Inclusive Language

What terminology is respectful?

Summary

  • Ask what language people use to describe themselves, their body, and their family structure. Then, use those terms!

  • Consider a patient’s entire office visit. What microaggressions might they be facing from the moment they walk in the door, and how can you mitigate them?

  • Work out a system in your workplace that communicates name changes in a meaningful way, so that a correction at check-in is acknowledged throughout an entire visit.

Transgender and non-binary people often spend a lot of time explaining their identity and fielding intrusive questions about their bodies.

The key thing is that it is better to ask than to assume, but how you ask makes a difference.

Names, Pronouns, and Honorifics

Legal name changes require both time and money. Not every trans person changes their name, and those that do may go through a period where they try different names to see what works best for them. While a person is transitioning or learning more about their gender identity, they may request to be called a name that is not their legal name. It is important to use that name, just as it would be important for rapport-building to use a nickname that someone asks to go by (i.e., someone named Robert who asks to be called Bob).

Like names, a person may wish to be addressed by different pronouns or honorifics. Pronouns and honorifics do not always equate gender identity, so a person assigned female at birth using he/him pronouns with the “Mr.” honorific may not mean that that person regards himself entirely as a man (or even as a man at all).

Subject they ze he she They like science.
Object them hir him her I told hir a story.
Possessive theirs hirs his hers That coat is his.
Reflexive themself hirself himself herself Sam did it herself.

Pronouns sets like ze/hir are known as neopronouns, and tend to be used as a gender-neutral pronouns. Some common honorifics include Mr., Miss, Ms., Mrs., and Mx. Mx. tends to be viewed as a gender-neutral honorific. Again, just because someone uses neopronouns or Mx. does not mean that they have a specific gender identity, or that those pronouns or honorifics match any particular gender identity.

You can learn more about pronoun usage on these sites:

Using the correct names, pronouns, and honorifics are the most basic form of respect that can be afforded to transgender and non-binary people.

Getting It Wrong

It is not realistic to expect someone to learn of a new name, pronoun, or honorific and immediately use it perfectly moving forward. Thus, it is necessary to know how to react when you realize your mistake or when you are corrected by someone else. Apologies that are overly profuse can make the other person uncomfortable. Similarly, taking the moment to say something like “it’s just so hard for me” places and emotional burden on the person who was misgendered or misnamed to comfort you. Offer a quick “sorry” and keep the conversation moving.

Eric, sorry, Erica…

Person 1: When I was talking to him earlier…

Person 2: Her

Person 1: Her, right sorry, when I was talking to her earlier…

Updating Workplace Forms and Processes

Forms used in healthcare settings often ask for demographic information in a way that can be alienating to transgender and non-binary patients. Forms that only ask for legal name and sex serve as a signal to patients that their identity is not something that will be respected in that space.3,4 Selecting the “wrong” box can also lead to awkward situations, such as someone believing that a transgender man who selected “Female” for their sex made a mistake, despite them being listed as female on their insurance. These forms also tend to include gendered options for honorifics, and may be written in such a way that assume a person is both heterosexual and monogamous.

Often, computer systems need to be updated in order to reflect preferred names for patients.5

References

  1. Klein A, Golub SA. Enhancing Gender-Affirming Provider Communication to Increase Health Care Access and Utilization Among Transgender Men and Trans-Masculine Non-Binary Individuals. LGBT Health. Ahead of print, DOI: http://doi.org/10.1089/lgbt.2019.0294.
  2. Brienne Hagen D, Paz Galupo M. Trans* Individuals’ Experiences of Gendered Language with Health Care Providers: Recommendations for Practitioners, Int J Transgend, 2014;15(1):16-34. doi: 10.1080/15532739.2014.890560.
  3. Carabez R, Pellegrini M, Mankovitz A, Eliason M, Scott M. Does your organization use gender inclusive forms? Nurses’ confusion about trans* terminology. J Clin Nurs, 2015;24:3306-3317. doi: 10.1111/jocn.12942.
  4. Skaistis SM, Cook JM, Nair D, Borden S. A Content Analysis of Intake Paperwork: An Exploration of How Clinicians Ask About Gender, Sex, and Sexual/Affectual Orientation, J LGBT Issues Couns, 2018;12(2):87-100. doi: 10.1080/15538605.2018.1455555.
  5. Imborek KL, Nisly NL, Hesseltine MJ, Grienke J, Zikmund TA, Dreyer NR, Blau JL, Hightower M, Humble RM, Krasowski MD. Preferred names, preferred pronouns, and gender identity in the electronic medical record and laboratory information system: Is pathology ready?. J Pathol Inform, 2017;8:42 Open Access