As nursing students, one of the first things we learn is to treat our patients with dignity and respect. Part of treating patients with dignity and respect is addressing patients by the appropriate name and/or pronoun. This can prove challenging when caring for patients from the lesbian, gay, bisexual, transgender, queer or questioning, intersex, and asexual or allied (LGBTQIA) community. As our thinking evolves and we continue to educate ourselves on cultural and ethnic diversity, we can better care for our patients.

When in doubt, respectfully ask.

• What pronoun do you prefer, and what name do you go by?
• To eliminate discrepancies in billing, or errors in the medical record, what name is noted on your health insurance card, and driver’s license?

Gender and Sex – What is the difference?

Gender does not mean the same thing as sex. Sex refers to the biological traits one was born with; their chromosomes are expressed as “XX,” “XY,” or other variations. Gender refers to one’s chosen identity, regardless of biological traits.

Know the Terminology

Learning the terminology, and appropriate pronouns, can assist you in starting an open-line of communication with a LGBTQIA patient.
L—Lesbian—women attracted to other women
G—Gay—one who has or desires to have a relationship with a person of the same sex; this term often refers to men who are attracted to other men
B—Bisexual—one who is attracted to both others of the same or different sex and/or gender
T—Transgender—people who identify or express their gender as the opposite of their biological birth sex.

• A trans woman is a biologic male that identifies as a female; MTF=male transitioning to female
• A trans man is a biologic female that identifies as a male; FTM=female transitioning to male
• One does not need to have undergone surgical intervention to be considered transgender. If a person says they are transgender, then they are transgender.
• Remember the importance of providing comprehensive care. For example, a transgender man (female transitioning to male) may still be at risk for ovarian or cervical cancer.

Q—Queer/Questioning

• Queer is an all-encompassing term that is not gender- or sex-specific.
• Questioning refers to people in the process of figuring out their identity and sexual orientation.

I—Intersex—a person who was born with both male and female sex organs, or ambiguous genitalia. This term is used instead of “hermaphrodite.”
A—Asexual/Ally

• An asexual person does not experience sexual attraction.
• An ally is any person that identifies as straight and is supportive of the LGBTQIA community

Cisgender—One whose identity and biological sex are the same.
 
Pronouns
Cismale: he/him/himself
Cisfemale: she/her/herself
Transgender male: he/him/himself
Transgender female: she/her/herself
Gender nonconforming (non-binary): they/them/themselves
Gender neutral: zhe/zhim/zher/zhimself/zherself
 
It’s important for all patients to feel respected, and safe in any healthcare environment. Communication is the beginning of a positive healthcare experience.

References:

Harker, M. (2018, November 3). LGBTQIA- Providing Care For Transgender Persons: Diversity and Inclusion in Care. INS National Academy, 2018.

Humphrey, C. (2018). Nursing Knowledge and Attitudes Toward Trans* and Gender-Nonconforming Patients. Magnet Conference, 2018.

Tollinche, L., Walters, C., Radix, A., Long, M., Galante, L., Goldstein, Z., Kapinos, Y., & Yeoh, C. (2018). The perioperative care of the transgender patient. Anesthesia & Analgesia, 127(2), 350-366. doi: 10.1213/ANE.0000000000003371