genetic discourses of relatedness constitute a new poetics of kinship. Discussing two exemplary contemporary novels, Amitav Ghosh's The Calcutta Chromosome (1995) and Zadie Smith's White Teeth (2000), this article argues further that literary fiction, and postcolonial literary fiction in particular, is uniquely positioned to critically engage this new biomedical discourse of global and interpersonal relations. Ghosh's and Smith's novels illuminate and amplify the concept of a cultural poetics of genetic kinship by aesthetically transcending the limits of genetic science to construct additional genetic connections between the West and the Global South on the level of metaphor and analogy. As both novels oscillate spatially between the West and a postcolonial Indian subcontinent, the texts' representations of literal and figurative genetic relations become a vehicle through which the novels test and reconfigure postcolonial and diasporic identities, as well as confront Western genetic science with alternative forms of knowledge. The emerging genetic imaginary highlights-evoking recent sociological and anthropological work-that meaningful kinship relations rely on biological as much as on cultural discourses and interpretations, especially in postcolonial and migrant contexts where genetic markers become charged with conflicting notions of connection and otherness.

Taking an antiracist posture in scientific publications in human genetics and genomics

From its earliest days, the field of human genetics has had a complex, and at times troubling, connection with racist ideologies. Although the modern field of human genetics and genomics has come a long way from those earlier errors, systemic racism remains ingrained in its institutions and practices. Although a variety of efforts are needed to excise systemic racism, we focus in this commentary on the work that must be done in scientific publishing in genetics and genomics. We propose eight principles that are both scientifically grounded and antiracist that we hope will serve as a foundation for the development of policies by publishers and editorial boards that address the unique needs of the field of genetics and genomics. Publishers and journals must go beyond mere policies, however. Editors and reviewers will need training on these policies and principles, and will benefit from resources like rubrics that can be used for evaluating the adherence of submissions to these guidelines.

A variant-centric perspective on geographic patterns of human allele frequency variation

A key challenge in human genetics is to understand the geographic distribution of human genetic variation. Often genetic variation is described by showing relationships among populations or individuals, drawing inferences over many variants. Here, we introduce an alternative representation of genetic variation that reveals the relative abundance of different allele frequency patterns. This approach allows viewers to easily see several features of human genetic structure: (1) most variants are rare and geographically localized, (2) variants that are common in a single geographic region are more likely to be shared across the globe than to be private to that region, and (3) where two individuals differ, it is most often due to variants that are found globally, regardless of whether the individuals are from the same region or different regions. Our variant-centric visualization clarifies the geographic patterns of human variation and can help address misconceptions about genetic differentiation among populations.