February marks a time to remember and celebrate people of the African diaspora. To kick off a Black History Month of reflection, we’d like to highlight some of the projects 23andMe has been working on to specifically address disparities in biomedical and genetic research for people of African ancestry.
Research shows that <a href="https://www.nature.com/articles/s41586-019-1310-4">genetic studies that include diverse, multi-ethnic participants</a> have a higher chance of discovering important genetic variants associated with diseases. Those associations would have been missed in studies that focus only on one homogenous group.
<h6>We Need to Do Better</h6>
Despite this, as of 2019, <a href="https://www.cell.com/cell/fulltext/S0092-8674(19)30231-4">only two percent of participants in genome-wide association studies</a> around the world were people of African ancestry. Additionally, <a href="https://www.23andme.com/dna-health-ancestry">genetic risk prediction</a> scores, which will be instrumental in the future of personalized medicine, need to take ancestry into account. A risk score developed for one population may not be as accurate for another, exacerbating already existing health disparities for African Americans.
But it’s not enough for us to wait for others to fix the problem. As our <a href="https://www.23andme.com/black-lives-matter">CEO Anne Wojcicki stated last June</a>, “We absolutely have the potential to be better. Despite our efforts, I have to honestly say that we are also part of the problem.”
<h6>Some History</h6>
Over the years, we have made an effort to ensure our product and research are relevant to those of African ancestry. Here is a snapshot of our progress over the last decade:
2011: We launched our <a href="https://www.23andme.com/roots/">Roots into the Future</a> project to recruit 10,000 African Americans to participate in research.<img loading="lazy" decoding="async" class="alignright size-medium wp-image-9427" src="https://blog-api.23andme.com/wp-content/uploads/2011/07/RootsLogo-300x300.png" alt="" width="300" height="300" srcset="https://blogcms.23andme.com/wp-content/uploads/2011/07/RootsLogo-300x300.png 300w, https://blogcms.23andme.com/wp-content/uploads/2011/07/RootsLogo-150x150.png 150w, https://blogcms.23andme.com/wp-content/uploads/2011/07/RootsLogo-768x768.png 768w, https://blogcms.23andme.com/wp-content/uploads/2011/07/RootsLogo-1024x1024.png 1024w, https://blogcms.23andme.com/wp-content/uploads/2011/07/RootsLogo-880x880.png 880w, https://blogcms.23andme.com/wp-content/uploads/2011/07/RootsLogo-271x271.png 271w, https://blogcms.23andme.com/wp-content/uploads/2011/07/RootsLogo-372x372.png 372w, https://blogcms.23andme.com/wp-content/uploads/2011/07/RootsLogo-574x574.png 574w, https://blogcms.23andme.com/wp-content/uploads/2011/07/RootsLogo-980x980.png 980w, https://blogcms.23andme.com/wp-content/uploads/2011/07/RootsLogo.png 1050w" sizes="auto, (max-width: 300px) 100vw, 300px" />
2013: We launched our first African Ancestry Project, which recruited people with four grandparents from Sub-Saharan Africa.
2014: With this additional data from people of African ancestry, we published <a href="http://www.cell.com/ajhg/abstract/S0002-9297%2814%2900476-5">the first large-scale study of genetic ancestry in the United States</a> that reflects historical migrations.
2015: Using external research, we launched our Health service with a report for sickle cell anemia and a report for beta-thalassemia and related hemoglobinopathies, among others. Both of these conditions are highly relevant for people with African ancestry.
2016: We reached the milestone of 45,000 African Americans participating in 23andMe research.
2016: We <a href="https://blog.23andme.com/articles/23andme-scientists-improving-diversity-in-genetic-research/">received a National Institutes of Health (NIH) grant</a> to help us develop a new analysis pipeline that may alleviate disparities in research.
2016: We launched the <a href="https://www.23andme.com/africa-project/">African Genetics Project</a>, further recruiting individuals with ancestry from one of 16 African countries, expanding our recruitment outside of Sub-Saharan African ancestry.<img loading="lazy" decoding="async" class="alignright size-medium wp-image-25259" src="https://blog-api.23andme.com/wp-content/uploads/2017/01/05242016_ig_ad_3-300x300.jpg" alt="" width="300" height="300" srcset="https://blogcms.23andme.com/wp-content/uploads/2017/01/05242016_ig_ad_3-300x300.jpg 300w, https://blogcms.23andme.com/wp-content/uploads/2017/01/05242016_ig_ad_3-150x150.jpg 150w, https://blogcms.23andme.com/wp-content/uploads/2017/01/05242016_ig_ad_3-768x768.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2017/01/05242016_ig_ad_3-1024x1024.jpg 1024w, https://blogcms.23andme.com/wp-content/uploads/2017/01/05242016_ig_ad_3-880x880.jpg 880w, https://blogcms.23andme.com/wp-content/uploads/2017/01/05242016_ig_ad_3-271x271.jpg 271w, https://blogcms.23andme.com/wp-content/uploads/2017/01/05242016_ig_ad_3-372x372.jpg 372w, https://blogcms.23andme.com/wp-content/uploads/2017/01/05242016_ig_ad_3-574x574.jpg 574w, https://blogcms.23andme.com/wp-content/uploads/2017/01/05242016_ig_ad_3-980x980.jpg 980w, https://blogcms.23andme.com/wp-content/uploads/2017/01/05242016_ig_ad_3.jpg 1080w" sizes="auto, (max-width: 300px) 100vw, 300px" />
2016: We launched the <a href="https://blog.23andme.com/articles/african-american-sequencing-project/">African American Sequencing Project</a>, which also received funding from the NIH, to create a genomic reference panel that was shared with the broader scientific community for research.
2017: We launched the <a href="https://blog.23andme.com/articles/global-genetics-project/">Global Genetics Project</a>, further recruiting individuals underrepresented in genomics research, including 45 countries in Africa.
2018: We launched our <a href="https://blog.23andme.com/articles/23andmes-populations-collaborations/">Populations Collaborations Program</a>, which partners with academic researchers working across the globe to genotype people in communities who are underrepresented in genetics research, including Angola, Madagascar, and the Democratic Republic of the Congo.
2018: Thanks to contributions from our African Genetics Project and Populations Collaborations Program, we <a href="https://blog.23andme.com/articles/new-african-east-asian-details/">updated our Ancestry Composition report</a> to now reflect nine additional ancestry regions within Africa.
2018: Using external research, we developed a health report for G6PD deficiency, a blood disorder that can affect one in 10 African American men.
2019: We reached the milestone of 295,000 African Americans participating in 23andMe research, which is six times our cohort size just four years prior!
2019: The de-identified data from the African American Sequencing Project was made available to qualified researchers through the <a href="https://www.ncbi.nlm.nih.gov/">National Center for Biotechnology Information’s database of Genotypes and Phenotypes (dbGaP)</a>, allowing other qualified researchers to improve the accuracy of their genetic research on people of African descent.
2019: Using external research, we developed a report for TTR-related hereditary amyloidosis.  About one in 28 African Americans is estimated to have a gene variant that predisposes to this heart condition.
2020: We expanded our Global Genetics Project to specifically recruit from subregions within Nigeria.
<img loading="lazy" decoding="async" class="alignright size-medium wp-image-27481" src="https://blog-api.23andme.com/wp-content/uploads/2019/09/GGP-face-asset-1-300x300.png" alt="" width="300" height="300" srcset="https://blogcms.23andme.com/wp-content/uploads/2019/09/GGP-face-asset-1-300x300.png 300w, https://blogcms.23andme.com/wp-content/uploads/2019/09/GGP-face-asset-1-150x150.png 150w, https://blogcms.23andme.com/wp-content/uploads/2019/09/GGP-face-asset-1-768x768.png 768w, https://blogcms.23andme.com/wp-content/uploads/2019/09/GGP-face-asset-1-1024x1024.png 1024w, https://blogcms.23andme.com/wp-content/uploads/2019/09/GGP-face-asset-1-880x880.png 880w, https://blogcms.23andme.com/wp-content/uploads/2019/09/GGP-face-asset-1-271x271.png 271w, https://blogcms.23andme.com/wp-content/uploads/2019/09/GGP-face-asset-1-372x372.png 372w, https://blogcms.23andme.com/wp-content/uploads/2019/09/GGP-face-asset-1-574x574.png 574w, https://blogcms.23andme.com/wp-content/uploads/2019/09/GGP-face-asset-1-980x980.png 980w, https://blogcms.23andme.com/wp-content/uploads/2019/09/GGP-face-asset-1.png 1080w" sizes="auto, (max-width: 300px) 100vw, 300px" />2020: We launched our Black Representation in Genetic Research study, which will conduct RNA sequencing that will also be made publicly available to qualified researchers when complete.
2020: Our <a href="https://research.23andme.com/research-innovation-collaborations/">Research Innovations Collaborations program</a> made a specific call for proposals that are of high significance for underrepresented populations, including groups with African ancestry, in order to further address health disparities.
2020: Using external research, we developed a report for APOL1-related chronic kidney disease. Chronic kidney disease (CKD) is common and underdiagnosed, and the risk for severe disease is about three times higher in African Americans. About one in eight African Americans has a genetic predisposition for CKD due to variants in the APOL1 gene.
2021: 23andMe now has one of, if not the largest research cohort of genotyped and phenotyped people of African ancestry, with hundreds of thousands of individuals consenting to participate in research.
<h6>Studies Relevant to the Black Community</h6>
Because of these recruitment efforts, 23andMe has already been able to conduct health-related genome-wide association studies specific to people with African ancestry for example around <a href="https://link.springer.com/article/10.1007/s00439-017-1836-1">uterine fibroids</a> and <a href="https://www.nature.com/articles/s41588-018-0307-5">alcohol and tobacco use</a>. This research may also help us develop more health reports that are particularly important for this group. Foundational studies like these are key to reducing disparities in health care in the future.
Thanks to this research, we have also learned more about human history and migration, and can now match customers to over 150 subregions within Africa. We also r<a href="https://blog.23andme.com/articles/transatlantic-slave-trade-paper/">ecently published one of the most comprehensive investigations of the genomic consequences of the transatlantic slave trade</a> ever done in the American Journal of Human Genetics.
<img loading="lazy" decoding="async" class="aligncenter wp-image-30848 size-full" src="http://35.88.189.111/wp-content/uploads/2022/02/DEI-Blog-1024x536-1.png" alt="" width="1024" height="536" srcset="https://blogcms.23andme.com/wp-content/uploads/2022/02/DEI-Blog-1024x536-1.png 1024w, https://blogcms.23andme.com/wp-content/uploads/2022/02/DEI-Blog-1024x536-1-300x157.png 300w, https://blogcms.23andme.com/wp-content/uploads/2022/02/DEI-Blog-1024x536-1-768x402.png 768w, https://blogcms.23andme.com/wp-content/uploads/2022/02/DEI-Blog-1024x536-1-880x461.png 880w" sizes="auto, (max-width: 1024px) 100vw, 1024px" />And this is only the beginning. With all this new data, the next few years should see a slew of new studies of particular interest and relevance to those of African ancestry. In addition to improving the inclusivity of our research and product, we are also committed to Diversity Equity and Inclusion across the board. That includes our hiring practices and employee experience, as well as community impact. And as Anne said, we’re asking that our customers hold us accountable. So keep checking back to make sure we’re advancing genetic research for all people, regardless of their ancestry.
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*The 23andMe PGS test uses qualitative genotyping to detect select clinically relevant variants in the genomic DNA of adults from saliva for the purpose of reporting and interpreting genetic health risks and reporting carrier status. It is not intended to diagnose any disease. Your ethnicity may affect the relevance of each report and how your genetic health risk results are interpreted. Each genetic health risk report describes if a person has variants associated with a higher risk of developing a disease, but does not describe a person’s overall risk of developing the disease. The test is not intended to tell you anything about your current state of health, or to be used to make medical decisions, including whether or not you should take a medication, how much of a medication you should take, or determine any treatment. Our carrier status reports can be used to determine carrier status, but cannot determine if you have two copies of any genetic variant. These carrier reports are not intended to tell you anything about your risk for developing a disease in the future, the health of your fetus, or your newborn child&#8217;s risk of developing a particular disease later in life. For certain conditions, we provide a single report that includes information on both carrier status and genetic health risk. For important information and limitations regarding each genetic health risk report and carrier status report, visit  <a href="https://www.23andme.com/test-info/">https://www.23andme.com/test-info/</a>.

23andMe Blog

23andMe Blog Team

Reflecting on Improving Diversity in 23andMe Research for Black History Month

23andMe Researchers analyzed weight measurements from 23andMe research participants in the weeks before, during, and after the Christmas holiday 2020. 
For many of us, holiday weight gain is just another end of year tradition. 
But this year&#8217;s seasonal celebrations, like many things in 2020, were different. 
23andMe scientists wanted to know whether the annual tradition of gaining a few pounds over the holiday was any different this year. 
To do this our scientists analyzed daily weight measurements from about 1,000 23andMe customers who consented to participate in research and connected their mobile health data (Apple® Health, Google FitTM) to the 23andMe mobile app. 
This is what we learned about weight trends between Dec 14 to Jan 3. 
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 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="1024" height="449" src="https://blogcms.23andme.com/wp-content/uploads/2019/09/Diet-Exercise-istock-1024x449.jpg" alt="" class="wp-image-27549" srcset="https://blogcms.23andme.com/wp-content/uploads/2019/09/Diet-Exercise-istock-1024x449.jpg 1024w, https://blogcms.23andme.com/wp-content/uploads/2019/09/Diet-Exercise-istock-300x132.jpg 300w, https://blogcms.23andme.com/wp-content/uploads/2019/09/Diet-Exercise-istock-768x337.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2019/09/Diet-Exercise-istock-880x386.jpg 880w, https://blogcms.23andme.com/wp-content/uploads/2019/09/Diet-Exercise-istock-1180x518.jpg 1180w, https://blogcms.23andme.com/wp-content/uploads/2019/09/Diet-Exercise-istock.jpg 1545w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>
 
<h6>We avoid the scale on Christmas</h6>
Weigh-ins on Christmas day are lower compared to other days of the year, by about 15 percent.
It is easy to imagine why we might not step on the scale on Christmas: maybe we&#8217;re away from the scale and out of our normal routines, or we might just be trying to avoid receiving negative information. There’s a name for that, a behavioral phenomenon known as the <a href="https://effectiviology.com/ostrich-effect/">Ostrich effect</a>.  
<h6>On average people gain weight, but it&#8217;s not very much</h6>
In the days leading up to Christmas, weight measurements indicated that participants&#8217; weight was relatively stable during that time. But on the days following Christmas, the data indicate that participants put on weight, about half a pound on average. That means that overall among the research participants in the study, there was more weight gained than lost in the few days after Christmas. 
<h6>The holiday aftermath </h6>
It may be no surprise that we tend to gain weight over the holidays, but according to the data, it doesn&#8217;t stop at Christmas. 
Approximately half of the participants in the study (51 percent) showed an increase in weight during the week following Christmas, which includes New Year&#8217;s Day. Fifty-eight percent of males and 43 percent of females in the study logged weight increases during this week compared to their pre-Christmas weight. 
Weight increases seen after Christmas were moderate, around one or two pounds. Only a fraction of participants (about 18 percent) logged weight increases of two pounds or more. 
<h6>Closing the book on 2020 </h6>
All in all, the results of our analysis suggest that despite the chaos of 2020, the consequences of seasonal holiday indulgences seemed to continue as expected, although we may have tried to avoid them by not stepping on the scale. 
<h6>Getting ready for 2021</h6>
The new year is still young and it likely has a few more curveballs in store for us. But in terms of your health, 23andMe customers can start tracking data like steps, exercise, heart rate, and calories using the Lifestyle Dashboard in the 23andMe Apple and Android apps. To visit, look for the ‘Lifestyle Dashboard’ link on your app home tab, or under the health section. (Not yet a customer? Find out more <a href="https://www.23andme.com/compare-dna-tests/?sub=fyf">here</a>,) 
Because even if we can&#8217;t predict what 2021 will bring for us, at least we can track it. 
<hr />
Apple®, iPhone®, Apple Watch® are registered trademarks of Apple, Inc.
©2020 Google LLC All rights reserved. Google FitTM is a trademark of Google LLC.

Holiday Season Weight Trends 2020

Editor&#8217;s note: Today is &#8220;Data Privacy Day&#8221; so we thought it was a good time for a chat with Jacquie Haggarty, who among other roles, is 23andMe&#8217;s Privacy Officer.
 Jacquie joined 23andMe in 2015 and serves as the company’s Vice President, Deputy General Counsel, and Privacy Officer.&nbsp;
Prior to her work at 23andMe, Jacquie served as Senior Commercial Counsel at Genomic Health, where she focused on global legal and health care compliance. She spent the first six years of her legal career at Latham &amp; Watkins LLP, working directly with a diverse portfolio of public and private companies on securities, employment, and general commercial litigation.&nbsp;
Jacquie earned her J.D. from Georgetown University Law Center, her Masters in Public Policy from Harvard Kennedy School, and her B.A. from U.C. Berkeley.
We sat down with Jacquie to hear her perspective on privacy and data protection within the consumer genetics industry.
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 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="683" height="1024" src="https://blogcms.23andme.com/wp-content/uploads/2021/01/Haggarty-HS-9.2019-683x1024.jpg" alt="" class="wp-image-28744" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/01/Haggarty-HS-9.2019-683x1024.jpg 683w, https://blogcms.23andme.com/wp-content/uploads/2021/01/Haggarty-HS-9.2019-200x300.jpg 200w, https://blogcms.23andme.com/wp-content/uploads/2021/01/Haggarty-HS-9.2019-768x1152.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2021/01/Haggarty-HS-9.2019-587x880.jpg 587w, https://blogcms.23andme.com/wp-content/uploads/2021/01/Haggarty-HS-9.2019-787x1180.jpg 787w, https://blogcms.23andme.com/wp-content/uploads/2021/01/Haggarty-HS-9.2019-scaled.jpg 1707w" sizes="auto, (max-width: 683px) 100vw, 683px" /></figure>
 
<h6></h6>
<h6>Q: How do you see your role as the Privacy Officer for 23andMe?&nbsp;</h6>
Privacy is complex in practice, but my focus is simple — to ensure the privacy of our customers’ data and support customers’ choice and access throughout their experience as they explore their DNA. That involves working across the company to educate on our privacy commitments to our customers, to support the design and build of systems, policies, and processes that maintain and strengthen data protection, and to foster the development of content that provides transparency. As Privacy Officer, it’s important to me that we are being clear with our customers about our data practices and then doing what we say.&nbsp;
So on top of making sure that we adhere to our own strict privacy policies, my job is also to ensure 23andMe adheres to what is an extremely complex set — and growing set — of local, federal, and international privacy laws, such as the European Union General Data Protection Regulation (GDPR), and the California Consumer Privacy Act of 2018 or “CCPA” which was recently amended and expanded by the California Privacy Rights Act of 2020 (CPRA) ).&nbsp;
Beyond that, as 23andMe’s Privacy Officer, my job is to educate and inform people about what we do to protect customers’ data. I remind people that customer choice and consent is core to our service and the customer experience — what you learn from your DNA with 23andMe and with whom it may be shared is up to you. And I let people know that 23andMe does not share our customer data with public databases. We don’t share it with employers, or insurance companies, and we have never provided customer information to law enforcement.&nbsp;
I also am continuing our work with the <a href="https://fpf.org/about/">Future of Privacy Forum</a> through which we collaborated with other genetic testing companies to develop the consumer genetic testing <a href="https://fpf.org/2018/07/31/privacy-best-practices-for-consumer-genetic-testing-services/">industry privacy best practices</a>. 23andMe is also a member of the <a href="https://geneticdataprotection.com/">Coalition for Genetic Data Protection</a> (CGDP) where we work to advance legislation and policies that support the privacy and security of individual genetic data so that all genetic testing companies will be held to the same high standards for protecting customers’ data.&nbsp;
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[vc_video link=&#8221;https://youtu.be/EW9nDuerQws&#8221; align=&#8221;center&#8221;]
<h6></h6>
<h6>Q: What should customers know about how 23andMe approaches the privacy of customer data?</h6>
Customers should know that choice and transparency are the two cornerstones of our privacy approach to what we do.&nbsp;
Our customers have control — they are in the driver’s seat when it comes to their data. 23andMe is a mission-driven company founded to empower people by giving them access to their genetic information. Part of empowering our customers is giving them a choice, such as the choice about whether they want to view certain sensitive health reports and the choice about whether they want to share any of their information. We do not make assumptions about the way our customers want to share their information when we build features; customers choose with whom they share their information and whether they want to participate in various features, such as DNA Relatives which allows customers who opt-in to participate to find genetic relatives in our database who have also opted into <a href="https://www.23andme.com/dna-ancestry">DNA Relatives</a>.&nbsp;
Giving customers choice also means allowing them to change their minds. At 23andMe, customers can simply revoke their consent to participate in research or opt-out of participation in any feature at any time.
We listen to customers and work closely with our Customer Care team to make sure we address privacy topics and concerns most important to them. Meaningful choice requires transparency and we work hard to make information accessible, including presenting information in ways that are easy to understand.&nbsp;&nbsp;
We give our customers the choice to participate in our research, and we communicate with our customers about the published studies where their data was used, if they chose to participate. We want our research participants to know how they are helping fuel scientific discoveries in this new genomic age. I know as a customer myself who is participating in research, being able to see that I have contributed to published discoveries on topics as varied as knee pain, depression, and Parkinson’s disease is immensely gratifying.
<h6>Q: What are some of the most common misconceptions about 23andMe’s approach to privacy?</h6>
The three biggest misconceptions are around law enforcement, selling data, and how our research works.&nbsp;
First, 23andMe does not allow law enforcement to access its database, nor does it voluntarily cooperate with any law enforcement investigation. We require all law enforcement inquiries to follow a valid legal process, such as a court order or search warrant and are prepared to exhaust available legal remedies to protect customer privacy.&nbsp;
We are committed to transparency in our interaction with law enforcement, which led us in 2015 to be the first direct-to-consumer genetic testing company to publish a <a href="https://www.23andme.com/transparency-report/">Transparency Report</a>. This report details the number of requests we receive from law enforcement, and the number of times we have produced customer information to law enforcement without the customer’s prior, explicit consent &#8211; to date, we have never provided customer information to law enforcement.&nbsp;
Second, 23andMe does not sell customer’s personal information. We do not share customer data with any third party without the customer’s consent. And, we do not share customer information with insurance companies or employers.
Finally, our Research program is no exception — customers have to separately opt-in to participate in Research. Research is at the core of our mission as a company and it has been from the start. 23andMe’s pioneering research model engages people and invites them to participate online, from anywhere. Traditional research was often limited to physical, onsite recruitment with limited numbers of participants. About 80 percent of our customers choose to participate in our Research program, many tell us they want to accelerate new insights into disease.&nbsp;
Our Research program is overseen by an independent institutional review board or “IRB” — this is an ethics review board that ensures 23andMe is meeting ethical and legal obligations for research and consent. We are also transparent about our research collaborations, sharing our projects and their findings via email, blog posts, and press releases when published.&nbsp;
23andMe does sometimes collaborate on research with third parties. In doing so, we only analyze data from customers who have consented to participate in Research. The data we analyze is de-identified — that is, it does not include personally identifiable information such as name or email — and results that are shared are aggregated datasets so that individuals cannot reasonably be re-identified. Customers can also separately choose to participate in Research with individual-level data sharing. And of course, customers can decide to opt-out at any time from any research.&nbsp;
<h6>Q: Why do you like working at 23andMe?&nbsp;</h6>
I’m disruptive — I love challenging the status quo — and I love working for a company that is focused on disrupting healthcare by empowering customers with their own data. For over five years, I’ve been inspired by our customers’ life-changing stories, inspired by our research efforts based on a pioneering, crowdsourced model. I’m hopeful that our efforts will lead to novel therapeutics that address unmet medical needs. It’s incredibly meaningful to be able to work in an ecosystem built on empowering today’s customers, today’s research participants &#8211; each as individuals &#8211; to be able to be a part of a collective that can turn healthcare on its head and accelerate drug discovery to help tomorrow’s patients. It’s an opportunity that is as unique as your DNA.
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A Conversation About Privacy Protections at 23andMe

Using insights from <a href="https://you.23andme.com/covid19-study/">23andMe&#8217;s COVID-19 Research Study</a>, our scientists have created a new interactive tool to help people better understand factors that contribute to a higher risk for hospitalizations due to the virus.
The <a href="https://you.23andme.com/covid19/">COVID-19 Severity Calculator</a>* allows people to see how certain non-genetic factors may impact the risk for hospitalization due to the virus. Using only data from 23andMe customers who consented to participate in our COVID-19 Research Study — and no data from outside sources — the tool looks at such things as age, exercise frequency, and health history, which may contribute to the likelihood of hospitalization from contracting the virus.&nbsp;
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 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="1024" height="536" src="https://blogcms.23andme.com/wp-content/uploads/2021/01/covid-calculator-1200x628-1-1024x536.png" alt="" class="wp-image-28728" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/01/covid-calculator-1200x628-1-1024x536.png 1024w, https://blogcms.23andme.com/wp-content/uploads/2021/01/covid-calculator-1200x628-1-300x157.png 300w, https://blogcms.23andme.com/wp-content/uploads/2021/01/covid-calculator-1200x628-1-768x402.png 768w, https://blogcms.23andme.com/wp-content/uploads/2021/01/covid-calculator-1200x628-1-880x461.png 880w, https://blogcms.23andme.com/wp-content/uploads/2021/01/covid-calculator-1200x628-1-1180x618.png 1180w, https://blogcms.23andme.com/wp-content/uploads/2021/01/covid-calculator-1200x628-1.png 1200w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>
 
<h6>More Information</h6>
&#8220;We created the Severity Calculator because people who have visited <a href="https://you.23andme.com/covid19/">23andMe’s COVID-19 Information Center</a> have consistently been asking for more information about the severity of the virus infection and what factors into why it impacts some people harder than others,&#8221; said Janie F. Shelton, Ph.D., MPH, a Senior Scientist at 23andMe who worked on the COVID-19 Research Study.
 “In addition to publishing our COVID-19 study results for the benefit of the greater scientific community, we wanted to look for additional ways in which people could utilize insights gleaned from our research,” Janie said. 

&nbsp;

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="1024" height="944" src="https://blogcms.23andme.com/wp-content/uploads/2021/01/Risk-Calculator-1024x944.jpg" alt="" class="wp-image-28731" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/01/Risk-Calculator-1024x944.jpg 1024w, https://blogcms.23andme.com/wp-content/uploads/2021/01/Risk-Calculator-300x277.jpg 300w, https://blogcms.23andme.com/wp-content/uploads/2021/01/Risk-Calculator-768x708.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2021/01/Risk-Calculator-880x812.jpg 880w, https://blogcms.23andme.com/wp-content/uploads/2021/01/Risk-Calculator.jpg 1158w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>
 
<h6>Insights into Risk Factors</h6>
That desire to learn more about the virus and its potential impact has only grown in the last few months as cases continue to surge. While the COVID-19 Severity Calculator offers insight into factors that contribute to the risk for hospitalization from the virus among 23andMe research participants, it is not meant to be used as a predictor for a person’s individual risk for severe COVID-19 symptoms. 
And no matter what the result, everyone should absolutely maintain the precautions and protocols implemented by local, state, and federal health officials. It does not predict a person&#8217;s individual risk for hospitalization. It also does not look at all possible factors that can impact the chances of being hospitalized due to COVID-19.

<h6>Research Data</h6>
Our research, and <a href="https://www.nature.com/articles/s41586-020-03065-y">other studies</a>, have shown that genetics does play an important role in the susceptibility to the virus and the severity of the disease. Last fall, our scientists <a href="https://www.medrxiv.org/content/10.1101/2020.09.04.20188318v1">published findings</a> from the COVID-19 Research Study that showed associations between both the ABO blood group and genes involved in the immune response and COVID-19 susceptibility or severity. But the study also found that non-genetic factors play a significant role.&nbsp;
The COVID-19 Severity Calculator looks only at those non-genetic factors. The Severity Calculator enables individuals to input some of those non-genetic factors. It then uses statistical modeling to estimate the likelihood of hospitalization. The statistical modeling uses data collected from more than a million people who participated in the 23andMe COVID-19 Research Study. Of those who participated, nearly 10,000 were diagnosed with the virus, and nearly 750 were hospitalized with severe symptoms.&nbsp;
Using the COVID-19 Severity Calculator highlights how certain underlying health conditions like obesity and type 2 diabetes significantly increased the risk for hospitalization for COVID-19. For example, our data showed that research participants with the virus who exercised at least once a week were almost 20 percent less likely to be hospitalized than those who did not exercise. In addition, our study found that simply being overweight increased the risk for hospitalization by about 34 percent over those with a normal body mass index among those participating in our study.&nbsp;
The COVID-19 Severity Calculator can illuminate how a few underlying health conditions might factor into hospitalizations due to the virus. However, it does not take into account all factors that might increase the likelihood of hospitalization.&nbsp;
<hr>
*The data powering this tool is from 23andMe consented research participants and does not represent the general U.S. population. There are also biases in the data that could affect the model. For example, individuals who died after being hospitalized for COVID-19 are not included in the data set, leading to an underestimate of hospitalization rates. This tool also does not include all possible factors that can impact the chances of being hospitalized due to COVID-19. This tool does not consider personal genetic information, nor does it predict any individual person&#8217;s chances of being hospitalized if they become infected with the coronavirus. Estimates are not available for people younger than 20 or older than 90, or for specific ancestries other than European, African American, or Hispanic, or Latino because sufficient data is not available. The strength of the associations in this tool may vary by geographic region or date of infection over the course of the pandemic. Two demographic inputs to the statistical model — median income per ZIP code and education level — are held constant at their sample median and mean, respectively.

A logo for 23andMe's COVID-19 Research Study

23andMe’s New COVID-19 Severity Calculator

The biggest changes often start with the smallest of steps, and that is particularly true with your health.
With our new Lifestyle Dashboards, 23andMe wants to help you along that path to wellness. Nudging you to eat a little better each day, or to take a few more steps outside, or reminding you of the importance of a good night&#8217;s sleep. Making these small incremental changes can add up to big improvements to your overall health.
We want to help you but, like with any journey, before you take that first step it helps both to know not just where you are but where you want to go. To do that, customers can connect their mobile devices — like an iPhone or Apple Watch with the <a href="https://www.apple.com/ios/health/">Apple Health Kit</a> or <a href="https://www.google.com/fit/">Google Fit</a> — through our app, or answer survey questions that allows 23andMe to assess their daily habits. 
&nbsp;

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="1024" height="520" src="https://blogcms.23andme.com/wp-content/uploads/2021/01/Frame-1-1024x520.png" alt="" class="wp-image-28725" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/01/Frame-1-1024x520.png 1024w, https://blogcms.23andme.com/wp-content/uploads/2021/01/Frame-1-300x152.png 300w, https://blogcms.23andme.com/wp-content/uploads/2021/01/Frame-1-768x390.png 768w, https://blogcms.23andme.com/wp-content/uploads/2021/01/Frame-1-880x447.png 880w, https://blogcms.23andme.com/wp-content/uploads/2021/01/Frame-1-1180x600.png 1180w, https://blogcms.23andme.com/wp-content/uploads/2021/01/Frame-1.png 1220w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>
 
<h6>Daily Healthy Habits 
</h6>
Your activity data from your phone and wearable devices, as well as your answers to those questions, allow you to compare how you are doing with other 23andMe customers, who have consented to participate in research. We’ll be able to show you how many of your daily habits, like your daily steps, your exercise routine, your veggie intake, your red meat consumption, your stress levels, compared to the thousands of individuals in our research community. 
The power of social comparison can open your eyes to things you’re doing well, and need to work on more. We even allow our 23andMe+ members to compare based on age, sex, and region.&nbsp; 
<h6>A Virtuous Circle 
</h6>
In addition, for those who opt into 23andMe&#8217;s research, your responses are aggregated with answers from other participants so that our scientists can study what works and doesn&#8217;t work in improving overall health in a sort of virtual cycle of information.
These dashboards are 23andMe&#8217;s first step into helping customers more easily integrate their day-to-day habits and behaviors into their overall 23andMe health experience. The genetic insights we provide can ground us in what lifestyle habits are especially important.
 23andMe wants to help you track and improve your wellness to work together towards a healthier future for you. If you’re a 23andMe Health + Ancestry Service customer in the United States, take a look at the Lifestyle Dashboards, and let’s take this next step to improve our health together.

23andMe’s New Lifestyle Dashboard

By Joe Banks, 23andMe Tech Lead
Editor’s note: This post by 23andMe’s Joe Banks, first appeared on 23andMe’s engineering blog. We’re reprinting an excerpt of it here to highlight issues around online accessibility and ideas for improving it. You can see the full version <a href="https://medium.com/23andme-engineering/accessibility-and-me-812c362031d2">here</a>.
I have a disability. Two, actually.
I was diagnosed with Usher Syndrome Type 2A, a rare genetic disease characterized by hearing loss and progressive vision loss.
When I was 3, my parents discovered that I was born with moderate-severe hearing loss in both of my ears. I was fitted with a pair of hearing aids, devices that would allow me to finally understand and hear my family.&nbsp;
The vision loss has had more of a profound impact on my life. While I knew that I was going blind, it didn’t feel real to me until I was in my 20s. I started to bump into people more frequently, which was followed by a quick apology by me and a glaring stare by the one whose space I invaded. Driving became increasingly difficult. For the safety of others and myself, I stopped driving at age 25. A few years later, I would learn how to use a white cane.&nbsp;
My visual field has narrowed from 180 degrees of visual field to less than 10 degrees. At this point, I’m considered legally blind and someone who has low vision.
&nbsp;

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="921" height="1024" src="https://blogcms.23andme.com/wp-content/uploads/2021/01/1-H-8KJLI4jqzxEbpJPPBEw-921x1024.png" alt="" class="wp-image-28733" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/01/1-H-8KJLI4jqzxEbpJPPBEw-921x1024.png 921w, https://blogcms.23andme.com/wp-content/uploads/2021/01/1-H-8KJLI4jqzxEbpJPPBEw-270x300.png 270w, https://blogcms.23andme.com/wp-content/uploads/2021/01/1-H-8KJLI4jqzxEbpJPPBEw-768x854.png 768w, https://blogcms.23andme.com/wp-content/uploads/2021/01/1-H-8KJLI4jqzxEbpJPPBEw-791x880.png 791w, https://blogcms.23andme.com/wp-content/uploads/2021/01/1-H-8KJLI4jqzxEbpJPPBEw-1061x1180.png 1061w, https://blogcms.23andme.com/wp-content/uploads/2021/01/1-H-8KJLI4jqzxEbpJPPBEw.png 1400w" sizes="auto, (max-width: 921px) 100vw, 921px" /></figure>
 
Today, I continue to do what I love: building websites — here at 23andMe I’m a tech lead writing the code that powers 23andMe’s website — and lifting heavy metal as well as enjoying the outdoors.&nbsp;
At work, I visually scan my computer screen with the vision I have left, increase the contrast and brightness of my screen, enlarge my mouse cursor, zoom in on smaller text, and use my keyboard as much as I comfortably can.
But even with these tools at my disposal, I run into issues that are difficult to overcome while browsing the web.&nbsp;
I’m sharing my experience both as someone with disabilities and as a tech lead at 23andMe, to highlight actions engineers, designers and others can take to fix the issues that exclude people with disabilities. The beauty of much of the technology today—like smartphones, computers, and the Web—is that they&#8217;re designed to be accessible to people with disabilities. Engineers, like me, who build on these platforms, have the responsibility to uphold this design, and not break it. Below are issues that I have personally experienced and steps engineers and web designers can take to fix these types of issues.

<h2>Accessibility issues that affect me</h2>
<h6>Low color contrast</h6>
I have enough functional vision to read text on a screen, but my sensitivity to contrast has diminished over time. I opt to increase the contrast and brightness on my computer screen, but that only can get me so far.
Low contrast text is a trendy design pattern, but it fails to consider how it affects people with low vision. Unfortunately, this practice is so popular that it ranks as the number one most common accessibility violation found in the <a href="https://webaim.org/projects/million/">WebAIM Million</a>, an accessibility audit of the one million most-visited home pages on the web.
I tend to skip over text that has low contrast because it’s too much of a strain to read it. I know that others like me with low vision, have the same issues. It’s common for me to leave a website or trash an email if the content is too difficult to read. A simple and subtle change in contrast to the design could open all that content to others who are visually impaired.&nbsp;
It’s simple to first check the contrast and then fix it if it falls below the threshold that is visible to the people with low vision. To measure contrast ratio, you can use <a href="https://webaim.org/resources/contrastchecker/">WebAIM’s contrast checker</a>, or something similar. Enter the text color and background color, and the checker will tell you if the contrast ratio passes.
While testing for color contrast is easy, changing a color palette that’s been tied to a brand, like 23andMe, can be difficult. However, that isn’t an excuse to avoid the problem. After all, continuing to use a color palette that’s discriminatory to people with low vision is not good for a brand.
At 23andMe, <a href="https://style.23andme.com/">our design system</a> provides a color palette that indicates what colors meet the <a href="https://www.w3.org/WAI/WCAG21/Understanding/contrast-minimum.html">minimum color contrast (AA) set by the Web Content Accessibility Guidelines (WCAG)</a>. This shared knowledge ensures that designers and developers are on the same page when it comes to accessible color usage.

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="512" height="338" src="https://blogcms.23andme.com/wp-content/uploads/2021/01/23andMe-Color-Palette.png" alt="" class="wp-image-28734" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/01/23andMe-Color-Palette.png 512w, https://blogcms.23andme.com/wp-content/uploads/2021/01/23andMe-Color-Palette-300x198.png 300w" sizes="auto, (max-width: 512px) 100vw, 512px" /></figure>
 
<h6>Inability to zoom</h6>
Another issue that people with low vision experience is the inability to magnify the text to make it more readable. Fixing that is also pretty straightforward by ensuring that the site isn’t restricting or disabling the zoom function.&nbsp;
<h6>No captions</h6>
While my hearing aids help me hear, they don’t completely restore my hearing. I’ll still miss words when listening to speech and I tend to subconsciously lip read when I’m talking to someone. When watching a video, I don’t always have the benefit of lip reading, so that’s when captions come in handy for me.
At 23andMe, we host our videos on YouTube. One of the great features of the platform is automatic captioning. This provides a quick and easy way for video authors to include captions in their videos. However, the quality of captions can vary, so it’s best practice to validate the captions in the video settings and make any corrections where needed. This ensures that the correct information is being communicated.
<h6>CAPTCHAs</h6>
I personally hate CAPTCHAs. Although they’re intended to prevent spam by distinguishing a human from a bot, for people with visual impairments are just another hurdle to accessing content.&nbsp; As someone with low vision, there’s nothing more frustrating than filling out a form and reaching a CAPTCHA where I repeatedly fail at scanning low-res photos for obscure objects. And what’s the alternative? Making out words in an audio track with distracting background noise? That’s also really difficult for me to accomplish with my hearing impairment.
I’m not alone. <a href="https://webaim.org/projects/screenreadersurvey7/#problematic">WebAIM’s 2017 screen reader survey</a> respondents agree that CAPTCHAs are the number one most problematic issue they face on the web.
Determining if someone is a robot is a tough problem to solve and there isn&#8217;t a clear solution. Non-interactive solutions, like Google&#8217;s reCaptcha v3, are great for accessibility. However, since users are tracked, privacy rights need to be considered and handled appropriately. In addition, methods to handle ambiguous results need to also be accessible and effective at blocking bots. My hopes are that the solutions developed for CAPTCHA consider people with disabilities and don&#8217;t lock them out.
To learn more about the challenges with CAPTCHA and accessibility, check out W3C’s document on the <a href="https://www.w3.org/TR/turingtest/">Inaccessibility of CAPTCHA</a>.
<h6>Moving forward</h6>
My journey with Usher Syndrome is still unfolding and I’m learning along the way. While I’ve accepted that this is my reality, I have an uneasy feeling about the current state of the web and what that means for my future. I’d like to continue being independent on the web, but I will need the help of the tech community to build experiences that I can continue to access and enjoy as my vision loss progresses.
In February 2020, WebAIM reevaluated the state of web accessibility for the top one million visited websites. Unfortunately, things have gotten worse since last year. Ninety-eight percent of the top million failed the accessibility audit. The kicker is that the audit only covered 30 percent of accessibility bugs.
This is a big problem. We need to do better.&nbsp; If we’ve learned anything from this pandemic, it is that access to the web whether it is for work, online learning, entertainment, or even simple social interactions is crucial for everybody.
At 23andMe, we’ve acknowledged this and have put an enormous effort towards making our digital experiences accessible. We&#8217;ve been working on educating colleagues about accessibility through talks, workshops, demos, online resources, and tickets addressing accessibility issues. Our design system requires components to be accessible and documents proper usage and accessibility considerations. To help prevent regressions, engineers are trained and provided documentation on how to evaluate accessibility with an automated scan, a keyboard, and a screen reader. The work continues, but we&#8217;re happy with the progress that we have made for our users.
I’ll end this with a few tips on getting started with accessibility. The breadth of accessibility topics can be pretty overwhelming, but starting somewhere is better than avoiding the problem.
<h6>Find where you can help and get involved</h6>
Accessibility is not just a front-end engineering problem.&nbsp;
If you have a role in making digital experiences that people use, then you should be familiar with how your decisions impact people with disabilities. For examples on how each role can contribute to accessibility, check out <a href="https://accessibility-for-teams.com/">Accessibility for Teams</a> and <a href="https://developers.google.com/web/fundamentals/accessibility/a11y-for-teams">Accessibility for Teams by Google</a>.
<h6>Learn about accessibility and share the knowledge</h6>
I started understanding accessibility when I began manually evaluating interfaces with a keyboard and a screen reader. I saw how bad the UX could be when accessibility is overlooked and how some features were completely unusable… and it was everywhere.
This prompted me to go back and re-evaluate how I was building websites. I browsed through <a href="https://webaim.org/articles/">WebAIM’s articles</a> on accessibility, watched through <a href="https://www.udacity.com/course/web-accessibility--ud891">Google’s online accessibility course</a> and used the <a href="https://www.w3.org/WAI/WCAG21/quickref/">WCAG as a quick reference</a>.&nbsp;
The point is, when you find out how you play a role in accessibility (see previous section), start digging into the topics where you can make the most impact.&nbsp;
Then, share that knowledge with your colleagues. At 23andMe, we’ve organized workshops, demos, meetings, and a company-wide presentation on a11y. In addition, we’ve curated documentation on a11y and created an #accessibility Slack channel where people can ask questions.
I invite you to start learning about accessibility and making the web a more inclusive place. At 23andMe, our mission is to help people access, understand and benefit from the human genome. We’re doing our best to include everyone in this pursuit. If you’d like to help us, please send feedback to our customer care team.&nbsp;
<h6>About the Author</h6>
Joe Banks is a tech lead at 23andMe and helps write the code for www.23andMe.com. He loves learning about new tech and aspires to make the Web more inclusive.

Accessibility and Me

In the last two years as interest in consumer DNA testing continues to remain strong, primary care physicians have become increasingly comfortable with discussing these results with their patients, a new study shows.
“This study highlights a significant shift in how primary care physicians view direct-to-consumer genetic health testing,” said L. Okey Onyejekwe Jr., MD, JD, Vice President of Healthcare Operations and Medical Affairs at 23andMe. 
The evolution of views has come as consumer interest in DNA testing remains strong.
“In just two year’s time, the data show primary care physicians are much more accepting, and in some cases wholeheartedly embracing this type of testing, especially tests that include health reports with FDA oversight,&#8221; Dr. Onyejekwe said. &#8220;As more consumers turn to direct-to-consumer genetic testing for health insights into their genome, it’s encouraging to see that primary care physicians are much more open to patients bringing their test results into the clinic for further discussion and potential follow up testing when warranted.” 
&nbsp;

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="1024" height="576" src="https://blogcms.23andme.com/wp-content/uploads/2021/01/Infographic-23andMe-Genetic-Testing-11-1024x576.jpg" alt="" class="wp-image-28720" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/01/Infographic-23andMe-Genetic-Testing-11-1024x576.jpg 1024w, https://blogcms.23andme.com/wp-content/uploads/2021/01/Infographic-23andMe-Genetic-Testing-11-300x169.jpg 300w, https://blogcms.23andme.com/wp-content/uploads/2021/01/Infographic-23andMe-Genetic-Testing-11-768x432.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2021/01/Infographic-23andMe-Genetic-Testing-11-880x495.jpg 880w, https://blogcms.23andme.com/wp-content/uploads/2021/01/Infographic-23andMe-Genetic-Testing-11-1180x664.jpg 1180w, https://blogcms.23andme.com/wp-content/uploads/2021/01/Infographic-23andMe-Genetic-Testing-11.jpg 1200w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>
 
<code></code>
<h6>Discussing Results </h6>
According to the study — done by Medscape and in collaboration with 23andMe — primary care physicians’ comfort level in discussing DNA testing results with patients has more than doubled since 2018. 
For this study, researchers surveyed 1,000 primary care physicians to gauge their comfort with genetic testing overall, including assessing attitudes toward direct-to-consumer genetic health testing specifically. The results were then compared to those of a similar survey conducted in 2018. The study found that when compared to two years ago, physicians were twice as likely to be comfortable discussing the benefits, risks, and limitations of genetic health testing, as well as interpreting and discussing results of a genetic test. 
<h6>Making Recommendations</h6>
Beyond that, the report also found that 80 percent of primary care physicians are open or likely to recommend direct-to-consumer genetic testing for health if asked about it by their patients, and for 61 percent of primary care physicians, FDA oversight of health reports was a necessary element of any direct-to-consumer genetic test they might recommend.
“The shift in the primary care community’s point of view on genetic testing over a relatively short period of time is striking, and points to the test’s results having greater utility and impact inpatient care,” said Hansa Bhargava, M.D., Medscape Senior Medical Director. “We are pleased that we could contribute to increasing awareness of the role of genetic testing in the primary care environment.”
<h6>Recommending Next Steps</h6>
When it comes to all testing, not just direct-to-consumer tests, 71 percent of primary care physicians said they are comfortable making appropriate referrals to specialists based on genetic information. In 2018, just 44 percent said they were comfortable making such recommendations. Further, 46 percent of the physicians surveyed said they are comfortable ordering genetic testing, which is more than four times as many as 2018. Finally, 41 percent of those surveyed said they are comfortable using genetic information to make treatment decisions, a two-fold increase over 2018. 
The survey indicates a sea change in how primary care physicians perceive direct-to-consumer genetic testing over the last decade and a half.
<h6>Changes Over Time </h6>
Just four years ago, a study by<a href="https://www.genomes2people.org/wp-content/uploads/2016/02/Van-Der-Wouden-et-al-2016.pdf"> the Impact of Personal Genomics Study Group</a> found that many consumers said their physicians were skeptical of direct-to-consumer genetic testing, about 11 percent. The study found that about 22 percent of patients said their physicians were uninterested in their results, and another 22 percent simply didn’t understand the results or lacked knowledge of genetic testing.
In 2019, researchers at Duke University’s Center for Applied Genomics and Precision Medicine and at 23andMe identified a need for more genetics training for primary care physicians.<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6617198/"> The study</a> went on to show that after completing direct-to-consumer testing themselves, many physicians felt much more confident and comfortable discussing direct-to-consumer testing.
23andMe has dedicated resources to support Healthcare Professionals to assist them in becoming familiar with its reports and direct-to-consumer genetic testing for health.

A photo of a doctor showing a patient information on a digital tablet.

Physicians Increasingly Comfortable Discussing Consumer DNA Testing with Patients

It wasn&#8217;t until she was 30 that Bonnie dared to search for the details of her birth.
An adoptee with loving parents and a brother and sister she adored, Bonnie said she never asked for more information about her origins because she thought she couldn&#8217;t.
&#8220;I didn&#8217;t ask questions because somewhere along the way, I think I was taught not to ask for too much,&#8221; she said. &#8220;Or maybe I was afraid.&#8221;
So Bonnie waited until after her first son&#8217;s birth to track down her birth certificate. On it, she learned of her biological mother&#8217;s name but nothing more. It would take almost three decades, two more sons, and a lucky connection on 23andMe before Bonnie filled in the details. She learned how she came to be born and found the links to establish deep relationships with newfound family.
&#8220;It was a surprise when it happened,&#8221; said Bonnie, who never expected to find any relatives.
<h6>Lucky Coincidence </h6>
The first surprise came a few years ago after she opened up her 23andMe results. She&#8217;d purchased a kit with the hope of finding more about her health, but within a day of getting her results, she instead found a half-brother on her birth father&#8217;s side. It turned out her brother had tested at almost the exact same time as Bonnie. She took the lucky coincidence as an omen that waiting all that time was all meant to be.
Both Bonnie and her brother were shocked by the connection, but he was more so because he&#8217;d always thought he was an only child.
It turned out their father — who died many years before Bonnie and her brother connected — had had an affair with Bonnie&#8217;s birth mother. Bonnie was born and put up for adoption, a secret kept from him. 
<h6>Nature and Nurture</h6>
While her brother didn&#8217;t have the details, he shared with Bonnie more about their father, a learned man interested in art. That explained a few things for Bonnie, who has a BFA in drawing and photography. She was also part of the first generation in her family to go to college. In addition to her path toward higher learning, her sons also have an academic bent. One is a medical doctor, the other a patent attorney, and her youngest son is a computer science major at Ohio State University.
&#8220;I can go into nurture versus nature quite well now,&#8221; Bonnie said. &#8220;Religion and politics: taught. Sense of humor, talents, intelligence: inherited.&#8221;
She believes her interest in art may have come from her father, who was somewhat of an artist himself.
&#8220;These inherited traits are why I mentioned the success of my children,&#8221; Bonnie said. &#8220;I always gave my husband credit for our kids&#8217; intelligence, but now I know it is inherent on both sides!&#8221;
<h6>Putting it Together</h6>
Connecting with her brother opened up the door into her paternal side. Still, that initial conversation with him also gave Bonnie little bits of information — places and names — that helped her piece together her mother&#8217;s identity. Within a few days of that initial conversation, Bonnie connected with her birth mother and found out she had two sons, two more half-brothers for Bonnie.
&#8220;The oddest thing about the off and on &#8216;search&#8217; for my birth mother through the years is that her name never came up in it,&#8221; Bonnie said. &#8220;I looked through vital statistics for hours to no avail. But the day I found a birth brother on 23andMe, I suddenly found a trail to her.&#8221;
After the initial connection, Bonnie spent time cultivating relationships with both sides of her family. By chance, her birth mother and birth father&#8217;s family lived not far from each other in California. Their proximity has allowed Bonnie to visit both sides of her family and, over the years, build authentic family connections.

 <figure class="wp-block-image size-large is-style-default"><img loading="lazy" decoding="async" width="728" height="1024" src="https://blogcms.23andme.com/wp-content/uploads/2021/01/IMG_2983-728x1024.jpg" alt="" class="wp-image-28701" srcset="https://blogcms.23andme.com/wp-content/uploads/2021/01/IMG_2983-728x1024.jpg 728w, https://blogcms.23andme.com/wp-content/uploads/2021/01/IMG_2983-213x300.jpg 213w, https://blogcms.23andme.com/wp-content/uploads/2021/01/IMG_2983-768x1080.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2021/01/IMG_2983-626x880.jpg 626w, https://blogcms.23andme.com/wp-content/uploads/2021/01/IMG_2983-839x1180.jpg 839w, https://blogcms.23andme.com/wp-content/uploads/2021/01/IMG_2983.jpg 1404w" sizes="auto, (max-width: 728px) 100vw, 728px" /></figure>
 
<h6>Mother and Daughter</h6>
She&#8217;s learned more about traits she shares with her mom — mannerisms, a love of books and learning, and she now understands more about what led to her adoption. There was never any question they were mother and daughter. The two look almost identical. They also share many of the same mannerisms, even some of the same likes and dislikes.
Bonnie said the connection helped her, but it has given her birth mother solace. Her birth mother was just a young college student when she became pregnant. She&#8217;d been alone and fearful. She never told her parents or her siblings about what happened. She also had to sign an agreement that she wouldn&#8217;t look for her daughter after the adoption.
&#8220;She struggled that year,&#8221; Bonnie said. &#8220;She loved my father and lost him, lost me, got married, and moved.&#8221;
She never forgot about Bonnie, and she sometimes agonized over giving her up.
&#8220;She had some healing to do,&#8221; Bonnie said.
When the two met in person the first time, Bonnie brought a small picture book. In it, she&#8217;d included photos from her life, her family, and her history to show her how happy she was.
&#8220;It helped,&#8221; Bonnie said.
<h6>Bonding</h6>
Meeting in person and meeting Bonnie&#8217;s sons also eased her mind that she&#8217;d made the right decision.
&#8220;It especially helped to meet us all and know that it had to be this way (her giving me up) to make the family I have,&#8221; Bonnie said.
Her birth mother had told her two sons when they were in high school about giving up a daughter, so they knew they had a sister out there. When Bonnie found them, they bonded.
&#8220;They accept me with love,&#8221; she said.
Bonnie has also bonded with one of her nieces, Ashlee, and continues to stay in touch with her brother on her father&#8217;s side. Bonnie&#8217;s siblings have also grown to embrace this bigger family.
&#8220;They know how happy I am that I got to grow up with them because I tell them all the time,&#8221; she said.
Bonnie said she felt so lucky not just to have the family she grew up with but two mothers, and two more families who opened their arms to her.
&#8220;It would have been nice to have this birth family relationship more years ago,&#8221; said Bonnie. &#8220;But maybe &#8230;  I wouldn&#8217;t have had the peace and joy that I do now. (And), hey, 23andMe wasn&#8217;t around back then to help me.&#8221;

23andMe Helps Adoptee Find Birth Family

By Amanda McCorquodale
For Christmas a few years ago, Tami Hawley’s brother gave her a 23andMe kit, a life-changing gift that ultimately connected her to the son she’d given up for adoption more than three decades ago.
“I was 17 and scared,” she said. “No one ever knew.”
When she received the gift, Tami had been writing a novel based on her family history and her experience of having to give up her son as a teenager, but she hadn&#8217;t finished it. She didn&#8217;t know how to write about that part of her life. That’s why the gift, even before she made the connection, had been so important.
“I just remember opening the 23andMe kit, crying and saying, ‘This is why my book’s not done,’” she said.
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<h6>A Match</h6>
Finding her son took time. For nearly two years, Tami opened up emails from 23andMe alerting her to new DNA relatives with bated breath. After a while, however, she stopped looking at the emails as regularly. But one day, she decided to take another look and saw she had new DNA Relatives on 23andMe. Among her matches was as predicted “Son.”  
“I was sitting on my living room couch and for five minutes, I just sat there in shock,” she said.
Tami saw his name for the first time. When she told her husband the secret she had kept for so long, he immediately urged her to direct message her son from her 23andMe account. 
<h6>The Note</h6>
Tami did, but she didn’t hear back right away. About a month later, on her son’s birthday, she looked him up on Facebook and wrote him a note:
I&#8217;m so glad that after 32 years, no one and nothing stands in the way of me wishing you a Happy Birthday.
“I wanted him to know that every April 26, I thought about him,” she said.
Her son, Matt, replied within 30 minutes. Initially, the two began texting and then having long conversations comparing their similarities and discovering their differences. 
<h6>Meeting for the First Time</h6>
Tami had been living in southwestern Connecticut when she had Matt, who was then adopted and raised in New Jersey. He now lives in Boston, about an hour and 20 minutes away from Tami in northeast Connecticut. They met for the first time in September of 2019.
“We met at a Starbucks where we sat for over an hour and talked non-stop,” she said. “I noticed that we had the same mannerisms with our hands. In fact, I eventually sat on my hands because I didn&#8217;t want to make him uncomfortable by seeing we were doing the same things.”
It was one of many traits the two share, Tami said.
“It has been eye-opening to realize how many things really are linked to genetics,” she said. “For the first time, he’s around people that look like him. I see me in him. I see each of my brothers. It’s fascinating.”
<h6>The Best Gift</h6>
Matt’s 23andMe kit was also a Christmas gift from his girlfriend.
“I think one of the big questions he always had was whether he was wanted,”  Tami said. “My hope is that finding out that he was wanted has had a very positive impact on him.”
Tami admits it’s been bittersweet to hear how wonderful Matt’s adoptive mother is and recognizing that as strong as genetics are, so much of our personalities are rooted in how we grew up.
“I’m a very emotional person and he definitely is not, at least not outward,” she said.
At one point she asked him if he was glad he took the test and connected with her and he reassured her by saying, “Absolutely, not even a question.” 
<h6>Bringing Joy </h6>
After their initial meeting, Matt and Tami got together about once a month until the pandemic stopped most in-person gatherings.
“First, he met my husband, brothers, and my best friend. Then he met my mother and my nieces literally the day before everything shut down,” Tami said. 
In August, the extended family and Matt got together again for an outdoor picnic. 
“Right now, we connect about once a week,” she said. “I would like it to be more often, but I&#8217;m trying not to overwhelm him.”
A year and a half after their first meeting, Tami said she finds herself looking at the selfie they took together.
“His smile is so big and both of us just look so happy,” she said. “It has been a roller coaster of emotions from fear to guilt to sadness to anger, and countless more. But I wouldn’t trade knowing him for anything.”
It has brought her happiness.
“The joy has been something I never imagined I could have, something I thought for so long I wasn’t deserving of,” Tami said. “It’s hard to put into words, in fact, but when I allow myself to fully experience it, it is a beautiful sense of wholeness and freedom, not just from finally being able to start living the truth of who I am, but in finding this amazing human I can tell the world is my son.”
Amanda McCorquodale is a freelance writer. Her work has appeared in Gourmet, Miami Magazine, and Mental Floss. She previously worked as an associate editor at the Huffington Post and as an Arts and Culture Editor at the Miami New Times. She lives in New York with her family. Previously she wrote a three-part series on her own DNA journey with 23andMe.

A tree in the snow in a forest that is lit up like a Christmas tree.

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