23andMe has added finer detail for customers with roots that trace back to Spain and Portugal.



This update is part of our continuing work to improve our Ancestry reports and features. It will also allow customers with ancestry from those regions to see connections back to 43 genetic groups. These groups include 29 in Spain (including the Canary and Balearic archipelagos). In addition there are another 14 in Portugal (including the Azores and Madeira archipelagos). The update will affect about 10 percent of our customers who tested on our <a href="https://customercare.23andme.com/hc/en-us/articles/218392668-Upgrading-to-23andMe-s-Newest-Chip-Version">latest genotyping chip</a>. 



Spain and Portugal&#8217;s long colonial history means that many individuals with roots in the Americas may also see how those trace back to the Iberian Peninsula. Spain and Portugal have distinct and rich cultures and histories, but their histories also intertwine. Part of that history includes centuries of exploration, colonization, and trade, including the slave trade.&nbsp;



Iberian Peninsula



Bordering the Atlantic and at the mouth of the Mediterranean, the history of the people of the Iberian Peninsula is marked by their ocean-going explorations and influences from North Africa. The Moors ruled the peninsula for almost 800 years, and this influence can still be seen in both Spain and Portugal. But even older influences from the Greeks, Phoenicians, and Romans, are apparent. Each of these cultures have left a distinct imprint on the culture and history of the Iberian peninsula.&nbsp;



Ancestry Composition Update



23andMe&#8217;s Ancestry Composition report is a living analysis that improves as we add new reference data. Underlying our Ancestry reports are powerful algorithms and analytical tools developed by 23andMe population geneticists and engineers to offer our customers more insights into their ancestral origins.



Over the last few years, we&#8217;ve updated results for people with <a href="https://blog.23andme.com/ancestry-reports/african-ethnolinguistic-groups/">African Ancestry</a>, <a href="https://blog.23andme.com/ancestry-reports/ancestry-composition-update-china/">Chinese ancestry,</a> <a href="https://blog.23andme.com/ancestry-reports/indigenous-genetic-ancestry/">Indigenous American ancestry</a>, and <a href="https://blog.23andme.com/ancestry-reports/caribbean-latin-american/">Latinx ancestry</a>, for instance. Customers may already see evidence of recent ancestry from the Iberian Peninsula. However, this update and these genetic groups represent improvements in accuracy. They are also more reflective of the distinct regional populations and customers&#8217; ancestry.



Regions in Spain and Portugal



In this update, the new methodology and algorithms use data from groups of people of Spanish or Portuguese ancestry with grandparents from specific regions in the Iberian Peninsula, and some of these regions overlap. Using this method we can connect customers with Portuguese or Spanish ancestry to those regional genetic groups through their shared DNA.



<figure class="wp-block-image size-full"><img loading="lazy" decoding="async" width="926" height="422" src="http://35.88.189.111/wp-content/uploads/2023/02/Spanish-Portuguese-percents.png" alt="" class="wp-image-31125" srcset="https://blogcms.23andme.com/wp-content/uploads/2023/02/Spanish-Portuguese-percents.png 926w, https://blogcms.23andme.com/wp-content/uploads/2023/02/Spanish-Portuguese-percents-300x137.png 300w, https://blogcms.23andme.com/wp-content/uploads/2023/02/Spanish-Portuguese-percents-768x350.png 768w, https://blogcms.23andme.com/wp-content/uploads/2023/02/Spanish-Portuguese-percents-880x401.png 880w" sizes="auto, (max-width: 926px) 100vw, 926px" /></figure>



For 23andMe customers with Portuguese ancestry, the update most commonly includes matches to the regions of Porto, Minho, and Via Real, as well as Central and Southern Portugal and Madeira. The least common regions for matching are Terceira, Santa Maria and Flores, Corvo, and Graciosa in the Azores.



For customers with Spanish ancestry the most common matches will be to Western Andalusia (near Huelva, Seville, and Badajoz). Also customers with Spanish ancestry will more commonly see Southern Andalusia (near Cadiz), as well as to the Canary Islands matches. The least common regions are Galician and Basque associated regions in northern Spain. 



<h6 class="wp-block-heading" id="h-more-on-matching">More on Matching</h6>



Among customers on the <a href="https://customercare.23andme.com/hc/en-us/articles/218392668-Upgrading-to-23andMe-s-Newest-Chip-Version">latest genotyping chip</a>, V5, who have more than 95 percent of their ancestry from the Iberian peninsula, around 40 percent will match with at least one Portuguese genetic group. Similarly, for customers on the latest chip with over 75 percent of their ancestry from the Iberian peninsula, approximately 40 percent will be matched to at least one Spanish genetic group.



Matching to one of these genetic groups means that you share a high genetic similarity with people in that group. Some regions overlap. But we&#8217;ve distinguished each geographically and descriptively. The names of these genetic groups also attempt to indicate the geographic regions.



Customers may receive a likely or highly likely match to one of these genetic groups. However, this update does not provide more breakdowns for customers&#8217; Spanish and Portuguese ancestry percentages. 



Your ancestry matters for your health



Many people find value in learning about their cultural roots but understanding your ancestry can also help you better understand your health. Your health and your likelihood of developing certain conditions involves several factors. These factors include your environment, family history and lifestyle. However, your genetics also plays an important role.



In some cases, that can be specific to the unique history of our ancestral groups.&nbsp;



So, for example, V30M, a genetic variant associated with<a href="https://www.23andme.com/topics/health-predispositions/hereditary-amyloidosis/"> TTR-related hereditary amyloidosis</a> is more common among people of <a href="https://pubmed.ncbi.nlm.nih.gov/12832749/#:~:text=Portuguese%2Dtype%20amyloidosis%20(transthyretin%20amyloidosis%2C%20ATTR%20V30M)%20is,inherited%20in%20autosomal%20dominant%20mode.">Portuguese ancestry</a>. It&#8217;s also common in people of Northern Swedish and Japanese ancestry. The condition causes a buildup of a protein called transthyretin (TTR) in the body&#8217;s tissues and organs. That build up can damage the nerves, the heart, or other organs in the body. 



People of Iberian descent have a higher likelihood of having one of the genetic variants linked to <a href="https://www.23andme.com/topics/health-predispositions/alpha-1-antitrypsin-deficiency/">alpha 1 antitrypsin deficiency</a>. Alpha 1 antitrypsin deficiency is a genetic condition that can lead to lung and liver disease



Find out more



23andMe customers who want to learn more about their Ancestry Composition can go <a href="https://you.23andme.com/reports/ancestry_composition_hd/">here</a>. 



Not yet a customer? 



Find out more about 23andMe’s Ancestry service and other services offered to customers here.

A map of Spain and Portugal noting the 43 new genetic groups in Iberia.

23andMe Blog

23andMe Blog Team

23andMe Adds More Detail for Spanish and Portuguese Ancestry

For anyone with a rare disease, the winding journey from symptoms to diagnosis to treatment is often long and isolating.&nbsp;



And yet the singularity of that lonely experience — the often-frustrating search for answers and treatment, if there is even treatment available — is surprisingly common for those with a rare disease. On average, it takes five years or more to reach a diagnosis, according to the <a href="https://rarediseases.org/new-patient-journey-infographic-gives-a-glimpse-into-the-diagnostic-odyssey/">National Organization for Rare Diseases.</a>&nbsp;



<h6 class="wp-block-heading" id="h-essential-thrombocythemia">Essential Thrombocythemia</h6>



As part of Rare Disease Day, 23andMe wanted to shine a light on Dima, a software test engineer with essential thrombocythemia, a rare blood disorder that includes symptoms like difficulty breathing, weakness, fatigue, and blood clots that can lead to strokes &#8211; and is one of the rare diseases 23andMe is studying. His experience echoes that of many people living with one of the more than 7,000 known rare diseases.



<figure class="wp-block-image aligncenter size-large"><img loading="lazy" decoding="async" width="853" height="1024" src="http://35.88.189.111/wp-content/uploads/2023/01/Dima-Image-853x1024.jpeg" alt="" class="wp-image-31082" srcset="https://blogcms.23andme.com/wp-content/uploads/2023/01/Dima-Image-853x1024.jpeg 853w, https://blogcms.23andme.com/wp-content/uploads/2023/01/Dima-Image-250x300.jpeg 250w, https://blogcms.23andme.com/wp-content/uploads/2023/01/Dima-Image-768x922.jpeg 768w, https://blogcms.23andme.com/wp-content/uploads/2023/01/Dima-Image-733x880.jpeg 733w, https://blogcms.23andme.com/wp-content/uploads/2023/01/Dima-Image-983x1180.jpeg 983w" sizes="auto, (max-width: 853px) 100vw, 853px" /></figure>



A rare disease, by definition, affects 200,000 or fewer people, but because there are so many of these conditions, many millions of people like Dima live with a rare disease. It&#8217;s estimated that between <a href="https://rarediseases.info.nih.gov/about/">one-in-ten</a> to <a href="https://rarediseases.org/understanding-rare-disease/rare-disease-facts-and-statistics/">one-in-13</a> people in the United States have a rare disease. In other words, millions of people, each struggling to sort out how to navigate a journey with few clear markers of where to go next. These are individuals who are often faced with unexplained symptoms that neither they nor their doctor can explain.&nbsp;



&#8220;It’s hard to say when my symptoms began,” said Dima.



<h6 class="wp-block-heading">Waiting for a Diagnosis</h6>



For more than six years, Dima had consistently seen elevated platelet levels in his blood tests. On top of that he had other symptoms — nosebleeds, numbness, fatigue, and flashes in his eyes. But his doctor failed to recognize the abnormalities in his blood or to connect them to his other symptoms.



Dima wasn’t diagnosed until 2021 when he was rushed to an emergency room.



“After multiple MRIs, CTs and ultrasounds it was confirmed that I had a transient ischemic attack (stroke) caused by a blood clot,” Dima said. “I underwent an emergency surgery where a blood clot was removed from my carotid artery.”



After several tests, including a genetic test, as well as a bone marrow biopsy, he was diagnosed with essential thrombocythemia, a rare type of myeloproliferative neoplasms (MPN) in which the bone marrow produces too many platelets.&nbsp;



“I’d never heard (essential thrombocythemia) or MPN before I was diagnosed,” he said.



<figure class="wp-block-image aligncenter size-full"><img loading="lazy" decoding="async" width="381" height="154" src="http://35.88.189.111/wp-content/uploads/2023/02/Green-DNA-thread.png" alt="" class="wp-image-31177" srcset="https://blogcms.23andme.com/wp-content/uploads/2023/02/Green-DNA-thread.png 381w, https://blogcms.23andme.com/wp-content/uploads/2023/02/Green-DNA-thread-300x121.png 300w" sizes="auto, (max-width: 381px) 100vw, 381px" /></figure>



<h6 class="wp-block-heading">Finding Support</h6>



Dima’s experience is not so different from a lot of people with a rare disease. It often takes years for a diagnosis. Even when a proper diagnosis is made, it might be difficult to find effective treatments.&nbsp;&nbsp;



In Dima’s case he is being treated with a drug called an antiviral interferon drug, that has a host of serious side effects, but appears to be helping. He’s also joined an advocacy group called <a href="https://www.mpnvoice.org.uk/about-mpns/questions/essential-thrombocythaemia-et/">MPN Voice</a>. He knows he is lucky, there are&nbsp; approved treatments for fewer than 5 percent of the known rare diseases. And the fact that they are rare also makes them that much more challenging to study.&nbsp;



Finding enough people with one of these conditions to participate in research is often difficult, and this can be particularly difficult among people of non-European descent who are already underrepresented in research. 



<h6 class="wp-block-heading">Researching Rare Diseases</h6>



23andMe has an ongoing effort to improve the diversity of our research more broadly and will regularly contact customers in underrepresented groups through our rare disease research. An example of that is our <a href="https://blog.23andme.com/articles/sarcoidosis-representation">Sarcoidosis Research Study</a>, a rare condition that impacts the Black community at double the rate of people of European descent.



While each of the rare diseases 23andMe is studying is different, our research model combines genetic and phenotypic data from millions of people who&#8217;ve consented to participate in research, offering unique opportunities to study these conditions. It&#8217;s not just that understanding the genomics of rare diseases can help scientists understand the underlying causes; it&#8217;s that the scale of 23andMe&#8217;s data and the fact that people can participate online and from home allows our researchers to quickly gather insights from large numbers of people with a rare disease. In 2021, researchers from 23andMe presented some of their <a href="https://blog.23andme.com/articles/rare-disease-research">early findings</a> that helped to illustrate our ability to leverage that data to gain insights quickly.&nbsp;



<h6 class="wp-block-heading">Rare Disease Study</h6>



In 2022 23andMe launched a rare disease study, the Rare Disease Research Study, which has grown to include a <a href="https://blog.23andme.com/articles/rare-disease-expanded-study">dozen rare diseases</a>. This work offers an incredible opportunity to speed progress toward treatment. Among the diseases 23andMe is studying is <a href="https://www.23andme.com/rare-disease-research-study/essential-thrombocythemia/">essential thrombocythemia</a>, the condition affecting Dima&#8217;s life.&nbsp;



In just four months since launching our Rare Disease Study, 23andMe has already recruited more than 1,500 individuals across all the rare diseases we are researching. That’s incredibly fast for rare disease research, and 23andMe already has some of the largest cohorts for some of these very rare conditions. 23andMe’s study of <a href="https://www.23andme.com/rare-disease-research-study/essential-thrombocythemia/?utm_source=google&amp;utm_medium=search_generic&amp;utm_campaign=US_ET_sales_google-search&amp;utm_term=thrombocythemia">essential thrombocythemia</a>, the condition Dima is living with, is expected to reach its goal of recruiting 1,000 participants by the fall of 2023.



The work has already been noticed, especially among advocates for those living with rare diseases who are pushing to raise awareness and spur new research.



<hr class="wp-block-separator has-alpha-channel-opacity"/>



<h6 class="wp-block-heading">Dima Answers Some Questions about Living with a Rare Disease</h6>



<h6 class="wp-block-heading">When were you diagnosed, and how long did it take from when you had your first symptoms to get a diagnosis?</h6>



I was diagnosed in 2021 at the age of 31. I had symptoms of a stroke and was taken to the emergency department. After multiple MRIs, CTs and ultrasounds it was confirmed that I had a transient ischemic attack (stroke) caused by a blood clot. I underwent an emergency surgery where a blood clot was removed from my carotid artery. After doing a genetic test for JAK2 V617F mutation (which returned positive) and two bone marrow biopsies, I was officially diagnosed with essential thrombocythemia &#8211; a rare type of Myeloproliferative neoplasms (MPNs) in which the bone marrow produces too many platelets.



<h6 class="wp-block-heading">Can you give some sense of what it is like to have something wrong — symptoms — but not know and not having doctors know what it is that is wrong with you?</h6>



In my case it was devastating. I had a history of consistently elevated platelets since 2016. My (doctor) failed to recognize the issue, check for underlying conditions and diagnose me. He never referred me to a hematologist. After each routine blood test I was told that my results were normal, even though I saw elevated platelets in results. All complaints about my symptoms were neglected.



I believe the blood clot forming could have been prevented and the surgery could have been avoided if I was diagnosed and started treatment earlier.



I also blame myself for not paying more attention to my blood test results and for blindly trusting doctors. Lesson learned the hard way. Now I do my extensive research before going to doctors for any reason. I do my best to educate myself as much as possible and verify every recommendation I get from doctors.



<h6 class="wp-block-heading">When you heard the diagnosis, was it something that you were familiar with?</h6>



I’d never heard about essential thrombocythemia or myeloproliferative neoplasms before I was diagnosed.



<h6 class="wp-block-heading">Do you stay up on research?</h6>



When I was first diagnosed, I spent a significant amount of time going through available research and collecting information about treatment options. Today I’m trying to stay on top of new research. In addition to that I receive weekly subscription email from the MPN Voice community on<a href="https://healthunlocked.com/"> https://healthunlocked.com</a>. This community is very active. Multiple people all around the world share their stories, treatment options and side effects, research and studies, news and more importantly support to each other.



<h6 class="wp-block-heading">Are you involved in any clinical trials?</h6>



At this moment I’m not involved in any clinical trials however if opportunity arises, I will be open to it.



<h6 class="wp-block-heading">What do you believe people should know about rare diseases in general and how they might be able to help?</h6>



Of course it would be helpful and beneficial for people to be aware of rare diseases. However, there are so many rare diseases that the general population has never heard about them. I learned about the existence of MPNs only after I was diagnosed with it. People are not trained to analyze symptoms. They might not recognize that their symptoms are a result of some underlying condition and simply brush it off.&nbsp;



That is why we go to doctors when something bothers us. And that’s why I want to have more trust in doctors’ ability to listen to patients, recognize and diagnose them correctly and timely.

Raising Awareness of Rare Disease

Some types of close relatives, like aunt, uncle, half-sibling, nephew, niece, grandparent, and grandchild have very similar patterns of shared DNA, making predicting those relationships from DNA alone difficult. That’s why some customers might see someone incorrectly labeled as one of these relationships. To help improve detection of these relationships, 23andMe is now using a new technique that analyzes DNA from full siblings.



23andMe, like other companies, uses shared segments of DNA to detect customers’ relationships to each other. But unlike other companies, we also combine information from every pair of relatives using 23andMe’s <a href="https://blog.23andme.com/23andme-research/large-human-pedigrees/">Bonsai software</a>. In addition to <a href="https://blog.23andme.com/ancestry-reports/23andmes-latest-feature-automates-genetic-family-trees/">building your 23andMe Family Tree</a>, Bonsai uses segments from multiple pairs of relatives at once, allowing it to make a better prediction than if we only analyzed you and each of your relatives one by one.&nbsp;



Still, no way of estimating relationships from DNA is perfect, and that’s true even for close relatives.&nbsp;



<figure class="wp-block-table"><table><tbody><tr><td>Relationship</td><td>Amount of DNA shared (95% confidence interval)*</td><td>Age distribution 23andMe uses (95% confidence interval)</td></tr><tr><td>Half-sibling</td><td>~19.8-30.2%</td><td><style>
span:after {
content: "\2264";}
</style>
<style>
span:after {
content: "\2264";}
</style> 17.4 year age difference</td></tr><tr><td>Avuncular (aunt/uncle- nephew/niece)</td><td>~20.3-29.7%</td><td>17.5 &#8211; 39.3 year age difference</td></tr><tr><td>Grandparental</td><td>~18.7-31.3%</td><td>45.3 &#8211; 67.7 year age difference</td></tr></tbody></table><figcaption class="wp-element-caption">* Calculated using shared segments from the autosomes (i.e., excluding the X and Y chromosomes) from <a href="https://github.com/williamslab/ped-sim">simulated relatives</a>.</figcaption></figure>



<h6 class="wp-block-heading">Using ages or shared parents to distinguish relative types</h6>



Telling these relative types apart is especially difficult because the amount of DNA each type shares is almost identical (see the above table). Because of this similarity, Bonsai relies on customers’ self-reported ages to make a decision about their relationships.&nbsp;&nbsp;



Even though general age differences exist between these relative types—half-siblings are typically closer in age than aunt-nephew or uncle-niece relatives—there are always families that don’t follow these trends. In such families, Bonsai is prone to making mistakes. For example, as shown in the above table, Bonsai will often consider half-siblings who were born 20 years apart as avuncular or it will confuse a grandmother for an aunt if the grandmother is less than 40 years older than her grandchild.



It’s worth noting that if the parent who links two half-siblings, a grandparent and grandchild, or an aunt/uncle and niece/nephew is a 23andMe customer, Bonsai would detect this and get the relationship right in nearly all cases.&nbsp;



For example, in the figure below, if we had data for Ava and Beau’s parents, Bonsai would almost always infer their mystery relative correctly as the aunt of the two siblings. Still, not all families have these parents or other informative relatives tested, and in the end, Bonsai predicts a significant fraction of half-sibling and avuncular relatives (aunt/uncle or niece and nephews) incorrectly when it relies on age data alone to distinguish between them (see the table near the end of this post).



<figure class="wp-block-image size-full is-resized"><img loading="lazy" decoding="async" src="http://35.88.189.111/wp-content/uploads/2023/02/Mystery-Relative.png" alt="" class="wp-image-31115" width="650" height="410" srcset="https://blogcms.23andme.com/wp-content/uploads/2023/02/Mystery-Relative.png 856w, https://blogcms.23andme.com/wp-content/uploads/2023/02/Mystery-Relative-300x189.png 300w, https://blogcms.23andme.com/wp-content/uploads/2023/02/Mystery-Relative-768x484.png 768w" sizes="auto, (max-width: 650px) 100vw, 650px" /><figcaption class="wp-element-caption">On average, people share ~25 percent of their DNA with half-siblings, aunts, uncles, nieces, nephews, grandparents, or grandchildren. Based only on a DNA comparison of a pair of relatives, it is difficult to distinguish between these relationships and pinpoint the correct one.&nbsp; But there&#8217;s a simple trick to help narrow down the correct relationship when one person in the pair has a full sibling: If—at the same location in their genomes—a pair of siblings share identical segments of DNA with another relative, and those siblings do not share any DNA at those locations with each other, this often means that the relative is an aunt or an uncle to the siblings. Having more than 90 cM of such locations almost always means the relative is an aunt or uncle.</figcaption></figure>



A new approach for distinguishing aunts and uncles from other relative types



The ambiguities between these relationships would be impossible to fully resolve except for the fact that information from shared DNA segments can be combined and their positions analyzed across multiple relatives.&nbsp;



In the case of distinguishing avuncular from half-sibling or grandparental relationship types, we can leverage information carried by DNA segments that are shared between full siblings. Full siblings are related through both of their parents, and this leads them to have a somewhat unique pattern of sharing: an average of 25 percent of their DNA is contained in fully identical segments. This is roughly 880 centiMorgans in 23andMe customers. (<a href="https://isogg.org/wiki/CentiMorgan">CentiMorgans</a>, or “cM,” are a unit of measuring lengths of DNA.) In other words, full siblings have certain sections of their chromosomes where they each inherited a matching segment of DNA from their mom and, at the same location, a matching segment of DNA from their dad. With such high fully identical sharing rates, genetic relationship prediction methods rarely make mistakes when labeling full siblings.



<h6 class="wp-block-heading">A Technique for Detecting Aunts and Uncles</h6>



Researchers at Cornell University used this signature of fully identical segments from full siblings to build <a href="https://www.sciencedirect.com/science/article/pii/S0002929718301691">a technique for detecting aunts and uncles</a> of a pair of siblings even if their parent has not had their DNA tested. 



The idea is to find places where the shared segments between siblings Ava and Beau and their aunt or uncle indicate that the siblings’ parent has a fully identical segment with the aunt or uncle. If this recovers a lot of fully identical shared segments, we can be quite confident that the aunt or uncle is an aunt or uncle and not a half-sibling, niece, nephew, grandparent, or grandchild.



<h6 class="wp-block-heading">Full siblings </h6>



Consider the figure below that again shows DNA from the full siblings Ava and Beau, their father Tom, and the father&#8217;s full sister, Maria. In the highlighted regions, Ava and Beau inherited DNA from different copies of their father’s chromosomes: Ava inherited DNA from their father’s mom and Beau from their father’s dad. Because of this (and because they inherited DNA from different copies of their mother’s chromosomes), Ava and Beau have no shared segments with each other in the chromosomal region with a box around it. 



This fact allows us to reason about whether, in the boxed region, the untested father had a fully identical segment with Maria (the potential aunt). Sure enough, in this location, Maria is fully identical to Tom (has the same DNA as him) and has a shared segment to each of the siblings. All this allows us to conclude that, in this region, the father does have a fully identical segment to Maria, and, with enough of these present, the updated version of Bonsai would conclude that Maria is Ava and Beau’s aunt and not any of the other relationship types with similar amounts of shared segments.



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" width="776" height="1024" src="http://35.88.189.111/wp-content/uploads/2023/02/Fully-Identical-Graphic-Explainer-776x1024.png" alt="" class="wp-image-31116" srcset="https://blogcms.23andme.com/wp-content/uploads/2023/02/Fully-Identical-Graphic-Explainer-776x1024.png 776w, https://blogcms.23andme.com/wp-content/uploads/2023/02/Fully-Identical-Graphic-Explainer-227x300.png 227w, https://blogcms.23andme.com/wp-content/uploads/2023/02/Fully-Identical-Graphic-Explainer-768x1013.png 768w, https://blogcms.23andme.com/wp-content/uploads/2023/02/Fully-Identical-Graphic-Explainer-667x880.png 667w, https://blogcms.23andme.com/wp-content/uploads/2023/02/Fully-Identical-Graphic-Explainer-894x1180.png 894w, https://blogcms.23andme.com/wp-content/uploads/2023/02/Fully-Identical-Graphic-Explainer.png 952w" sizes="auto, (max-width: 776px) 100vw, 776px" /></figure>



<h6 class="wp-block-heading">Can other close relatives have this pattern of shared DNA?</h6>



Importantly, neither a grandparent, grandchild, half-sibling, niece, or nephew is expected to have fully identical sharing with Ava and Beau’s parent, or with the parent of any pair of siblings. The key reason is that fully identical regions occur at places where two people inherited the same DNA from both their parents.&nbsp;



Because full siblings share the same two parents, fully identical regions arise most frequently between them. You can see this above by looking at Ava and Beau’s parent Tom and his full sibling Maria. A half-sister of Ava and Beau through Tom should not share fully identical segments with Tom because she would have inherited only one chromosome from him—and the other from her mother. That mother will typically be unrelated to Tom and so will not share DNA with him. Similarly, Ava’s grandson would inherit Ava’s DNA, but only on one of his chromosomes, making fully identical sharing with Ava’s father Tom impossible in nearly all cases. By the same token, Ava’s grandmother (Tom’s mother) shares DNA with Tom on only one chromosome, and Ava and Beau’s nephew, being Tom’s grandchild, could only inherit DNA from one of Tom’s chromosomes at any location.



<h6 class="wp-block-heading">Fully Identical Segments</h6>



Even though this technique&nbsp; is designed to detect aunts and uncles, when a half-sibling does not have these implied fully identical segments, that provides evidence that they are half-siblings, and this can override the age-based relationship detection in Bonsai.&nbsp;



For example, if two full siblings had a half-sister that is &gt;20 years older than each of them, the old version of Bonsai would predict the half-sister as the aunt of the two full siblings (assuming other close relatives such as the shared parent had not done a 23andMe test). However, the latest Bonsai version would look for implied fully identical segments, and, finding few or none of these, it would conclude that a half-sibling relationship is more likely than aunt. Therefore ages have less influence on the Bonsai relationship prediction for these classes of relationships (half-sibling, avuncular, and grandparent-grandchild) than before this new release.



<h6 class="wp-block-heading">Incorporating this technique into Bonsai greatly improves relative prediction accuracy</h6>



<figure class="wp-block-table"><table><tbody><tr><td>Relationship to full sibling pair</td><td>Percent correct without IBD011</td><td>Percent correct with IBD011</td></tr><tr><td>Aunt/uncle</td><td>98.7%</td><td>~100%</td></tr><tr><td>Half-sibling</td><td>75.6%</td><td>83.8%</td></tr><tr><td>Grandparent</td><td>97.9%</td><td>98.6%</td></tr></tbody></table></figure>



We have incorporated this technique (which researchers called IBD011 for reasons described in the summary figure below) into the latest version of Bonsai. The table above shows the percent of relatives that Bonsai correctly infers both without the IBD011 signal and with it. Bonsai does very well in both settings, but always much better when using IBD011, so it now works better at telling apart half-sibling, avuncular, and grandparent-grandchild relatives.&nbsp;



<h6 class="wp-block-heading">Here’s how you can apply this updated Bonsai method to your relative predictions:</h6>



You can use this updated Bonsai method by rebuilding your family tree. To do this, you can request a recalculation of your tree through a link in the DNA Relatives FAQ page, in the question called “<a href="https://you.23andme.com/tools/relatives/faq/#how_do_i_recalculate">How do I recalculate my tree?</a>”&nbsp;



The 23andMe database currently includes over 2 million customers who could be affected by this update, which translates to many thousands of relationships potentially changed. For those of you with a full sibling and a predicted half-sibling, aunt, or uncle, the updated Bonsai may produce a different (and more trustworthy) tree.&nbsp;



Keep in mind that unfortunately your tree annotations don’t carry over when you rerun Bonsai. Still, some of you will see changes and the predictions Bonsai now makes are much more reliable for the close relationship types discussed here.



<h6 class="wp-block-heading" id="h-what-is-ibd011">What is IBD011?</h6>



On average, people share ~25% of their DNA with their half-siblings, aunts, uncles, nieces, nephews, grandparents, or grandchildren, among a few other less common relationship types.&nbsp;



Based only on a DNA comparison of a pair of relatives, it can be very difficult to distinguish between these relationships and pinpoint the correct one.&nbsp;



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" width="1024" height="756" src="http://35.88.189.111/wp-content/uploads/2023/02/IBD011-Image-1024x756.png" alt="" class="wp-image-31117" srcset="https://blogcms.23andme.com/wp-content/uploads/2023/02/IBD011-Image-1024x756.png 1024w, https://blogcms.23andme.com/wp-content/uploads/2023/02/IBD011-Image-300x221.png 300w, https://blogcms.23andme.com/wp-content/uploads/2023/02/IBD011-Image-768x567.png 768w, https://blogcms.23andme.com/wp-content/uploads/2023/02/IBD011-Image-880x650.png 880w, https://blogcms.23andme.com/wp-content/uploads/2023/02/IBD011-Image-1180x871.png 1180w, https://blogcms.23andme.com/wp-content/uploads/2023/02/IBD011-Image.png 1390w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>



But there&#8217;s a simple trick to help narrow down the correct relationship when one person in the pair has a full sibling: If — at the same location in their genomes — siblings share identical segments of DNA with a relative, and those siblings do not share any DNA at those locations with each other, this almost always means that the relative is an aunt or an uncle.&nbsp;

New Algorithm Cleans Up 23andMe Family Trees

February is a time for celebrating Black history. While we&#8217;re doing that here at 23andMe, we&#8217;re also reflecting on our efforts to address the disparities in biomedical and genetic research for people of African ancestry.



We want to share some of what we&#8217;ve been doing over the last year or so — around sickle cell disease and for a rare condition called sarcoidosis, both of which impact the Black community at much higher rates than other populations. But first, we want to give you some context and history.



Representation is important because, without it, the benefits from research fail to help all people, further compounding health disparities.



In addition to it being the right thing to do, improving representation also makes for good science. For example, 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 significant genetic variants associated with diseases. Researchers would have missed those associations if the studies had only focused on one homogenous group.



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" width="1024" height="717" src="http://35.88.189.111/wp-content/uploads/2022/09/GettyImages-1251922051-1024x717.jpg" alt="" class="wp-image-30161" srcset="https://blogcms.23andme.com/wp-content/uploads/2022/09/GettyImages-1251922051-1024x717.jpg 1024w, https://blogcms.23andme.com/wp-content/uploads/2022/09/GettyImages-1251922051-300x210.jpg 300w, https://blogcms.23andme.com/wp-content/uploads/2022/09/GettyImages-1251922051-768x538.jpg 768w, https://blogcms.23andme.com/wp-content/uploads/2022/09/GettyImages-1251922051-880x616.jpg 880w, https://blogcms.23andme.com/wp-content/uploads/2022/09/GettyImages-1251922051-1180x826.jpg 1180w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>



<h6 class="wp-block-heading" id="h-representation-in-23andme-research">Representation in 23andMe Research</h6>



So, what is 23andMe doing to address these research disparities?



23andMe&#8217;s vice president for Research, Joyce Tung addressed that question two years ago in <a href="https://www.statnews.com/2020/06/10/23andme-ancestry-racial-inequity-genetics/">an opinion piece</a>, saying:



&#8220;There is no silver bullet to solve this problem, and it will require prioritizing multiple efforts now and into the future to ensure that we help everyone benefit from the human genome.&#8221;&nbsp;



We have made it a priority and done a lot, but we have so much more work.



Our first significant effort to address research disparities goes back to 2011 when we launched our <a href="https://www.23andme.com/roots/">Roots into the Future</a>. For this project, we recruited 10,000 African Americans to participate in research and help improve the kind of research we could do within the Black community.&nbsp;



Since then, we&#8217;ve had a steady cadence of projects, the <a href="https://www.23andme.com/africa-project/">African Genetics Project</a>, the <a href="https://blog.23andme.com/23andme-research/african-american-sequencing-project/">African American Sequencing Project</a>, and the <a href="https://blog.23andme.com/23andme-research/global-genetics-project/">Global Genetics Project</a>, to name a few. And over the decade, we have built a research cohort that now is among the largest, if not the largest, cohort of African Americans (more than 500,000 people) with both genotypic and phenotypic information and who have consented to participate in research. Moreover, this large group of people with African ancestry who have consented to participate in 23andMe research offers our scientists the chance to study conditions relevant to the Black community.



Over the last year, we&#8217;ve undertaken several additional projects to improve the diversity of our research, doing research relevant to people within the Black Community, and enhancing the types of results we can return to customers with African ancestry.



<h6 class="wp-block-heading">Sickle Cell Anemia &amp; Sickle Cell Trait</h6>



Many of the projects we&#8217;ve been doing over the last year, and continue to be working on now, were only possible with all the effort we&#8217;ve made over the last decade to improve the diversity of our research participants. But, more importantly, customers of African descent who have consented to participate in 23andMe research have allowed us to study conditions important for the Black community.&nbsp;



One of those areas of study is sickle cell anemia, an inherited red blood cell disease caused by the HbS variant in the HBB gene. People who carry just one copy of the HbS variant in the HBB gene have what&#8217;s called sickle cell trait. These carriers will not develop sickle cell anemia, because that requires having two copies of HbS. However, their children could be at risk of inheriting sickle cell anemia if both parents have sickle cell trait. Sickle cell anemia got its name because, in people with the condition, red blood cells become &#8220;sickled&#8221; or crescent-shaped in certain circumstances. Sickle cell anemia affects people around the world. It is most common in people of African descent, but it also impacts people of Middle Eastern and South Asian descent, and people from the Caribbean, the Mediterranean, and parts of Central and South America.&nbsp;



We&#8217;ve been focused on research, new product improvements, and efforts to raise awareness within the Black community about what it means to be a carrier of sickle cell anemia. We recently updated the 23andMe <a href="https://blog.23andme.com/articles/23andme-updates-carrier-status-report-on-sickle-cell-anemia">Sickle Cell Anemia Carrier Status report,</a>* which helps identify carriers who may not otherwise have known their status, as well as provide information about sickle cell anemia and what this report may mean for someone&#8217;s own health and the health of their children.



This comes on the heels of a collaboration with the non-profit <a href="https://blog.23andme.com/articles/sickle-cell-awareness">Breaking the SSickle Cell Cycle Foundation</a> to increase access to sickle cell trait information, promote sickle cell disease awareness, and offer resources for individuals with sickle cell trait and sickle cell disease. About 1 in 13 African Americans and ~300 million people worldwide are carriers for sickle cell anemia, but awareness of sickle cell anemia and how it&#8217;s inherited is often limited. We&#8217;re hoping to change that.



In addition, 23andMe researchers have also undertaken an important research collaboration with scientists at the <a href="https://www.nih.gov/">National Institutes of Health</a> (NIH), and <a href="https://www.hopkinsmedicine.org/som/">Johns Hopkins University School of Medicine</a>. The study is now the largest and most diverse <a href="https://ash.confex.com/ash/2022/webprogram/Paper163883.html">genetic study of sickle cell trait</a> ever done. There will be more to come with this work in the coming months.



<h6 class="wp-block-heading">Representation in Sarcoidosis Research</h6>



In 2022, we also launched a study into the genetic underpinning of sarcoidosis, a rare condition that disproportionately impacts people of African descent. African Americans develop the condition at <a href="https://pubmed.ncbi.nlm.nih.gov/27509154/">twice the rate</a> of those of European ancestry.



<figure class="wp-block-image size-full"><img loading="lazy" decoding="async" width="844" height="754" src="http://35.88.189.111/wp-content/uploads/2022/11/sarcoidosis-logo.jpg" alt="" class="wp-image-30870" srcset="https://blogcms.23andme.com/wp-content/uploads/2022/11/sarcoidosis-logo.jpg 844w, https://blogcms.23andme.com/wp-content/uploads/2022/11/sarcoidosis-logo-300x268.jpg 300w, https://blogcms.23andme.com/wp-content/uploads/2022/11/sarcoidosis-logo-768x686.jpg 768w" sizes="auto, (max-width: 844px) 100vw, 844px" /></figure>



Sarcoidosis is an inflammatory disease that results in the clumping of inflammatory cells in different organs. While it mainly affects the lungs, it can affect any organ in the body. Symptoms include fatigue, swollen lymph nodes, or painful swelling of the joints. Because it often affects the lungs, sarcoidosis symptoms may also include shortness of breath, wheezing, a persistent cough, or chest pain. When it involves the heart, the condition may result in irregular heartbeat, accelerated heartbeat, or swelling of the heart, known as edema. It can also affect the eyes resulting in blurred vision.



Currently, there is no cure and few approved treatments.



23andMe wants to change that, yet sarcoidosis is rare, making it particularly challenging to study. However, this is where 23andMe&#8217;s research model and our efforts to recruit within the Black community have proven uniquely suited. In the months since launching the study, we&#8217;ve been able to recruit individuals from across the United States.This has allowed many individuals who might not otherwise be able to participate in research to participate from home.&nbsp;



Just as with most other rare diseases, there is a strong genetic component to sarcoidosis, but many genetic variants associated with the condition have not yet been identified. Nevertheless, we&#8217;re well on our way to meeting our goal of enrolling 2,000 people with sarcoidosis to learn more about the disease&#8217;s genetics.



This research aims to improve the lives of people living with sarcoidosis through a potential treatment discovery.



<h6 class="wp-block-heading">What&#8217;s Next?</h6>



As 23andMe expands representation within our research cohort, we strive to better reflect the rich diversity of the U.S. and world. With continued participation, we hope to continue to share scientific and health insights and conduct research on diseases that have high rates in the Black community to equitably improve health outcomes.



<hr class="wp-block-separator has-alpha-channel-opacity"/>



*The 23andMe PGS test uses qualitative genotyping to detect select clinically relevant variants in the genomic DNA of adults for the purpose of reporting carrier status and reporting and interpreting genetic health risks. The relevance of each report may vary based on ethnicity. 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 or anything about 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. The Sickle Cell Anemia carrier status report is indicated for the detection of the HbS variant in the HBB gene. The report can tell you if you have two copies of the tested variant, and if you are at risk of developing symptoms of sickle cell anemia, but does not describe your overall risk of developing symptoms. This test is most relevant for people of African descent. It is also relevant for people of Middle Eastern and South Asian descent, as well as people from the Caribbean, the Mediterranean, and parts of Central and South America.

Improving Research on Conditions Relevant to People of African Ancestry

We often hear that heart disease is the <a href="https://www.cdc.gov/heart-disease/data-research/facts-stats/">leading cause of death in the United States</a>. This statistic is especially top of mind during February, which is American Heart Month and Heart Month in many other countries. But did you know that <a href="https://pubmed.ncbi.nlm.nih.gov/38264914/">~50% of adults over 40 may have hidden heart disease</a>, and <a href="https://www.sciencedaily.com/releases/2019/01/190131084238.htm">80% of cardiovascular disease is preventable</a>?



For those looking to take control of their heart health, learning about your risk factors, including what your genetics might say about your risk, is an important first step. 23andMe offers four kinds of genetic reports related to heart health:



Genetic Health Risk Reports*: Rare genetic variants that lead to high risk for heart attack, heart failure, and/or stroke. Included in the Health + Ancestry, 23andMe+ Premium, and Total Health services



<ul class="wp-block-list">
<li>Familial Hypercholesterolemia</li>



<li>Hereditary Amyloidosis (TTR-Related)</li>
</ul>



<a href="https://blog.23andme.com/articles/after-the-click-paulo">Learn what Paulo did after finding out he had a genetic variant in the TTR gene</a>



Polygenic Risk Scores*: Combinations of common genetic variants that impact the chances of developing heart-related conditions and traits. Included in the 23andMe+ Premium and Total Health



<ul class="wp-block-list">
<li>Atrial Fibrillation</li>



<li>Coronary Artery Disease</li>



<li>High Blood Pressure</li>



<li>LDL Cholesterol</li>



<li>HDL Cholesterol</li>



<li>Triglycerides</li>



<li>Type 2 Diabetes (also included in the Health + Ancestry service)</li>
</ul>



Pharmacogenetics Reports**: Genetic variants that impact how your body may process certain heart-related medications. Included in 23andMe+ Premium and Total Health



<ul class="wp-block-list">
<li>SLCO1B1 Drug Transport
<ul class="wp-block-list">
<li>Simvastatin Medication Insight</li>
</ul>
</li>



<li>CYP2C19 Drug Metabolism
<ul class="wp-block-list">
<li>Clopidogrel Medication Insight</li>
</ul>
</li>
</ul>



Exome-based Reports for Total Health™ members?: Comprehensive genetic screen of high-impact, actionable genetic variants associated with arrhythmia syndromes, aortic and other blood vessel syndromes, cardiomyopathies, and high cholesterol and heart attack.



<ul class="wp-block-list">
<li>Hereditary Cardiovascular Disease (44 genes tested)</li>
</ul>



While genetics influences the likelihood of developing heart disease, lifestyle—<a href="https://blog.23andme.com/articles/genetics-and-a-healthy-heart">diet, exercise, sleep and stress</a>—often plays an outsized role in heart health. While you can’t change your genetics, you can do a lot to protect the health of your heart by changing your lifestyle. Cutting out smoking, reducing stress, exercising more, and eating right can go a long way towards keeping your heart healthy.



Finally, getting <a href="https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease/heart-health-screenings">regular recommended screenings</a> for things like your cholesterol and blood pressure can help you know where your current heart health stands, and if there may be any lifestyle or other changes you may need to make. In addition to these common biomarkers, advanced blood tests for heart health can include other lipids associated with increased risk of heart disease, including:&nbsp;



<ul class="wp-block-list">
<li>Apolipoprotein B (ApoB). The main protein in several types of &#8220;bad&#8221; cholesterol, including LDL.</li>



<li>Lipoprotein (a) (Lp(a)). A type of LDL &#8220;bad&#8221; cholesterol. Lp(a) particles are considered the most &#8220;sticky&#8221; and therefore most likely to cause blockages. </li>
</ul>



While heart disease remains the leading cause of death in the United States, understanding and managing your heart health is within your control. By learning about your genetic risks, adopting a heart-healthy lifestyle, and monitoring key biomarkers, you can significantly reduce your chances of developing cardiovascular conditions. Taking action today can pave the way for a healthier tomorrow, and with the right tools and knowledge, you can take charge of your heart health at any age.



Disclaimers:



*The 23andMe PGS test includes health predisposition and carrier status reports. Health predisposition reports include both reports that meet FDA requirements for genetic health risks and PRS reports which are based on a genetic model that includes data and insights from 23andMe consented research participants, and have not been reviewed by the FDA. The 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. Each PRS report describes if a person has a certain likelihood of developing a condition, but does not describe a person’s overall likelihood. 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. Warnings &amp; Limitations:. These reports are for over-the-counter use by adults, and provide genetic information to inform discussions with a healthcare professional. The PGS test is not a substitute for visits to a healthcare professional for recommended screenings or appropriate follow-up. Results should be confirmed by an independent genetic test prescribed by your own healthcare provider before taking any medical action. For important information and limitations regarding genetic health risk reports, visit 23andme.com/test-info/.



**23andMe PGS Pharmacogenetics reports: The 23andMe test uses qualitative genotyping to detect 3 variants in the CYP2C19 gene, and 1 variant in the SLCO1B1 gene in the genomic DNA of adults from saliva for the purpose of reporting and interpreting information about the processing of certain therapeutics to inform discussions with a healthcare professional. It does not describe if a person will or will not respond to a particular therapeutic. Our CYP2C19 Pharmacogenetics report provides certain information about variants associated with metabolism of some therapeutics and provides interpretive drug information regarding the potential effect of citalopram and clopidogrel therapy. Our SLCO1B1 Pharmacogenetics report provides certain information about variants associated with the processing of some therapeutics and provides interpretive drug information regarding the potential effect of simvastatin therapy. Results for certain CYP2C19 results should be confirmed by an independent genetic test prescribed by your own healthcare provider before taking any medical action. Warning: Test information should not be used to start, stop, or change any course of treatment and does not test for all possible variants that may affect metabolism or protein function. The PGS test is not a substitute for visits to a healthcare professional. Making changes to your current regimen can lead to harmful side effects or reduced intended benefits of your medication, therefore consult with your healthcare professional before taking any medical action. For important information and limitations regarding Pharmacogenetic reports, visit 23andme.com/test-info/pharmacogenetics/



? Exome Sequencing and blood testing services are available to eligible customers upon completion of the intake questionnaire that must be reviewed, approved and ordered by a third-party clinician. Exome Sequencing is analyzed by a CLIA- and CAP-accredited laboratory. Blood testing is completed by Quest Diagnostics. All telehealth services are provided in accordance with the Telehealth Terms and Consent to Telehealth.

An illustration of a heart for heart health

A Healthy Heart: The Power of Genetics and Healthy Habits

A new study adds another layer of understanding to genetics of musicality, specifically rhythmic perception, and musical engagement or appreciation.



The research led by scientists from the University of Colorado, Vanderbilt University Medical Center and 23andMe, follows on a series of studies looking at the genetics of several different aspects of musicality. 



<figure class="wp-block-image size-full"><img loading="lazy" decoding="async" width="661" height="529" src="http://35.88.189.111/wp-content/uploads/2022/06/Beat-GettyImages-561165061.jpg" alt="" class="wp-image-29888" srcset="https://blogcms.23andme.com/wp-content/uploads/2022/06/Beat-GettyImages-561165061.jpg 661w, https://blogcms.23andme.com/wp-content/uploads/2022/06/Beat-GettyImages-561165061-300x240.jpg 300w" sizes="auto, (max-width: 661px) 100vw, 661px" /></figure>



<h6 class="wp-block-heading" id="h-music-in-life">Music in Life</h6>



These studies explore not just music ability but a wide range of associations between those abilities and such things as cognition, health, language, and neurodevelopment.



“Music plays a huge role in our lives, and we want to understand why music is so tied to our development, personality, and health,” said Daniel Gustavson, an Assistant Research Professor at the University of Colorado Boulder’s Institute for Behavioral Genetics. Gustavson is also a co-author of the study.&nbsp;&nbsp;



“We&#8217;re especially interested in learning whether genetic factors make some people more likely to play music than others, and who might benefit most from being exposed to music lessons,” he said.&nbsp;



<h6 class="wp-block-heading">Nature and Nurture</h6>



Published in the journal, <a href="https://nyaspubs.onlinelibrary.wiley.com/doi/10.1111/nyas.14964">Annal of the New York Academy of Science</a>, this study used a polygenic score from the results of a recent <a href="https://blog.23andme.com/23andme-research/we-got-the-beat/">genome-wide association study</a> to determine the impact of genetic influences on beat synchronization on both rhythmic perception and music engagement.



The work provides a heritability estimate for musical traits that relies on genetic data from 23andMe customers who consented to participate in research and then used a polygenic score to confirm these were some of the same shared genetic influences observed in a recent study of beat synchronization. 



<h6 class="wp-block-heading">Associations with Other Traits</h6>



The researchers then did a cross trait analysis to find distinct associations with non-musical traits like cognition or personality traits. For example, genetic scores capturing high extraversion and a preference for being an evening person were related with more self-reported musical engagement.



“On the one hand, individuals with more accurate (genetically influenced) ability to move in synchrony with a musical beat may be more likely to seek out and engage with music to a greater degree in their lifetime simply because it is easier for them to learn and play,” according to the paper.



The researchers noted that the reverse could also be true. In other words, genes that support musical skills may lead us to seek out music experiences, but early music engagement could also strengthen music skills.



Although we cannot know the direction of causality in these associations from the current data, genetic links among these musicality traits may be explained by multiple factors. Additionally, there are many environmental factors that influence music skills and musical engagement, and their relationship.&nbsp;



The Vanderbilt Music Cognition Lab has very helpful resources to explain genetic research more fully around musicality. You can find out more<a href="https://www.vumc.org/music-cognition-lab/news/faq-about-beat-synchronization-gwas-study"> here</a>.



Related Posts



•<a href="https://blog.23andme.com/articles/rhythm-and-musical-traits"> What the Polygenic Basis of Rhythm Can Tell Us About Musical Traits</a>



• <a href="https://blog.23andme.com/articles/we-got-the-beat">We Got the Beat</a>

Encore, Another Study of the Genetic Influences on Musicality

This week, 23andMe updated its Carrier Status report on sickle cell anemia, an inherited red blood cell disease caused by the HbS variant in the HBB gene.



With this update, 23andMe&#8217;s Sickle Cell Anemia Carrier Status report* can now tell customers if they have two copies of the HbS variant, including what that may mean for their own health and the health of their children. Specifically, the report will inform these customers that they are at risk of developing symptoms of sickle cell anemia, and that they will pass one copy of the HbS variant on to each of their children.



&#8220;We are excited to release this updated report, which allows us to provide meaningful genetic information to a number of our customers,&#8221; said 23andMe Product Scientist Ruth Tennen. &#8220;More broadly, we hope our report can help raise awareness about sickle cell anemia, identify carriers who may otherwise not have known their status, and provide important educational information about sickle cell anemia and its health impacts.&#8221;



As part of this report update, 23andMe consulted with experts from Johns Hopkins University School of Medicine, Breaking the SSickle Cell Cycle Foundation, Morehouse School of Medicine, and the Sickle Cell Foundation of Georgia. These experts noted that the update of 23andMe’s Carrier Status report could help increase awareness about sickle cell trait and sickle cell anemia.



&#8220;23andMe is making genetic testing more accessible to anyone wanting to find out more information about their carrier status,&#8221; said Dr. Jason Payne, pediatric hematologist and sickle cell doctor at Morehouse School of Medicine.



<h6 class="wp-block-heading" id="h-what-is-sickle-cell-anemia">What is sickle cell anemia?</h6>



<a href="https://medlineplus.gov/genetics/condition/sickle-cell-disease/">Sickle cell anemia</a> is a genetic condition caused by a specific genetic variant called HbS in a gene called HBB. The <a href="https://medlineplus.gov/genetics/gene/hbb/">HBB gene</a> contains instructions for making part of the hemoglobin protein, which is found in red blood cells and transports oxygen through the body. Inheritance of two copies of the HbS variant can lead to changes in the structure of hemoglobin, in certain situations. This can cause the hemoglobin to stick together and form long, rigid molecules that distort red blood cells into a sickle (crescent) shape. These sickled cells get destroyed prematurely, leading to anemia and symptoms such as fatigue. These cells can also get stuck in small blood vessels, which can lead to pain crises, frequent infections, and complications including kidney damage, acute chest syndrome, and stroke.<a href="https://www.ncbi.nlm.nih.gov/pubmed/20301551">1</a> 



<h6 class="wp-block-heading">Who is impacted by sickle cell anemia?</h6>



Sickle cell anemia affects people around the world. It is most common in people of African descent, but it also impacts people of Middle Eastern and South Asian descent, and people from the Caribbean, the Mediterranean, and parts of Central and South America. The HbS variant that causes sickle cell anemia is most common among people with ancestry from places where malaria is endemic, as having one copy of the HbS variant (also known as having sickle cell trait) provides significant protection against severe malaria. <a href="https://www.cdc.gov/ncbddd/sicklecell/data.html">2</a> (See sidebar &#8220;History of the HbS variant.&#8221;)



23andMe&#8217;s updated Sickle Cell Anemia report can now inform customers with two copies of the HbS variant that they are at risk of developing symptoms of sickle cell anemia. These customers will also receive information about how their result may be relevant for their children and for other relatives.



<div style="float: right; text-align: justified; width: 400px; background-color: #eee; padding: 15px; margin-left: 10px;">History of the HbS variant

In 2018, scientists published a genetic study analyzing the DNA of nearly 3,000 people to trace the genetic history of sickle cell anemia. They found that the HbS variant arose once, in sub-Saharan Africa, about 7,000 years ago. As people migrated to other parts of the world, the HbS variant became more common in places where malaria-carrying mosquitoes were common, because it provided significant protection against severe malaria. Reference: Shriner D et al. (2018). &#8220;Whole-Genome-Sequence-Based Haplotypes Reveal Single Origin of the Sickle Allele during the Holocene Wet Phase.&#8221; Am J Hum Genet. 102(4):547-556. [https://pubmed.ncbi.nlm.nih.gov/29526279/] </div>



<h6 class="wp-block-heading">How sickle cell anemia is inherited</h6>



In order to have sickle cell anemia, a person must inherit two copies of the HbS variant — one from each biological parent. People with just one copy of the HbS variant are called carriers; they&#8217;re also said to have <a href="https://www.cdc.gov/ncbddd/sicklecell/traits.html">sickle cell trait</a>. They’re not expected to have sickle cell anemia themselves, and they typically do not experience any health complications. But they could pass their variant on to their future children. If their partner has the HbS variant or another variant in the HBB gene, there&#8217;s a 25 percent chance that each child may have sickle cell anemia or a related blood disorder. (See sidebar &#8220;Other Types of Sickle Cell Disease.&#8221;)



<h6 class="wp-block-heading">Why it&#8217;s important to learn about sickle cell anemia</h6>



About 1 in 13 African Americans and ~300 million people worldwide are carriers for sickle cell anemia. <a href="https://www.cdc.gov/ncbddd/sicklecell/data.html">2</a>, <a href="https://my.clevelandclinic.org/health/diseases/12100-sickle-cell-disease">3</a> But individual and community awareness of sickle cell anemia and how it&#8217;s inherited is often limited.&nbsp;



For example, although all 50 U.S. states include newborn screenings for sickle cell trait and sickle cell disease, many people with sickle cell trait do not know their status, in part because it&#8217;s up to individual state health departments to <a href="https://blog.23andme.com/articles/sickle-cell-awareness">follow up</a> with those families, leading to variability in who receives their results, how they are notified, and how much follow-up education and counseling is provided. <a href="https://my.clevelandclinic.org/health/diseases/12100-sickle-cell-disease">4</a> <a href="https://pubmed.ncbi.nlm.nih.gov/18200513/">5,</a> <a href="https://pubmed.ncbi.nlm.nih.gov/33072956/">6,</a><a href="https://pubmed.ncbi.nlm.nih.gov/22261754/">7,</a> <a href="https://pubmed.ncbi.nlm.nih.gov/29178654/">8,</a> <a href="https://pubmed.ncbi.nlm.nih.gov/22903793/">9,</a> <a href="https://pubmed.ncbi.nlm.nih.gov/22903793/">10</a> There are also common misunderstandings about how sickle cell anemia is inherited, the distinction between sickle cell trait and sickle cell anemia, and how common it is to be a carrier. <a href="https://pubmed.ncbi.nlm.nih.gov/16749645/">11,</a> <a href="https://pubmed.ncbi.nlm.nih.gov/19998646/">12,</a> <a href="https://pubmed.ncbi.nlm.nih.gov/17505208/">13,</a> <a href="https://pubmed.ncbi.nlm.nih.gov/21748660/">14</a>



<div style="float: right; text-align: justified; width: 400px; background-color: #eee; padding: 15px; margin-left: 10px;">Other types of sickle cell disease

In addition to sickle cell anemia, there are other types of sickle cell disease caused by variants in the HBB gene. Instead of having two copies of the HbS variant like people with sickle cell anemia, people with other types of sickle cell disease have one copy of the HbS variant and one copy of another variant in the HBB gene. Examples of other types of sickle cell disease include hemoglobin SC disease and sickle beta thalassemia disease.
 </div>



In addition, sickle cell anemia is often thought to be a condition that primarily impacts people with African ancestry. But the HbS variant is found around the world, including in people with ancestry from the Middle East, South Asia, the Mediterranean region of Europe, and parts of Central and South America.<a href="https://www.ncbi.nlm.nih.gov/pubmed/20301551">1,</a><a href="https://www.ncbi.nlm.nih.gov/pubmed/23103089">15</a> For this reason, the American College of Medical Genetics and Genomics (ACMG) and the American College of Obstetricians and Gynecologists (ACOG) recently updated their carrier screening guidelines to recommend that people of all ethnicities who are considering having children should be offered carrier screening for hemoglobinopathies such as sickle cell anemia.<a href="https://pubmed.ncbi.nlm.nih.gov/34285390/">16,</a> <a href="https://www.ncbi.nlm.nih.gov/pubmed/23103089">17</a> Previously, most guidelines only recommended this type of screening for people of certain ancestries.



<h6 class="wp-block-heading">Actionable health information</h6>



Knowing if you&#8217;re a carrier for sickle cell anemia — or for another type of sickle cell disease caused by variants in the HBB gene — can be important in family planning. In addition to providing information that may be important for reproductive decision-making, carrier testing can help parents to plan for the birth of a child with the condition, and can prompt cascade testing of family members who may also have the same variant.



People with one copy of the HbS variant may also have another variant in the HBB gene, so it&#8217;s important that they talk to a healthcare professional about additional testing. In addition, in rare cases carriers for sickle cell anemia may experience some health impacts. You can learn more about sickle cell trait from the <a href="https://www.cdc.gov/ncbddd/sicklecell/traits.html">CDC</a> and the <a href="https://www.hematology.org/education/patients/anemia/sickle-cell-trait">American Society of Hematology</a>.



In addition to the Sickle Cell Anemia Carrier Status report — which can help people learn whether they are a carrier for sickle cell anemia and explore information about the health risks associated with the condition — 23andMe is working on other projects to raise awareness and improve our understanding of sickle cell anemia and sickle cell trait.&nbsp;For example, we have worked with the Breaking the SSickle Cell Cycle Foundation on an <a href="https://blog.23andme.com/articles/sickle-cell-awareness">awareness campaign</a> to increase access to sickle cell trait information, promote sickle cell disease awareness, and offer resources for individuals with sickle cell trait and sickle cell disease.



Our Research team is also working with collaborators at Johns Hopkins University School of Medicine and the National Human Genome Research Institute to <a href="https://blog.23andme.com/articles/new-research-on-sickle-cell-trait">investigate</a> potential health risks associated with having sickle cell trait.



<h6 class="wp-block-heading">Want to learn more?</h6>



The updated Sickle Cell Anemia Carrier Status report is available to 23andMe Health + Ancestry Service customers. Customers with two copies of the HbS variant who were genotyped after November 2013 will now receive information about their risk of developing symptoms of sickle cell anemia. Customers on all genotyping platforms can learn whether they are carriers for the HbS variant.



Acknowledgements: We are incredibly grateful to the following individuals for their valuable input on the updated report: Rakhi P. Naik, MD, MHS, Johns Hopkins University School of Medicine; Dr. Lametra Scott, Breaking the SSickle Cell Cycle Foundation; Dr. Herman Taylor, Dr. Tennille Leak-Johnson, and Dr. Jason Payne from the Morehouse School of Medicine; and Jacquelyn George, MPH, Jeanette Nu’Man, MEd, and Kadeem Harrison from the Sickle Cell Foundation of Georgia. We also thank the 23andMe employees who worked to make this update possible. This includes members of the Product R&amp;D, Medical Affairs, Research, Regulatory, Quality Assurance, Engineering, Legal, Customer Care, Product, Marketing, and Communications teams who contributed to the development and release of the report, as well as the members of 23andMe&#8217;s Sickle Cell Carrier Status Awareness Program core team.



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*The 23andMe PGS test uses qualitative genotyping to detect select clinically relevant variants in the genomic DNA of adults for the purpose of reporting carrier status and reporting and interpreting genetic health risks. The relevance of each report may vary based on ethnicity. 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 or anything about 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. The Sickle Cell Anemia carrier status report is indicated for the detection of the HbS variant in the HBB gene. The report can tell you if you have two copies of the tested variant, and if you are at risk of developing symptoms of sickle cell anemia, but does not describe your overall risk of developing symptoms. This test is most relevant for people of African descent. It is also relevant for people of Middle Eastern and South Asian descent, as well as people from the Caribbean, the Mediterranean, and parts of Central and South America.



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<h6 class="wp-block-heading">References</h6>



[1] Bender MA et al. (2003). &#8220;Sickle Cell Disease.&#8221; [Accessed Oct 11, 2022]. [<a href="https://www.ncbi.nlm.nih.gov/pubmed/20301551">https://www.ncbi.nlm.nih.gov/pubmed/20301551</a>]&nbsp;



[2] Centers for Disease Control and Prevention. &#8220;Data &amp; Statistics on Sickle Cell Disease.&#8221; Retrieved Sep 16, 2022, from https://www.cdc.gov/ncbddd/sicklecell/data.html [<a href="https://www.cdc.gov/ncbddd/sicklecell/data.html">https://www.cdc.gov/ncbddd/sicklecell/data.html</a>]&nbsp;



[3] Cleveland Clinic. &#8220;Sickle Cell Disease.&#8221; Retrieved Jan 6, 2023, from https://my.clevelandclinic.org/health/diseases/12100-sickle-cell-disease [<a href="https://my.clevelandclinic.org/health/diseases/12100-sickle-cell-disease">https://my.clevelandclinic.org/health/diseases/12100-sickle-cell-disease</a>]&nbsp;



[4] Harrison SE et al. (2017). &#8220;Knowledge and Awareness of Sickle Cell Trait Among Young African American Adults.&#8221; West J Nurs Res. 39(9):1222-1239. [<a href="https://pubmed.ncbi.nlm.nih.gov/27550467/">https://pubmed.ncbi.nlm.nih.gov/27550467/</a>]



[5] Kavanagh PL et al. (2008). &#8220;Communication of positive newborn screening results for sickle cell disease and sickle cell trait: variation across states.&#8221; Am J Med Genet C Semin Med Genet. 148C(1):15-22. [<a href="https://pubmed.ncbi.nlm.nih.gov/18200513/">https://pubmed.ncbi.nlm.nih.gov/18200513/</a>]



[6] El-Haj N et al. (2018). &#8220;Newborn Screening for SCD in the USA and Canada.&#8221; Int J Neonatal Screen. 4(4):36. [<a href="https://pubmed.ncbi.nlm.nih.gov/33072956/">https://pubmed.ncbi.nlm.nih.gov/33072956/</a>]



[7] La Pean A et al. (2012). &#8220;A qualitative secondary evaluation of statewide follow-up interviews for abnormal newborn screening results for cystic fibrosis and sickle cell hemoglobinopathy.&#8221; Genet Med. 14(2):207-14. [<a href="https://pubmed.ncbi.nlm.nih.gov/22261754/">https://pubmed.ncbi.nlm.nih.gov/22261754/</a>]



[8] Creary S et al. (2017). &#8220;Sickle cell trait knowledge and health literacy in caregivers who receive in-person sickle cell trait education.&#8221; Mol Genet Genomic Med. 5(6):692-699. [<a href="https://pubmed.ncbi.nlm.nih.gov/29178654/">https://pubmed.ncbi.nlm.nih.gov/29178654/</a>]



[9] Moseley KL et al. (2013). &#8220;Who counsels parents of newborns who are carriers of sickle cell anemia or cystic fibrosis?&#8221; J Genet Couns. 22(2):218-25. [<a href="https://pubmed.ncbi.nlm.nih.gov/22903793/">https://pubmed.ncbi.nlm.nih.gov/22903793/</a>]



[10] &#8220;The current state of sickle cell trait: implications for reproductive and genetic counseling.&#8221; Hematology Am Soc Hematol Educ Program. 2018(1):474-481. [<a href="https://pubmed.ncbi.nlm.nih.gov/30504348/">https://pubmed.ncbi.nlm.nih.gov/30504348/</a>]



[11] Treadwell MJ et al. (2006). &#8220;Using qualitative and quantitative strategies to evaluate knowledge and perceptions about sickle cell disease and sickle cell trait.&#8221; J Natl Med Assoc. 98(5):704-10. [<a href="https://pubmed.ncbi.nlm.nih.gov/16749645/">https://pubmed.ncbi.nlm.nih.gov/16749645/</a>]



[12] Acharya K et al. (2009). &#8220;A pilot study to explore knowledge, attitudes, and beliefs about sickle cell trait and disease.&#8221; J Natl Med Assoc. 101(11):1163-72. [<a href="https://pubmed.ncbi.nlm.nih.gov/19998646/">https://pubmed.ncbi.nlm.nih.gov/19998646/</a>]



[13] Gustafson SL et al. (2007). &#8220;Health beliefs among African American women regarding genetic testing and counseling for sickle cell disease.&#8221; Genet Med. 9(5):303-10. [<a href="https://pubmed.ncbi.nlm.nih.gov/17505208/">https://pubmed.ncbi.nlm.nih.gov/17505208/</a>]



[14] Long KA et al. (2011). &#8220;Attitudes and beliefs of African-Americans toward genetics, genetic testing, and sickle cell disease education and awareness.&#8221; J Genet Couns. 20(6):572-92. [<a href="https://pubmed.ncbi.nlm.nih.gov/21748660/">https://pubmed.ncbi.nlm.nih.gov/21748660/</a>]



[15] Piel FB et al. (2013). &#8220;Global epidemiology of sickle haemoglobin in neonates: a contemporary geostatistical model-based map and population estimates.&#8221; Lancet. 381(9861):142-51. [<a href="https://www.ncbi.nlm.nih.gov/pubmed/23103089">https://www.ncbi.nlm.nih.gov/pubmed/23103089</a>]&nbsp;



[16] Gregg AR et al. (2021). &#8220;Screening for autosomal recessive and X-linked conditions during pregnancy and preconception: a practice resource of the American College of Medical Genetics and Genomics (ACMG).&#8221; Genet Med. 23(10):81793-1806. [<a href="https://pubmed.ncbi.nlm.nih.gov/34285390/">https://pubmed.ncbi.nlm.nih.gov/34285390/</a>]&nbsp;&nbsp;



[17] American College of Obstetricians and Gynecologists. (2022). &#8220;Practice Advisory: Hemoglobinopathies in Pregnancy.&#8221; Retrieved Oct 11, 2022, from https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2022/08/hemoglobinopathies-in-pregnancy [<a href="https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2022/08/hemoglobinopathies-in-pregnancy">https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2022/08/hemoglobinopathies-in-pregnancy</a>]&nbsp;

23andMe Updates Carrier Status Report on Sickle Cell Anemia

This summer brought special visitors to 23andMe: 10 high school students from<a href="https://streetcode.org/" target="_blank" rel="noreferrer noopener"> Streetcode Academy</a>, a Bay Area nonprofit committed to empowering communities of color with access to technology.



<figure class="wp-block-image alignright size-full"><img loading="lazy" decoding="async" width="746" height="992" src="http://35.88.189.111/wp-content/uploads/2023/01/Streetcode.jpg" alt="" class="wp-image-31062" srcset="https://blogcms.23andme.com/wp-content/uploads/2023/01/Streetcode.jpg 746w, https://blogcms.23andme.com/wp-content/uploads/2023/01/Streetcode-226x300.jpg 226w, https://blogcms.23andme.com/wp-content/uploads/2023/01/Streetcode-662x880.jpg 662w" sizes="auto, (max-width: 746px) 100vw, 746px" /><figcaption class="wp-element-caption">Our Exposureship participants pose for a group selfie.</figcaption></figure>



The students spent one week exploring life at 23andMe as part of a newly developed Exposureship program.&nbsp;



They attended panels and workshops hosted by 23andMe and StreetCode with subjects ranging from career development to diversity, participated in team meetings, scheduled one-on-one discussions with employees, and capped off their experience with presentations and a celebratory lunch.



&#8220;We wanted to create a one-of-a-kind experience that would build connections in both directions &#8212; giving students a window into life at a tech company, and giving 23andMe employees the chance to connect with the next generation of innovators in our community,” said<a href="https://education.23andme.com/community/sarah-laskey/" target="_blank" rel="noreferrer noopener"> Sarah Laskey</a>, Ph.D., a Senior Scientist at 23andMe who was actively engaged in creating the program.



<h6 class="wp-block-heading" id="h-one-student-s-experience">One student’s experience</h6>



For Ziyan Batada, a senior at Mission San Jose High School in Fremont, California, the program presented a chance to accelerate learning and experience the “range of professions and ventures in [the field of] genetics.”



“I was very excited because 23andMe is my dream company to work at,” Ziyan said. “I am interested in the workings of life, both the psychological and biological aspects.”



Ziyan kept busy during his week at 23andMe. He had in-depth conversations with therapeutics and computational biology team members and attended four different meetings.



“I got to learn a lot about the culture at 23andMe and the value of higher education,” he reflected.



He also had the opportunity to speak to a 23andMe employee who is neurodivergent, just like him. “I am neurodivergent,” Ziyan explained, “and I got to learn from a high-achieving member of the neurodivergent community [at 23andMe] about his struggles and how he worked with them to get far in life.”



This type of authentic connection embodies the goal of the exposureship program, Sarah said. &#8220;They say, &#8216;if you can see it, you can be it.&#8217; That&#8217;s what the Exposureship was all about. Now, these students have seen what it means to work at 23andMe, and maybe they&#8217;ll be back in a few years to work with us!&#8221;

A photo of some of the young people who participated in Streetcode

A New Program Brings High School Students to 23andMe

By Alisa Lehman and Shirley Wu*



As 23andMe Product Scientists, our work focuses on making genetics and science valuable, understandable, and relatable to our customers. Learning about your DNA is incredibly personal, and we know that people have different experiences with our product.



This goes beyond the fun fact that everyone&#8217;s DNA is unique. Unfortunately, it&#8217;s also because our product doesn&#8217;t serve everyone equally.&nbsp;



<h6 class="wp-block-heading" id="h-the-problem">The problem</h6>



Creating inclusive products that serve and engage as many people as possible is both good for business and the right thing to do.



But even for a company like 23andMe, which was founded on the idea that everyone should be able to understand and benefit from the information in their DNA, tackling diversity, equity, and inclusion (DEI) in our product hasn&#8217;t been that simple.



23andMe has all the DEI considerations of any consumer-facing software product, but also has challenges related to how DEI intersects with biology, genetics, medicine, scientific research, data, identity, culture and geopolitics. Historical bias in research has led to disparities in the discoveries — and therefore products — that apply to people of non-European descent. Connecting genetics to identity can be controversial. The way that health information and disease risk are typically communicated does not reflect the experiences of those who are transgender and/or nonbinary.&nbsp;



For a long time, we relied on individual employees to identify and advocate for DEI. And things did happen — there were several projects that improved diversity within our database and we added new genetic reports that could broaden the value of our product to underserved groups. The problem was that these were isolated projects, and championing them required extra effort to gain organizational support and resourcing. Some issues, like gender inclusivity, were simply never prioritized despite repeated attempts.&nbsp;



That changed in 2020.



<h6 class="wp-block-heading">Empowering&nbsp;</h6>



In the aftermath of George Floyd&#8217;s murder, our CEO and co-founder Anne Wojcicki publicly <a href="https://www.23andme.com/black-lives-matter/">acknowledged our shortcomings and our need to do more</a>. Anne had also been listening to employees who’d long advocated for more inclusivity in our product and our company. She decided to make DEI a company priority.



Words matter, particularly public commitments from leadership. These statements empowered employees to drive change across the company, shifting the organizational mindset and starting what has become the most systematic revisioning that 23andMe has ever done of our approach to DEI. It triggered a broad reexamination not only of our workplace and hiring practices but also of the research we do and the products we create.



With that new focus and organizational support, we&#8217;ve made a number of improvements in the last two years. We created more options around birth sex and <a href="https://blog.23andme.com/23andme-and-you/more-inclusive-for-all-genders/">gender identity</a>, improved our <a href="https://blog.23andme.com/articles/accessibility-and-me">accessibility</a> features and software development process, and added <a href="https://blog.23andme.com/health-traits/dfnb1/">health updates</a> that increase the value of the product for customers of East Asian descent. We launched new regions in our flagship Ancestry Composition feature, including<a href="https://blog.23andme.com/ancestry-reports/indigenous-genetic-ancestry/"> Indigenous American ancestry</a>, ethnolinguistic groups in <a href="https://blog.23andme.com/ancestry-reports/african-ethnolinguistic-groups/">Africa</a> and greater detail in <a href="https://blog.23andme.com/ancestry-reports/ancestry-composition-update-china/">China</a>, incorporating input from customers and/or experts with these ancestries. We&#8217;ve used more <a href="https://blog.23andme.com/health-traits/new-23andme-eczema-report/">inclusive illustrations</a> and language to reflect the diverse experiences of our customers.



Just as importantly, we&#8217;ve established metrics and processes that help us understand where we are and bring concepts of inclusivity and equity into our day to day work.&nbsp;



<h6 class="wp-block-heading">Elements of change</h6>



We&#8217;ll admit: addressing the very real, complex DEI issues with our product can be incredibly daunting. There is often no blueprint, and it requires real mental and physical effort.&nbsp;



Four important elements have helped us get to where we are: action, persistence, intentionality, and grace.&nbsp;



<ul class="wp-block-list">
<li>Action: You may not have all the resources you want or a playbook for what to do, but you can always do something. Tackle some low-hanging fruit and build momentum through those successes. You will learn as you go. </li>
</ul>



<ul class="wp-block-list">
<li>Persistence: Making your product more equitable and inclusive isn&#8217;t going to be a one-time fix, but an ongoing journey, so commit to the long haul. Enthusiasm and support, especially from the top, will be difficult to sustain, so create infrastructure for measuring progress, and embed DEI into existing processes and tools to reduce burden. Sustaining the work efficiently — and independently of individuals — is the goal. </li>



<li>Intentionality: 23andMe is a business juggling multiple priorities, and we&#8217;ve made product decisions that don&#8217;t always align perfectly with DEI goals. There can be mixed feelings about this, but we are increasingly making those decisions with intentionality and awareness of the DEI impact. There is greater accountability, and we can be more thoughtful about how we follow through.&nbsp;</li>
</ul>



<ul class="wp-block-list">
<li>Grace: There is often a fear of getting things wrong. And the truth is that there is often no right answer. 23andMe tackles uncomfortable subjects head-on, often venturing into new territory. We do the best we can with the information we have, and we extend ourselves a fair amount of grace — permission to try, to mess up sometimes, to learn, and keep going.&nbsp;</li>
</ul>



We still have so much we need to do at 23andMe, but we&#8217;ve been heartened to see the growing number of companies making the same kind of commitment to making equitable and inclusive products. For us, DEI means we have the potential to connect with and help even more people access, understand, and benefit from the human genome.



<hr class="wp-block-separator has-alpha-channel-opacity"/>



*Alisa is a senior manager on 23andMe’s product science team. She holds a Ph.D. in biology from Stanford. Shirley is the director of 23andMe’s Product Science and Genetics Platform Analytics teams and holds a Ph.D. in biomedical informatics from Stanford.&nbsp;

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