The Military Health System (MHS), the United States Department of Veterans Affairs (VA) and civilian health care systems provide care for over 18 million active-duty military service members, veterans and their families in the United States. Genetic and genomic testing can have unique implications for members of this patient population, which genetic counselors are well-prepared to discuss. However, serving this population often involves addressing questions regarding policy and counseling issues that are not regularly considered in the civilian sector. The NSGC Military SIG was created in December 2023 as a community resource to connect genetic counselors serving U.S. military populations worldwide, in order to provide a space and opportunity to exchange support, education and leadership resources related to this important patient population.

Within the first months of its launch, the SIG was thrilled to have 30 members (!). In our first meetings, Military SIG members began planning educational activities and creating a repository of genetic counseling resources. Keep an eye out for our directory of genetic counselors within the MHS and VA networks who can be contacted for questions regarding your local patient population. This will be a great resource, as military system-affiliated genetics providers are few and far between!

As already seen on our SIG discussion board, there are special counseling and policy considerations related to genetic testing for current, former, and future United States military service members and their families. A big topic is military service exceptions to the employment protections of the Genetic Information Non-Discrimination Act (GINA). For example, while testing for a known familial MLH1 pathogenic variant in a young, healthy adult can be beneficial for cancer screening and reproductive planning, a diagnosis of Lynch syndrome can impact future military career aspirations. Lynch syndrome is listed in the Medical Standards for Appointment, Enlistment or Induction in the Military Services (DoD Instruction 6130.03) as a condition that may disqualify an individual from enlisting in, or continuing military service. Having space to share professional experiences and raise awareness of specific challenges to this patient population will help inform our genetic counseling practices, and may shape future guidance at both NSGC and military policy levels. This SIG strives to support genetic counselors working in the MHS and VA, plus those working outside these health systems who also provide patient care, laboratory testing, advocacy or engage in genomic research activities involving these populations. In addition, the Military SIG provides leadership in this area and strives to educate the public, policymakers, healthcare industry leaders and NSGC leadership on military-specific considerations.

The SIG looks forward to learning from genetic counselors across various specialties, supporting one another and connecting at future conferences. Continue to reach out, ask about this community and add your experience to help build genetic counseling resources — the Military SIG is excited to keep growing!

Cheyenne Caldwell, MS, CGC Cheyenne and Valerie are licensed clinical genetic counselors at Madigan Army Medical Center in Tacoma, WA. Between the two GCs and one medical geneticist, the small but mighty team covers a broad scope of genetics services for the military populations of the West Coast, including virtual and in-person referrals for adult and pediatric general genetics, adult cancer, and prenatal/preconception counseling. Kruger and Caldwell oversee practice improvement projects such as the development of virtual prenatal screening and preconception carrier screening group classes and providing genetics education for fellows and residents at Madigan. Ms. Kruger further maintains the genetics care standards for the hospital’s Commission on Cancer and Ms. Caldwell collaborates with the University of Washington Genetic Counseling Graduate Program to support genetic counseling fieldwork supervision.

Lydia Hellwig, PhD, ScM, CGC is a licensed genetic counselor and Assistant Professor of Pediatrics at the Uniformed Services University of the Health Sciences. Dr. Hellwig currently leads the Clinical Implementation Division at the Center for Military Precision Health. She is a researcher and counselor for many military genomic research studies. Her clinical practice, research, and teaching efforts seek to improve the way in which genomic technologies are used to maximize health and psychosocial outcomes.

Valerie Kruger, MS, CGC Cheyenne and Valerie are licensed clinical genetic counselors at Madigan Army Medical Center in Tacoma, WA. Between the two GCs and one medical geneticist, the small but mighty team covers a broad scope of genetics services for the military populations of the West Coast, including virtual and in-person referrals for adult and pediatric general genetics, adult cancer, and prenatal/preconception counseling. Kruger and Caldwell oversee practice improvement projects such as the development of virtual prenatal screening and preconception carrier screening group classes and providing genetics education for fellows and residents at Madigan. Ms. Kruger further maintains the genetics care standards for the hospital’s Commission on Cancer and Ms. Caldwell collaborates with the University of Washington Genetic Counseling Graduate Program to support genetic counseling fieldwork supervision.