We use pronouns to refer to people’s gender—for example, “she/her” or “he/him”.
But not everyone resonates with binary definitions of gender; some individuals may use gender-neutral pronouns such as “they/them” or “ze/zir”.
Every person deserves dignity and respect. Utilising someone’s pronouns is a simple gesture with a significant impact, reassuring trans and gender nonconforming clients and staff that they are welcome and included in your practice.
To promote inclusivity, many private practice owners facilitate conversations to include people’s gender pronouns.
As per Stonewall’s definition, I will use the term “trans” as an umbrella term to describe people whose gender is not the same or does not sit comfortably with the sex they were assigned at birth.
Gender pronouns: why do they matter?
If this is new to you, it’s okay to feel confused. Nevertheless, it’s essential to take the time to understand these concepts, as every person’s right to be respected is valid.
We use language to convey meaning to others, communicate, and characterise and describe everything around us.
Names and pronouns are, therefore, among the most personal words people use to describe us.
Recent studies show:
- LGBTQ identification among millennials is twice as high as that of previous generations.
- Fifty-six per cent of Generation Z respondents know someone who uses gender-neutral pronouns—a significant increase from previous generations.
Think about your clients and the demographics you treat. These findings make it likely that you will treat transgender and gender nonconforming patients now or in the future. You may have even unknowingly treated trans people in the past.
It can be hurtful, offensive, or simply distracting to use the wrong pronouns to refer to someone, whether this is done intentionally or not. For the patient, it might feel like being told they don’t matter or deserve respect.
An anonymous teenager said of misgendering:
“When someone can’t be bothered to try because it’s too much effort for them, then that really stings. It feels like I am not being heard, and that they don’t take me seriously, and they think this is a phase that I’ll soon get over … that hurts, and it feels very uncomfortable … It makes my heart sink.” ¹
Respect is demonstrated when correctly using an individual’s pronouns.
How does the UK’s healthcare system treat trans people?
As a result of interviews with more than 800 trans and non-binary people, a 2018 study by Stonewall looked at the discrimination trans people face on a daily basis in the UK. ²
Through a number of frankly shocking statistics, the report revealed the discrimination faced by transgender individuals in the healthcare environment:
- Seven per cent of transgender people were denied healthcare directly due to being LGBT.
- When accessing general healthcare services, 45% said healthcare staff lacked understanding of trans health needs.
- Twenty-four per cent fear discrimination from a healthcare provider.
Healthcare access is often difficult for those transgender people with other protected characteristics, too.
For example, the Race Equality Foundation reported that “trans people of colour experience higher rates of discrimination when trying to access mental health support, access to substance abuse treatment and domestic violence support.” ³
People with poor experiences with healthcare providers are less likely to seek medical treatment and support in the case of an emergency, resulting in poorer mental and physical health outcomes.
How do I ask a patient what their pronouns are?
The first place you can ask someone’s pronouns is in your patient intake or booking form.
Make sure there are options for patients to select their pronouns from a list, provide their own, or simply “prefer not to say”. Your patient has the right not to share their pronouns with you at all if they don’t wish to.
Additionally, avoid using the term “preferred pronouns”. Even though the term is popular, it’s incorrect and implies someone’s gender can be a preference.
When you first meet a patient who has not shared their pronouns, try introducing yourself with your name and pronouns. This can make it feel safer for your patient to share theirs.
You can use gender-neutral pronouns (they/them) when referring to someone you haven’t met yet, or simply call them by their name.
Always use a patient’s correct pronouns or form of address once you’re aware of these designations.
In any policy or letter you write, gendered pronouns are not necessary unless you are discussing a specific individual in the third person and they have already provided their pronouns.
Check through your T&Cs and policy documents and replace “he/she” with “them”. Further, the salutations of letters or emails should never start with “Dear Sir/Madam,” but instead use a gender-neutral alternative, e.g. “To whom it may concern” or “Dear Patient”.
Find out more about collecting data on gender identity and sexual orientation here.
What if I use the wrong gender pronoun for a patient?
It’s okay to make a mistake; we all slip up now and again.
As soon as you realise, correct yourself. Reply with an apology and the correct pronoun, such as “Sorry, I meant to say she.”
When you realise your mistake after the fact, apologise to them privately the next time you see them.
It’s inappropriate to make someone feel awkward, so don’t dwell on your mistake — it’s not productive.
You are responsible for remembering and respecting someone’s pronouns, and the best way to make amends is to do better in future.
How can my practice promote inclusion for transgender people?
Let the world know that you are inclusive
Make it obvious to co-workers and clients that your practice is safe for LGBTQIA+ people.
Here are a few ways you can do this:
- Change email signatures and staff badges to reflect pronouns
- Place a statement supporting LGBTQIA+ inclusive care on your website, social media or in your practice.
- Support LGBTQIA+ causes or events such as Transgender Day of Visibility.
- Ensure that an all-gender bathroom is available for use.
- Update your social profiles (such as LinkedIn) to include your pronouns.
It will save a lot of anxiety that could otherwise lead to a patient not seeking care at all, or withholding information from you. Understand that gender nonconforming people often face the threat of physical or psychological abuse when disclosing their pronouns to people they don’t know.
Train yourself and your staff
Give all staff basic trans inclusion training, and give medical staff more specific training around trans people’s health needs if necessary. Encourage administrative staff to use patient’s correct pronouns and names when greeting patients in person or leaving voicemails.
If you take appointments by phone, staff should know that gender cannot be determined by the pitch of a person’s voice. They should refer to the person’s medical record or to the information you were given on the referral form.
You can find information online about trans people’s inclusion in healthcare, but TransActual’s policies and guidance on trans inclusion for healthcare professionals is a great place to start.
Listen to trans people and be an ally
When your trans patients tell you about their needs, it is important to listen to them and remember that their trans status isn’t always relevant to their current needs.
In the case of a sprained ankle, there is no need to ask a trans person about their transition.
Listen to people’s experiences when they share about their lives and be receptive. Consider taking action to help create a more inclusive environment by learning from them.
Being a trans ally means that you should:
- Show support
- Actively challenge transphobic language, behaviour and actions
- Recognise systemic inequalities
- Realise the impact of microaggressions
- Believe the experiences of underrepresented people
- Listen, support, self-reflect and change
- Be aware of gendered terms
WriteUpp and Gender Pronouns
WriteUpp strongly believes in diversity and inclusivity.
Thanks to a recent update, users of our software can more accurately reflect their clients’ gender identity and gender expression.
Consequently, transgender and gender nonconforming clients do not have to provide information that is false or inaccurate.
To learn more about the steps needed to set up a trans-inclusive practice, I suggest reading TransActual’s guidance and policies on trans-inclusion for healthcare specialists.
For general guidelines on building a more LGBTQIA+-inclusive working environment, start with Stonewall’s top 10 tips on inclusion in the workplace.
For more information, email me at firstname.lastname@example.org or find me on LinkedIn.
Sincere thanks to Michael Bonebright, Associate Director of Content at TechnologyAdvice for proofreading and consulting with me on this article.
- Pronouns and Prejudice: Over a third of Brits do not … – Mermaids: https://mermaidsuk.org.uk/news/pronouns-and-prejudice-over-a-third-of-brits-do-not-recognise-non-binary-pronouns/
- Stonewall | LGBT in Britain – Trans Report (2017): https://www.stonewall.org.uk/resources/lgbt-britain-trans-report-2018
- Trans inclusive healthcare — TransActual: https://www.transactual.org.uk/inclusive-healthcare