Gender-Inclusive Language Is Key to Transgender Patient Care

Jay Lankau

March 31, 2022

When Micah Ballard moved to St. Louis a few years ago and established care with a new dentist, the last thing he was worried about was having to justify his identity.

Going into a dentist's office, the most one should have to think about is cavities or flossing, not defending your rights. But for transgender people such as Ballard, even healthcare unrelated to transitioning can at best become a hassle to navigate and at worst, potentially dangerous.

"When our pronouns and our names are not used, that is an instant barrier to care," Ballard said at the recent LGBTQ+ Virtual Healthcare Conference, sponsored by Indiana University. "I made my name, my pronouns, and my salutation, 'mister,' clear from the beginning of my interaction with them and was repeatedly misgendered. I corrected people, and mistakes were still made, and I haven't been back to the dentist since then."

Ballard works as an administrator at the Office of Surgical Education at Washington University School of Medicine, a member of OUTmed, the university's LGBTQ+ advocacy group, as well as a facilitator for the St. Louis Metro Trans Umbrella Group.

He discussed his own personal experience and also the experiences of those he works with in his numerous support groups. Ballard described the unique perspective he brings to his office as a trans person who has been on the patient side of healthcare interactions.

Perhaps the most important part of making healthcare more inclusive and approachable for trans people, Ballard explained, is the use of gender-inclusive language. According to Ballard, language is the first point of contact, from the way a patient is addressed in an office or on the phone to filling out intake forms. Having options for listing a legal name and a preferred name, as well as choices regarding honorifics and salutation information (such as "ma'am," or "sir," or neither) can quickly let a patient know what kind of environment they're in.

Ballard described gender-inclusive language as "the words we use to talk about people and spaces," and spoke of how important it is for healthcare professionals to prioritize gender-inclusive language when working with trans patients: "As healthcare professionals, it's incredibly important to prioritize transgender people first when it comes to the language we use in healthcare environments, because transgender patients have the most to lose when we are not prioritized in healthcare environments."

"Language Is Powerful"

This is a common conversation in Ballard's peer support group, where many trans people are afraid to come out to their doctor. By simply allowing space for patients to identify themselves, poor health outcomes can be avoided.

"Trans people have historically held all the responsibility for asserting their identity," Ballard said. "As healthcare professionals, it is our responsibility to take some of that weight off of trans people."

He explained the dilemma that many trans people face when going to a new provider: "I have to ask myself: Am I going to come out to my doctor? Am I going to tell them that I'm trans? Am I going to be honest with them and risk any danger or mistreatment that might come with that, or am I going to leave out that pertinent health information and risk having something overlooked or having a complication not noticed because I wasn't able to be honest?"

When it comes to solutions, Ballard restated the important takeaway of his presentation: language is powerful. By using and normalizing more inclusive language, healthcare providers can let their patients know that the focus is on their health, and their patients won't have to worry about being misgendered or treated unfairly. This includes degendering the language regarding one's partner, ie, not assuming that every married woman has a husband and every married man has a wife, and introducing oneself to patients with one's pronouns as well so that they feel safe doing the same.

Integrating inclusive language into everyday conversations takes practice, but it will become a habit over time; the goal is to create a culture in which inclusive language is the norm. Additionally, it's important for people in positions of power, such as doctors, surgeons, program directors, and administrators, to take these steps, because it sets an example. Continued education is important, especially since this type of language changes quickly, and it's okay to make mistakes, Ballard noted. Critiques should be accepted as learning opportunities, not as attacks on one's character or as a call out.

"Coming out [as trans] in the professional medical world and being a patient, I have learned that language really is the foundation of creating an inclusive environment," Ballard concluded. "There's not really a way around that. If we can't talk about people in a way that is helpful, affirming, and celebrating of their identity, we won't get an opportunity to do anything else."

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