Achieving cultural safety in genetic counseling for Aboriginal and Torres Strait Islander people in Australia

Globally, Indigenous people, including Aboriginal and Torres Strait Islander people in Australia, experience significantly poorer health outcomes than their non-Indigenous counterparts. In part, this can be attributed to the ongoing impacts of colonization, marginalization, and systemic discrimination. In the genomic healthcare era, Indigenous people remain underrepresented in public genetic health services, raising concerns about cultural competency and inclusivity within the genetic counseling profession. Without culturally safe and accessible genetic services, the disparities in Indigenous people's health could widen. This paper explores cultural safety within the context of genetic counseling for Aboriginal and Torres Strait Islander people in Australia. It outlines the historical, social, and cultural factors influencing engagement with healthcare, including the ongoing impacts of colonization, intergenerational trauma, and institutional racism, and discusses how these continue to shape experiences of care today. Drawing on the core competencies defined by the Human Genetics Society of Australasia (HGSA), the paper highlights how relationship building, reflective practice, client-centered counseling, and advocacy can be applied to foster culturally safe and responsive practice. Ultimately, providing culturally safe genetic counseling requires moving beyond cultural awareness and competency toward practices that empower Aboriginal and Torres Strait Islander clients, families, and communities. This includes recognizing collective decision-making processes, kinship systems, and the importance of trust and respect in clinical encounters. By embedding cultural safety at both individual and institutional levels, genetic counselors can contribute meaningfully to reducing health inequities and ensuring equitable participation in genomic healthcare for Aboriginal and Torres Strait Islander people.