Factors affecting genetic counseling experiences of foreign residents in Japan: implications for healthcare inclusivity

The rapid development of genomic medicine and simultaneous global diversification of societies present new and complex challenges for healthcare systems worldwide. Medical professionals are now expected to communicate highly complex and evolving genetic information while simultaneously addressing the diverse linguistic, cultural, and social needs of their patient populations. At the center of this effort is the genetic counselor, who must navigate cultural perceptions of genetics, varying levels of health literacy, language barriers, and socioeconomic disparities to deliver equitable and effective care. Research in this area is expanding. However, its global distribution remains uneven and disproportionately concentrated in certain regions. In Japan, where many sectors of society are not yet fully equipped to meet the needs of its increasing migrant population, i.e., foreign residents, research describing the factors that impact their genetic counseling experiences is scarce. To fill this gap, we conducted semi-structured qualitative interviews with ten individuals who have had genetic counseling in Japan for prenatal diagnosis/screening, hereditary cancer, or hereditary monogenic disease. Thematic analysis revealed five factors that impacted their experience with genetic counseling: (1) Japanese language proficiency, (2) genetic literacy, (3) digital health literacy, (4) global family connections, and (5) interactions with medical professionals. These findings not only provide nuance to existing literature but also suggest areas of improvement for the cultural competence training of genetic counselors in Japan and point towards the need for guiding resources at the international level.