You do not need a genetic counselor for an ancestry or trait report. You should seriously consider one before a test that could reveal a serious inherited risk, when you are planning a pregnancy with a family history, or when you are weighing predictive testing, and after a pathogenic, uncertain or confusing result.
A counselor helps you decide whether to test, what the result can and cannot mean, and what it means for your relatives.
What a genetic counselor does
A genetic counselor is a healthcare professional trained in both medical genetics and counselling. The role is part educator, part interpreter, part support. A counselor does not usually replace your doctor, and the job is not to tell you what to do. It is to make sure you understand your options well enough to make your own decision.
In practice that means they take a family history, explain how conditions are inherited, describe what a given test can and cannot find, help you think through what you would do with each possible result, and explain next steps. Many also help families decide who else should be told or tested.
When to see one before testing
- A family history that worries you. Cancers at young ages, several relatives with the same condition, sudden cardiac deaths, or a known family variant. Our guide to genome testing for cancer risk and the post on hereditary cancer panels versus WGS explain what different tests can see.
- Planning a pregnancy. Carrier screening raises questions about partners, odds and options. See genetic testing before having kids.
- Predictive testing for a serious adult-onset condition with no cure, such as Huntington's disease. Many people find the decision to test hard, and counselling is a standard part of the process. Read our Huntington's testing guide.
- Considering whole genome sequencing with secondary findings. You can decide in advance what you want to hear. See secondary findings: opt in or opt out.
- Testing children for conditions that appear in adulthood, where parents and child may have different interests.
When to see one after a result
- A pathogenic or likely pathogenic variant. A counselor explains what the finding means, how reliable it is, and what changes in your care or your family's.
- A variant of uncertain significance. These are common and often confusing. See VUS explained.
- A result from a consumer test or third-party tool that alarms you. Counselling helps you decide whether to confirm it in a clinical laboratory. See DTC versus clinical-grade testing.
- A surprising family finding, such as unexpected relatives or a different biological parent. Counselors are used to supporting people through these.
- A result you are unsure how to share with relatives.
When you probably do not need one
An ancestry estimate or a trait report, such as bitter-taste or earwax type, carries no serious health decision. You can read about it, enjoy it and move on. The same goes for most wellness reports, although the more a report claims about disease risk, the more useful a second opinion becomes. For example, a polygenic score looks precise and often is not, as we explain in polygenic risk scores explained.
Not a replacement for a doctor. A genetic counselor can interpret and advise, but treatment decisions stay with the clinicians who care for you. Many counselors work alongside your doctor and may write to them directly.
What a session usually covers
- Your history. Personal and family health, drawn as a family tree where useful.
- The question. What you are trying to find out and why.
- Test options. Which tests exist, what each finds and misses, and whether a test is appropriate.
- Possible results. What each outcome could mean, including uncertain ones.
- Practical issues. Cost, insurance, privacy and who gets the results. The US Genetic Information Nondiscrimination Act has gaps, which we describe in our GINA explainer.
- Next steps. Screening, referrals, and whether relatives should be told.
How to find one
- Ask your doctor for a referral to a genetics clinic, especially if you are in a health system with one.
- Search a professional directory. In the United States, the National Society of Genetic Counselors maintains a Find a Genetic Counselor directory. Other countries have their own professional bodies.
- Consider telehealth. Many counselors see people remotely, which widens your choices.
- Know who you are talking to. Some testing companies provide counselling with their tests. Ask whether the counselor is independent of the lab and whether you can book a separate session.
Fees and insurance coverage vary widely by country, plan and provider, so ask for the current cost and what your coverage includes before you book.
How to prepare
- Gather your family history: which relatives had which conditions, and at what ages.
- Bring any previous genetic test reports.
- Write down your questions, and what you most want or fear to learn.
- Decide who you would want to tell, and how you feel about relatives learning the result.
If you plan to take the result to your regular doctor afterwards, see how to bring consumer DNA results to your doctor.
Bottom line
Think of a genetic counselor as a decision aid. The more serious, uncertain or family-affecting the result could be, the more a session before or after testing is worth it. For curiosity-level reports you can skip it. When in doubt, a short appointment is cheap insurance against acting on a result you misunderstood.
Common questions
What does a genetic counselor do?
A genetic counselor is a healthcare professional trained in genetics and counselling. They take a family history, explain inheritance and test options, help you interpret results, and support decisions about next steps and sharing information with relatives.
Do I need a genetic counselor before taking a DNA test?
Not for ancestry or trait reports. It is worth seeing one before tests that could reveal serious inherited risks, when you have a concerning family history, when planning a pregnancy, or before predictive testing for adult-onset conditions.
Can I see a genetic counselor after getting my results?
Yes, and many people do. It is especially useful after a pathogenic or uncertain variant, an alarming consumer or third-party report, or an unexpected family finding.
Is a genetic counselor the same as a geneticist?
No. A medical geneticist is a physician who diagnoses and manages genetic conditions, while a genetic counselor is a specialist in genetics and counselling who educates and supports. They often work together.
How much does genetic counselling cost?
It varies by country, provider and insurance. Some health plans cover it when criteria are met, and some providers offer it as part of a test. Ask for the current fee and what your coverage includes.
Sources and verification
This article describes the role of genetic counselors in general terms and contains no statistics. We could not load the professional directory or a counselling-society page during this update, so details such as the directory's features should be confirmed on the National Society of Genetic Counselors website.
Medical disclaimer. GenomeTesting.org publishes educational content about genetics and consumer genomic testing. Nothing here is medical advice, a diagnosis, or a substitute for care from a qualified clinician or genetic counsellor. Decisions about testing, treatment, or interpreting your own results should be made with a healthcare professional who can see your full history.