On October 28, 1987, the U.S. Congress passed a proclamation of the first national Immigrants Day (Proclamation 5737, 1987). To commemorate this day, we are focusing this piece on a group of immigrants that are often stigmatized and condemned through stereotypes and fallacies, the undocumented and DACAmented immigrant community. As undocumented members of the genetic counseling community, we wanted to share the challenges we faced while pursuing a genetic counseling career. Our five perspectives may not represent the breadth of experience of 11 million undocumented immigrants in the U.S., but we hope that through sharing our experiences we can motivate our community to focus on making the genetic counseling profession more accessible (Esterline & Batalova, 2022). 

Understanding the Barriers to Entry in our Profession for Undocumented Prospective Students
For many immigrants in the U.S., a graduate education is the only path towards professional growth; a chance to create a promising future for us and our families. However, numerous barriers to entry can prevent undocumented students from reaching that goal.

In genetic counseling, some of the most prominent challenges undocumented students face that prevent us from attaining a graduate education include financial obligations, oppressive state educational policies, limited access to opportunities meant to fulfill application requirements and lack of guidance for undocumented applicants. Additionally, we have had to cope with uncertainty and shame surrounding our undocumented status which discourages us from sharing with friends and colleagues the hardships and fear we experience. Throughout the graduate program application process, we often feel vulnerable and unsure of how to productively disclose our immigration status. Feeling unable to openly share our circumstances with peers can make our journey seem incredibly isolating. To combat this, we have found that building a community of undocumented students has helped us feel less vulnerable and encouraged us to be transparent about our statuses. As we further develop this community, we have created a guide for undocumented students as they navigate entrance into the field. Guide for prospective undocu/DACAmented genetic counseling students.

Building Institutional Support for our Undocumented Genetic Counseling Students
Undocumented graduate students provide a rich and unique source of lived experience at academic institutions. This can enhance their peers’, colleagues’ and supervisors’ understanding of and compassion for the broader undocumented community (Whitla et al., 2033). As a group, undocumented students are self-reliant, and compassionate and possess the qualities necessary to be successful genetic counselors.  

Yet unlike their resident peers, undocumented students face unique challenges when pursuing graduate education. These may include confronting difficult emotions associated with the precarious regulations impacting our immigration status, the burden of acting as a community representative, lack of access to health care, limited financial resources (e.g., academic loans/aid) and an ill-defined career trajectory (i.e., no roadmap to practicing genetic counseling while undocumented). 

To navigate these challenges without guidance is difficult. Because of this, we rely on the support of those in institutional leadership positions. We are thankful for those who have listened, have provided unconditional positive regard, have elevated our voices and have helped us see a future for ourselves that we may not have imagined otherwise. However, we acknowledge that this support is not available at every institution. For that reason, we have written recommendations with solutions that can be implemented within graduate programs to best support undocumented genetic counseling students.

Guidance for genetic counselors that work with undo/DACAmented students

Enabling and Sustaining Undocumented Genetic Counseling Practitioners
Unsurprisingly, obstacles for undocumented genetic counselors persist beyond our graduate training. A notable barrier to practicing genetic counseling while undocumented is the personal identification requirement for our exam certification and licensure registration. Although DACA recipients can fulfill proper identification requirements, many undocumented individuals are not eligible for DACA and thus do not have appropriate ID preventing them from meeting these registration requirements. This, of course, negatively impacts their job prospects. Furthermore, unlike other international applicants, undocumented genetic counselors cannot apply for employment visa sponsorship through their employer. However, there are other work options, such as independent contracting, that remain largely unknown to many in our field. These hurdles are a harsh reality for undocumented genetic counselors hoping to contribute to our field and are key motivators driving us to give back to our communities and advance our careers in the present, because our futures are in no way guaranteed. 

We cannot do the work of addressing these issues alone. As such, we hope that this article will spur action in our field to help secure the futures of all genetic counselors. Visit www.undocugc.com to learn more ways to support the undocumented genetic counseling community!

Reposted from Genetic Counselor Insights. Stefania Alastre, MSPH, a coauthor of this story, is a bilingual genetic counselor and USF College of Public Health alumna who was a DACA recipient.