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In June, President Joe Biden signed an executive order asking the federal health and education departments to expand access to gender-affirming medical care. While it’s wonderful to see the evolution of Biden and Harris’s personal and political stances on LGBTQIA+ issues, many LGBTQIA+ people remain skeptical of government protections around LGBTQIA+ healthcare.
The surge of anti-LGBTQIA+ legislation like Florida Senate Bill 1834 and House Bill 1557, known colloquially as the “Don’t Say Gay” bill, highlights how many spaces are still unsafe for LGBTQIA+ people and how much work we need to do to not only legally protect their rights, but to challenge and diminish anti-LGBTQIA+ values. It is imperative that medical practitioners, educators, and law-makers alike understand the extent of the trauma that this group of people have experienced at the hands of systems and individuals that, in theory, exist to protect people. Only by acknowledging this can LGBTQIA+ people begin to heal and build back trust in these systems.
Members of the community often feel like they need to educate their practitioners and medical providers, which can be exhausting and disheartening. This might looks like practitioners defaulting to assumptions of heterosexuality with patients or a provider making inaccurate assumptions about a patient’s sexual behaviors and basing their diagnosis and treatment plan off it. Heteronormative language and anti-LGBTQIA+ practices are woven throughout our current healthcare system, and it will take active effort to unlearn those practices. Below are some key practices that can greatly improve the experiences LGBTQIA+ people have in a healthcare setting.
1. Removing Unnecessary Gendered Language
LGBTQIA+ individuals already have disproportionately low access to healthcare services—and the healthcare options they have often are not equipped to meet their needs. A crucial piece of ensuring access to comprehensive healthcare is ensuring that transgender and nonconforming patients see themselves represented in the materials, language, and services that healthcare services provide. For example, if the language on a clinic’s website or advertisement is highly gendered and labels services for “men” and “women,” it is an indication that the institution might not be a welcoming place for a nonbinary or gendernonconforming person. If gendered services make assumptions about patients’ body parts, this is a clear indication that transgender and gender expansive people have not been considered. Minimizing gendered language as much as possible and training staff to avoid making assumptions about patients’ bodies and needs is the surest way to minimize harm.
2. Ask for Required Information in a Clear Way
It’s always best practice to remove gendered language when it is not necessary, but when information often associated with body parts, gender, or sex is needed from a patient, it can be beneficial to ask for additional patient information. For example, if you require a patient’s sex assigned at birth, also asking for a patient’s gender identity shows that you understand the difference in these questions and want to respect your patients.
On the other hand, if you only require “gender” or “sex,” patients again might be confused what information is being asked of them, causing confusion later on in the appointment, at pharmacies, or at labs. Additionally, it is important that practitioners treat patients using the correct reference ranges for their bodies. If clinicians do not ask for this information in a clear way, it could lead to patients receiving inaccurate treatment which is concerning from both legal and health standpoints. Having this information available for staff will also minimize assumptions about a patient’s gender identity or the body parts they have. Making these questions a routine part of the intake process will help guide and set an expectation for any staff who are new to the language or conversations.
3. Introduce Yourself with Your Pronouns & Ask What Name Patients Use
For this same reason, providers and practitioners should be in the habit of introducing themselves with their pronouns as well as asking patients theirs. Some people only do this when introducing themselves to people they assume are queer based on their appearance, but queer people do not look any certain way, and it is best to avoid assumptions about anyone’s identity based on the way they present themself.
Normalizing these questions and processes is exceptionally important if a patient is going through a healthcare process that touches multiple businesses. For example, a doctor might ask a patient for the name they go by as well as their legal name (sometimes referred to as a deadname). Many people go by a different name than their legal name, so adopting the practice of asking patients the name they use is a way to be inclusive. If a doctor has adopted this practice but not properly communicated with a lab or pharmacy, a patient might not know what name they need to say to get the tests or medication they require. This might lead to a patient having a painful and invalidating experience with another touchpoint in the medical system.
4. At-Home Testing
At-home testing allows LGBTQIA+ people to take charge of their own wellbeing and needs, making healthcare more accessible than ever. This model offers individualized and comprehensive care to individuals with a variety of needs: they might live in rural areas, not have the time or funds to travel to in-person appointments, or require the safety and comfort of selecting the space where they take their appointment. This model also reduces potential harm in spaces like public transportation and the pharmacy, since patients can bypass steps that have historically been barriers to care.
As remote healthcare becomes increasingly popular, it is even more important to center LGBTQIA+ people when building inclusive and gender-affirming businesses. Learning from businesses who provide gender-affirming healthcare services is a great place to start, as they likely have been intentional about the language they use to promote their services and interact with their patients.
No one reaches a point of gender competence; language is constantly evolving and we are all learning together how to use new language and what language feels validating and affirming for ourselves. Look to organizations led by LGBTQIA+ people and resources made by LGBTQIA+ people to engage in ongoing learning, rather than having that education come from patients. While taking the time to routinely read up on gender-affirming best practices and to facilitate staff trainings might take time, this is time well spent investing in the LGBTQIA+ community. All of these efforts will be noticed—and they could even be life-saving.
Photo credit: sasirin pamai, Getty Images
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