As a genetic counselor, teaching people about genetics and how it fits into their lives is obviously a passion of mine. In graduate school, I began teaching genetics in prison. At one point I taught a short course on family health history to a group of women incarcerated in a state prison in Utah. The discussion was lively and thoughtful. The students made ties between social family histories of trauma and complex modes of genetic inheritance. At the end of the class, one of the women who had been the most engaged asked me if she could also become a genetic counselor. She was looking to help others upon her release and the class had resonated with her as someone who had long been interested in genealogy. My heart sank knowing that the answer was almost certainly “No.” In nearly all states that have licensure, a felony will automatically disqualify you. She could likely not become board certified, let alone make it past a graduate school admissions committee.

My relationships with incarcerated people have forced me to be honest about the stigma we still place upon them. Before I had any exposure to prison life and the stories of incarcerated people, I had not questioned why people went to prison or the utility of prisons as part of a system of justice. My experiences taught me to ask questions, and I now know that the majority of people incarcerated in America are serving time for “crimes of poverty” or acts related to the extensive exploitation of a system that denies universal access to the basic tools of life such as healthcare, education, and a living wage (Hayes, 2020). For example, evidence suggests that the single most impactful program that could be implemented to reduce crime, is universal healthcare (Doleac, 2018).

Our culture is rife with generational trauma related to systems of oppression (as my students aptly pointed out) that feeds violence. Although certainly many people in prisons have caused harm (as have many who have never been to prison), our prisons provide few (if any) resources aimed at personal or societal growth and healing, redemption, restitution for victims of harm, or solutions to the root causes of harm. Instead, they are primarily a misguided attempt to offload the consequences of our social problems. However, in the words of Angela Davis, “prisons do not disappear social problems, they disappear human beings.” Instead of providing solutions, prisons may actually increase harm by housing people in dangerous, traumatizing environments that leave them less able to function in society once released (Davis, 2003; Law, 2021).

It took me hundreds of questions and hours of reading and conversations to arrive at this new knowledge; I am still learning every day. I recently started asking questions about incarceration through a professional lens. I have come to feel that “disappearing” people is not in line with the stated values of our profession. Each patient, each person deserves dignity, autonomy, and respect; this is true for both people who have been harmed and who have done harm. Ultimately, we are all both of those things. I hope we can start asking questions about the ways that we disappear those who experience incarceration in the field of genetic counseling, and become critical of systems of incarceration in general. What patients are we not seeing because they are behind bars? What is life like for someone with a genetic condition who is experiencing incarceration? Who do we feel deserves genetic counseling and why? How has past incarceration or the incarceration of a family member affected our patients? What contributions to our field are we losing by closing the door on people like my student and what motivates us to keep that door closed? The list of questions could be endless and I hope we can add to them as a community. I look forward to the discussions they may generate and the news paths for moving forward that they may create.

References:

1. Davis, A. Y. (2003). Are Prisons Obsolete?
2. Doleac, J. L. (2018, January 3). New evidence that access to health care reduces crime. Brookings.
3. Hayes, T. O. (2020, June 30). Incarceration and Poverty in the United States. AAF; American Action Forum.
4. Law, V. (2021). “Prisons Make Us Safer”: And 20 Other Myths about Mass Incarceration. Beacon Press.

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