A guide to understanding your transgender patients
Self • noun
- a person referred to with respect to complete individuality: one's own self.
- a person's nature, character, etc.: Your self is who you are, how you perceive and express the qualities and characteristics that make you a unique individual. It applies to every aspect of you, including your gender.
Throughout your entire life you've completed forms like this one. You may think that gender (man, woman, gender queer, etc.) and assigned sex at birth (male, female, intersex) are the same thing — but they are not.
What's your gender identity?
Your gender identity is how you perceive yourself — your own understanding of your gender. You may think that gender is either man or woman, but it's a continuum. And it may or may not correspond with your assigned sex.
Cisgender: If you identify with the sex you were assigned at birth.
Transgender: If your gender identity is different than your assigned sex at birth.
Examples: Someone who was assigned male at birth, but identifies as a woman, is a trans woman. Someone who was assigned female at birth, but identifies as a man, is a trans man.
How do you express your gender?
That is, how do you present your gender to the world through your style, your dress, and your demeanor?
Gender reflects cultural classifications of behavior, experience, and personality commonly labeled as masculine or feminine.
But gender expression also lies on a continuum and there are people on all points in between.
What's your sexual orientation?
To whom are you attracted? Both cisgender and transgender people can be attracted either romantically or sexually to men, women, transgender or cisgender people, or any combination. Once again, it's a continuum.
Understanding that these aspects of gender fall on a continuum may leave you uncertain of how to behave with transgender patients.
Be open. Respectful. Kind.
Treat all patients the way they want to be treated.
What should you say? What should you do?
Treat transgender patients the way they want to be treated.
Ask patients for the name they go by, and then use it! Using a name assigned at birth (sometimes called a “dead name”) may cause emotional distress. Also, ask which pronouns you should use. For example, a trans man may use “he” or even “they.” Avoid using the terms “preferred name” or “preferred pronouns” when asking because this implies the experience is a choice and invalidates the patient.
Not all transgender patients will want medical gender affirming procedures, such as hormones. So, ask your transgender patients what care they may be interested in to affirm their gender, if any.
If Emily, a trans woman, is your patient, refer to her as transgender or a transgender woman. It's an adjective that describes her, not a noun that defines her, so she's not “a transgender.” She's also not “transgendered.”
Using proper terms shows that you respect your patient. Avoid hurtful terms like she-male, he-she, it, tranny, hermaphrodite, transsexual, or transvestite.
It's not appropriate to mention if you think transgender patients “pass” as their gender identity.
Unless a patient is pursuing surgical intervention, don't use the term “pre-op/post-op.” Don't use offensive terms like “sex-change” or “born a boy/girl.”
And if you say the wrong thing by mistake, say you're sorry. If you don't understand, be honest. But don't make assumptions.
As with any patient, don't ask personal, medical, anatomy questions unless they are clinically relevant for specific recommended exams or treatment.
Treat transgender patients with the same respect and professionalism that you show to every patient.
For more information, visit http://www.mydiversepatients.com/le-lgbt.html
Centers for Disease Control and Prevention, 2016
Institute of Medicine (US) Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities, 2011