I appreciated the thoughtful and balanced editorial by Brittaney L. Kyle, BSN, RNC-NIC, and Donna A. Dowling, PhD, RN, addressing the importance of inclusive language when caring for families in the neonatal intensive care unit. This is such an important topic in our efforts to promote equitable environments for patients, families, visitors, and staff in healthcare settings.

I appreciated the focus on purposeful inclusion and specifically the use of gender-neutral language and the trauma-informed use of each individual's identified personal pronouns and reference words associated with parenting. This is essential in creating a welcoming and inclusive environment in our perinatal and neonatal care settings.

I want to add one additional consideration regarding personal pronouns. The pronouns that each individual uses in reference to themselves are their pronouns. Asking someone their preferred pronouns is considered by many to be a triggering, trauma-insensitive microaggression that suggests each of us has a pronoun that is consistent with our sex assigned at birth, our physical characteristics or appearance, or something else but would prefer a different pronoun be used. In addition, if that question is asked to only some individuals some of the time rather than to everyone, every time, the question itself suggests an assumption or judgment based on some observable characteristic that implies the individual is "other" than one assumed to be cisgender/gender-normative.

An individual's pronouns can most respectfully and simply be learned by the inclusive approach of introducing yourself to parents and family members (and others) with your name and pronouns and asking about theirs. "Hi I'm Kyle, baby Sam and family's nurse today. My pronouns are she/her. How may I address you that will be most comfortable?" is just one of many approaches.

The editorial makes many additional recommendations for promoting inclusivity in this care setting, especially noting the structural and naming conventions that have been long a part of perinatal care, but are insensitive and "othering" for many and can be triggering and deeply traumatic. Knowing our families, and individualizing our care including appropriate use of inclusive language, is important and highlighting it in this editorial with balance and perspective was welcome.

-Katherine L. Criswell, MSN, RN

Oregon Health and Sciences University

Portland, Oregon