Respecting Pronouns in Medical Practice

LGBTQ+ individuals face substantial health disparities due to the societal repercussions of identifying as a member of the community. Increased risk of mental illness and abuse combined with less access to healthcare ( factors which are amplified when leaving the liberal realm of the West) highlight the need for healthcare professionals to create a safe inclusive zone in their practice in order to provide high quality care and encourage members of this community to approach medical facilities for care.

It is the basic responsibility of a healthcare provider to be conscious of their manner of talking to any patient that enters their clinic. In the case of transgender or nonbinary individuals this is particularly pertinent, as the use of misgendered language can be dangerous: increasing dysphoria and feelings of alienation whilst also degrading the bond of trust between doctor and patient which is vital to to good practice. Language is a tool which is used to communicate intent and action, therefore to establish basic trust obvious respect can be shown by respecting gender pronouns in practice.

“Of all the things that could offend a trans person or lead them to feel misunderstood, excluded and distrustful, mistakes involving forms of genderrelated speech are perhaps the most upsetting. Potentially they are also easiest to pay attention to getting right.”

(Trans: A practical guide for the NHS, Department of Health. 2008)

A common barrier with this proposal takes the form of how to approach such conversations consistently. Some suggestions that I have picked up from my research ( see links below for more information) follow:

  • Use a pin identifying your pronouns on your lanyard
  • On official documents/emails place your pronouns in your signature
  • Get used to introducing your pronouns whenever meeting a patient for the first time -eg. “Hello, I’m Dr. Quigley. My pronouns are he/him. How would you like to be addressed?”
  • Avoid using gendered language such as Welcome Ladies and Gentleman or Hi Guys

As you can see these changes are subtle, however they have the potential to transform the doctor patient relationship for the better.

Another issue that faces the integration of the use of pronouns in the medical profession, is that of time and efficiency. Under high pressure environments these things can easily be sidelined however if we can get in the habit from the earliest days of medical training to be conscious of our pre-built gendered biases then over the course of ones medical career it shall effectively become an autopilot procedure for patient interaction. The complications of creating patient databases which are inclusive and provide the right information for medical procedures (such as transfusions where both sex and gender influence who can donate and receive blood) have also lent substance to the systematic alienation of LGBTQ+ individuals from healthcare, and taking measures such as introduction of pronouns into practice is a way to combat this.

“if you misgender or misname them and don’t respond respectfully when corrected, you’re telling them right off the bat that they don’t know themselves as well as you know them; that they don’t have the same right to self-identity as your other patients, and you aren’t willing to respect them as they are. Why, in lieu of that, should they trust you with their health? “

(Carbone, 2019)

Ultimately the doctor has a duty of care for all their patients regardless of whether they belong to a minority, or their views contradict those of the physician. So I shall leave you with the following quote which I believe puts forward the argument for pronouns better than an entire blog post could:)

let’s keep in mind that helping our patients live as their authentic selves is some of the best medicine we can provide.

(MacMillan, 2018)

Bibliography

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J Pathol Inform. 2017; 8: 42.

https://journalofethics.ama-assn.org/article/pronouns-and-advocacy-medicine/2020-03

https://shcs.ucdavis.edu/blog/archive/why-pronouns-are-important

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5653959/

https://www.prideinpractice.org/articles/transgender-pronouns-guide/

https://blog.columbusmedicalassociation.org/blog-1/2019/12/10/the-importance-of-respecting-pronouns-in-medicine

https://thehill.com/opinion/healthcare/464233-doctors-should-ask-all-patients-their-preferred-pronouns

https://opmed.doximity.com/articles/pronouns-matter-how-we-can-do-better-in-lgbtq-patient-care?_csrf_attempted=yes

https://www.bma.org.uk/advice-and-support/gp-practices/gp-service-provision/managing-patients-with-gender-dysphoria

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