In an age where more transgender people are living openly, many well-meaning individuals, including health professionals, may shy away from engaging with the trans community because of anxieties about offending or disrespecting someone. For trans people, this often means there are even fewer physicians in their area who are comfortable treating them, which further complicates their ability to access health care.
Fortunately, these anxieties are easily resolved through learning and familiarizing oneself with the unfamiliar. This article will address some of the most common concerns and questions about interacting with trans people to enable more health professionals to feel capable and confident caring for trans patients.
Pronouns are a frequent scapegoat for why interacting with trans people is supposedly riddled with pitfalls. In reality, pronouns are an essential part of everyday language, a part of speech that takes the place of a name or names. Words like “we,” “you,” “I,” “she,” “our,” “him,” “theirs,” and other variations of those words are all pronouns. Everyone has pronouns. As such, pronouns are obviously not a new phenomenon—nor is the use of singular “they.” In fact, the use of “they” as a gender-neutral term to refer to one person goes back centuries, and most people regularly use singular “they” in everyday speech, whether or not they realize it.
This chart is a breakdown of some common pronouns people might use.
The proper use of pronouns is both a matter of grammatical correctness and basic respect. When someone requests that a certain set of pronouns be used to reference them, ignoring that request is equivalent to denying that person’s right to exist altogether. After all, if someone’s pronouns are he, him, and his, but another person insists on calling him “she,” the other person may as well not be talking to him at all; they are talking to an imaginary “she.”
However, while respecting pronouns is a matter of human decency, making mistakes is a simple matter of human error. Showing goodwill and respect by apologizing tactfully after making a mistake and then carrying on normally is all that’s necessary to recover from such a blunder. Excessive apologizing, such dragging an apology into a tangent or a soapbox, is inappropriate and will make the trans person in question more uncomfortable. Simply correcting the mistake and offering a discreet apology is the best way to handle making a mistake with someone’s pronouns.
Using unfamiliar pronouns for someone for the first time is often difficult. Practice is the best method to become familiar with using a set of pronouns. Simple exercises like saying example sentences out loud while making deliberate use of correct pronouns can be done easily anywhere, either alone or with a conversation partner.
Asking someone’s pronouns is best undertaken as a natural part of conversation. A question as straightforward as “What pronouns would you like me to call you?” succeeds by indicating understanding and respect. If the individual wishes to elaborate on their gender identity, they may, but that information is not necessary in order to engage with them professionally. If doubt ever arises about how to refer to someone of unknown gender identity, the word “person” always applies.
When asking someone’s pronouns, if there is a chance of interacting with their friends or family, be sure to ask whether or not the person is out to their friends or family, and if not, ask what pronouns should be used to refer to them around other people who know them. Remember, gender identity can be a matter of life and death for people in especially unstable households, and outing someone could put them in significant danger.
What Topics Are Appropriate?
Questions are inevitable, and many are acceptable. As a medical professional, some may be necessary. Tact, however, remains important. Trans people face constant scrutiny about their bodies in every aspect of life. If genitalia is not relevant to the health care they are receiving, it likely should not be a topic of conversation. If it is relevant, asking the patient how they wish to refer to their respective organs offers support by giving the person control over part of their health care experience.
It is sometimes the case that well-meaning questions, particularly about a trans person’s body or lifestyle, are needlessly taxing. People of minority identities are often asked to speak on behalf of their entire community, which falsely assumes their communities are so homogenous that one person should speak for them. Instead, pursuing research independently both succeeds in obtaining desired information and avoids placing the onus for answers on one individual.
Such a small commitment to patient care makes a difference that should not be underestimated; according to the National Transgender Discrimination Survey Report on Health and Health Care, a full 50% of respondents reported that they had to teach their own providers about transgender care. (Another 28% reported postponing medical care when sick or injured due to discrimination.) Crucially, this applies not only to providers, but also to staff at clinics and offices. “It’s about making a whole team that cares,” said Dr. Carol Feuerstein, M.D., a family physician in Wisconsin.
Many available resources provide trustworthy, helpful information. Taking the time to research everything from identity to the latest on hormone therapy shows goodwill and genuine care for trans patients, who are often expecting a hostile health care environment and may be pleasantly surprised. Even when mistakes happen, the effort to be informed has a positive impact. “You don’t have to be perfect to make a difference,” said Dr. Feuerstein.
Sound sources on caring for trans patients include the following:
This is the second in a series of articles about transgender topics. Read part one.