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MAKING MEDICAL FORMS AND DOCTOR VISITS MORE INCLUSIVE: CREATING SAFE APPOINTMENTS FOR TRANSGENDER, NONBINARY, AND GENDER DIVERSE INDIVIDUALS

Medical appointments that are not affirming of patients’ gender, name, and pronouns can be traumatic for individuals who are transgender, nonbinary, and gender diverse.

Similarly, medical forms that are appropriate for cisgender and heterosexual people often aren’t a good fit for individuals in the LGBTQ+ community.

Here are some ways to fix that.

Gender assigned at birth or sex

The gender we were assigned at birth is often assumed to be what our gender continues to be as we age. For transgender, intersex, or nonbinary people, that isn’t necessarily the case.

If a provider or clinic needs sex and gender information from their patients, the best option is to ask for gender assigned at birth and current gender identity, with blank spaces for folks to self-identify.

Pronouns and chosen name aren’t ‘preferred’

Some paperwork asks for both an individual’s legal or birth name and a name they might otherwise go by. However, they often request a “preferred” name or pronouns, insinuating that it’s optional to use this name. It isn’t. Being deadnamed (called by the name they no longer use) can have a significant psychological effect on these individuals and is something providers should avoid.

Relationship status

Many people never get married. Asking for their “relationship status” instead of “marital status” allows folks to share more: Do they date multiple people? Are they asexual or aromantic? Do they live with a partner? This opens the door to talk about important issues that could have bearing on the individual’s health.

Are there specific words you’d like to use for certain parts of your body?

For some transgender folks, using terms like breasts or penis can cause gender dysphoria. Hearing that when you might already be activated by, say, having a pap smear as a trans man can be really difficult. Genitals may be a preferred term, or chestfeeding rather than breastfeeding. Asking about the correct terms helps providers demonstrate they are safe and trustworthy.

Gender-neutral language

There are great examples of gender-neutral language, from the standard Southern “y’all” to “theydies and gentlethems” and beyond. Forms don’t need to use stand-ins for people’s names, like s/he, which fails to describe everyone.

From Shakespeare and Chaucer to the current dictionary definition, the use of “they” to describe an individual is correct and grammatical English: health care spaces should use the term, too. In addition, use other neutral terms, such as: birthing parent rather than mother, pregnant person rather than woman, child instead of daughter/son, and partner/spouse rather than husband/wife.

Gender-affirming care is vital for improved health outcomes

It’s OK to correct providers who use the wrong name or pronoun for you—or to bring someone with you to appointments who can take on that task. Stephanie Budge, PhD, a gender-affirming psychologist and part of the Trans CARE Collaborative, also suggests planning a pleasurable activity for right after what may be an upsetting appointment.

Being misgendered during health care appointments, or receiving care that is not gender-affirming, can be traumatizing and can contribute to anxiety and depression, Budge says.

“Folks tend to avoid going to their medical provider or seeking therapy because they are worried about how they are going to be treated, which only exacerbates these negative effects,” she says.    •

Gender-diverse individuals speak out

Long after legally changing their name, Quinn—who has fibromyalgia and is seeking affirming specialists to further explore test results that suggest an autoimmune condition—continues to get called their deadname by health care providers. This puts the burden on Quinn to correct them. “I want providers to know that they have to do their homework,” they share.

When providers haven’t, it shows. Charis, who lives with axial spondyloarthritis, “almost always get[s] misgendered” in medical notes. “Getting misgendered by health care providers affects my ability to communicate my needs and trust the providers,” they share. “If they don’t honor my gender, do they honor my need for safe and effective treatment and care?”

Sloane—who lives with cerebral palsy and regularly experiences painful spasms due to muscles that are overly toned to support misaligned joints and bones—was misgendered after a provider inputted their pronouns into an electronic health system without their consent or knowledge. The fact that Sloane, living in a heavily transphobic area, could not see that their pronouns were listed in the system came up in abrupt and distressing ways—such as when they were about to have top surgery, a procedure to remove chest tissue that can help make the outside match the inside for transgender, nonbinary, or gender-diverse individuals.

“While I was getting wheeled into the OR, the person said something like, ‘Don’t be upset if I call you the wrong thing! I’m always calling my kids the wrong pronouns, too! He, she, it, who can remember anymore!’” Sloane recalls.

For great ways to make clinic forms and spaces more inclusive, check out:

A Clinician’s Guide to Gender-Affirming Care by Chang, Singh, and dickey

Gender Spectrum: genderspectrum.org

PFLAG:

  • pflag.org
  • The National LGBTQIA+ Health Education Center from The Fenway Institute:
  • lgbtqiahealtheducation.org
  • The Human Rights Campaign: hrc.org
  • Think Again Training & Consulting:
  • thinkagaintraining.com

To find health care providers who are LGBTQ+-friendly, see if your benefits include care coordination services such as Included Health. If not, check out:

GLMA:

  • glma.org
  • OutCare Health:
  • outcarehealth.org

Trans Care Site:

  • transcaresite.org
  • Trans in the South:
  • bit.ly/transinsouth
  • Your local PFLAG chapter or LGBTQ+ center
  • Your local Planned Parenthood
  • Supportive online communities
  • Clinics that have done the work to be LGBTQ+ friendly and display “safe space” stickers

—Grayson Schultz