Which pronoun should I choose?

Clinical
By
Kevin Ou BPharm, GradCertAppPharmPrac, MHFA, MPS & Lichin Lim BPharm (Hons), Cert IV TAE, MHFA, MPS
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What are pronouns?

Pronouns are words used to refer to a person and contribute to a person’s gender identity. They can develop and change over time and can be gender specific (e.g. she/her/hers or he/him/his) or gender neutral (e.g. they/them/theirs or ze/hir/hirs).

A person may choose to use one set of pronouns or multiple sets interchangeably.

Which pronoun to use and when?

Since we cannot tell a person’s gender by simply looking at them, it is important that we do not assume their pronouns but rather, we ask them which ones they use. Never assume you know which pronoun to use.

Using the correct pronouns is an important way to validate and affirm a person’s gender.

The importance of getting it right

Trans and gender-diverse people experience poorer health outcomes due to negative health experiences (e.g. mistreatment, discrimination) and higher levels of psychological distress, mental illness, suicidal ideation and attempts.1,2 Misgendering and experiences of stigma lead to reduced engagement in health care and delays in seeking medical care.3

Negative interactions and past trauma experienced within the healthcare system will negatively impact the ability of trans and gender diverse people to form trusting relationships with healthcare professionals.

Creating an affirming clinical environment, such as through the use of a person’s correct pronouns, consistent with their gender identity. This is a fundamental aspect of gender affirmation that can result in improved health and well-being for trans and gender diverse individuals.4

This will help people to trust their healthcare provider, build positive therapeutic relationships and ensure optimal engagement with the health system resulting in better health outcomes.

A simple way to incorporate asking for pronouns into your practice is to provide your own name and pronouns before asking to be trusted with those of your patients e.g. ‘Hi, my name is XXXX, and my pronouns are he and him. How would you like to be addressed?’

What if I get it wrong?

Mistakes happen. When they do, acknowledge the mistake and apologise quickly and sincerely. You do not need to dwell on the mistake and a long apology is usually not necessary – this draws further, unnecessary attention to it. Put in measures to minimise the chances of this happening again. Examples of suitable apologies include:

  • ‘I’m sorry for using the wrong pronoun/ name. I didn’t mean to be disrespectful. What are your pronouns and what name do you prefer?’ ‘I apologise. I am still learning. Let me try again.’

Sometimes, a patient may show a negative reaction when mistakenly misgendered. This may be due to previous trauma and discrimination. Try not to take their reaction personally, as providing a thoughtful and sincere apology can go a long way.

References:

  1. Hill AO, Bourne A, McNair R, et al. Private Lives 3: The health and wellbeing of LGBITQ people in Australia. Melbourne, Australia: Australian Research Centre in Sex, Health and Society, La Trobe Unbiversity; 2020. (ARCSHS Monograph Series No. 122).  
  2. Strauss P, Cook A, Winter S, et al. Associations between negative life experiences and the mental health of trans and gender diverse young people in Australia: findings from Trans Pathways. Psychol Med 2020;50(5):808–17.
  3. Dolan IJ, Strauss P, Winter S, et al. Misgendering and experiences of stigma in health care settings for transgender people. Med J Aust 2020 Mar;212(4):150.
  4. The Trevor Project. LGBTQ & gender-affirming spaces. 2020. At: www.thetrevorproject.org/research-briefs/lgbtq-gender-affirming-spaces/