Individual Psychotherapy + Sex Therapy

Gender & Healthcare: Part II

Why Healthcare?

This is simple actually. As a healthcare provider, I notice where we drop the ball and don’t provide the best healthcare to many people.  I also recognize several areas where we can make pretty simple changes for a large impact the transgender, gender non-binary (GNB) and gender non-conforming (GNC) population.  

Research also shows that transgender, GNC, and GNB people are avoiding doctors, hospitals, and mental healthcare workers. This is partially because they have had negative, awful, and difficult experiences. They also (rightly) feel that healthcare workers are often gatekeepers standing in their way of healthcare. It’s true that many healthcare providers just don’t understand gender and, in turn, do not treat trans*, GNB, or GNC individuals as a whole people.  

Transwomen are avoiding checkups for prostate cancer.  While, transmen are not going for regular pap smears and breast exams because they do not feel welcome or made to feel comfortable enough to enter these spaces for exams.  Yes, this may be in part because of gender dysphoria, but also because of negative experiences.  

It is my hope to build empathy within the healthcare field. Could healthcare providers who identify as cisgender, imagine how it might feel if they were trans*, GNC or GNB?  What might help you feel more comfortable and welcomed into a providers’ office? What might make you feel less comfortable?  What changes would you be able to make?  I already address the simple changes that can be made with regard to paperwork in Part I of this blog. 

As a side note, I recently heard from someone in the healthcare field working on the west coast and they informed me that they have already created a lot more gender identity options for people on forms/paperwork and made great strides in this area, so those changes are likely to make their way to this part of the country very soon.

Honor Name and Gender Identity

If you are a healthcare provider, especially counselors/therapists, you will want to ask the client for their name and pronouns (not their “chosen” name and not their “preferred” pronouns – more on this in the next blog about micro aggressions). You may choose to do this in the paperwork, but will also discuss it the first time you meet.  The simplest thing that providers can do to make their practice more gender-friendly is to just go with whatever the client says.  Do not argue or question anything about name/pronouns in the first few interactions.  You’ll likely lose trust and rapport if you immediately deny them their name and identity.  

Think about this as if the roles were reversed. How would you like it if someone questioned your name or gender from the very beginning? Personally, I’d walk out of the office and never return.  This role reversal tool can be useful for many other situation – keep trying this out and notice if you might think about things differently. 

If you require a “legal” name (not “real” name), it can likely be found in your paperwork at a later time, and if not, you can always inquire later.  If you are concerned that you’re “feeding into their need or desire to be transgender/GNC/GNB” or something like that, you’re not.  You’re simply respecting their identity, and very importantly, their request.  Focus on listening more, saying/questioning less about gender, in the early stages. 

Use Non-Gendered Terms to Start

Instead of using terms like, husband / wife / boyfriend / girlfriend, choose to use the word partner. 

Rather than using Mom / Dad, you can start with parent or caregiver and notice how your client responds.  

Once your client responds with the terms they use for their partner or parent, then you follow accordingly using their terms.  I do my best to use these non-gendered terms for all clients until I know how they refer to the people in their lives.  It is just about showing respect.

Avoid Salutations & Honorific Titles

Please just stop referring to anyone as Mr. or Ms., etc. in verbal and written communication unless you know specifically which salutation they use.

I also believe the time has come to get rid of honorifics all together. They cause so problems for many people in the GNC and transgender community. Avoid Sir/Madam and you will not offend or hurt anyone by mistakenly misgendering them.

If you Make a Mistake…

Lastly, if you make a mistake with someone by accidentally using the wrong pronoun for them or a friend they talk about, just apologize and move on. Try not to make this same mistake repeatedly, but if you flub-up again, just quickly correct the mistake and move on. You don’t need to make a big deal about of it, but take your cue from your client. If they need to hear another apology, or clarify something about the mistake, then follow them. However, they would likely prefer you acknowledge, but then move forward as quickly as possible.

Coming up…

We will continue with other terms and language of which to be aware in the next blog about gender and healthcare soon.  

Kimberly Atwood is a licensed psychotherapist and certified sex therapist working in private practice in Princeton, NJ.  She also provides online therapy with clients living in Indiana, New Jersey, New York, Massachusetts, and Pennsylvania.  She specializes in sexual health, intimacy and relationship issues.  For more information, please check out her website.

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