About one in five U.S. adults knows someone who goes by a gender-neutral pronoun.1 It’s increasingly likely that a nonbinary person (someone who doesn’t identify as male or female) or a transgender person (someone with a gender identity different from their assigned sex at birth) is seeking care at your health organization. Nearly all nonbinary participants in a recent study said they’d encountered health care providers who didn’t provide gender-affirming or inclusive care.2 Are you welcoming this population, letting them know you’re ready to meet their needs?
A growing population with unique health care challenges
Most research hasn’t included nonbinary as a response category when asking about gender. Studies show that nonbinary individuals are estimated to make up 25 to 35% or more of transgender populations.3 But these studies sampled only transgender populations and didn’t capture nonbinary individuals who don’t identify as transgender.
An increasing number of people self-identify as nonbinary. As this population keeps growing, it’s important to recognize the struggles they face when seeking care from providers who aren’t educated about how to treat their needs. In turn, you’ll gain a better understanding of nonbinary and transgender biology to reduce stigma and respectfully provide care.4
6 tips for creating inclusive patient education
Follow these tips to set a foundation for inclusive patient education that encourages individuals to seek care and adhere to their provider’s recommendations:
1. Use purposeful pronouns that speak to everyone
Embrace they, them, and their as singular, gender-neutral pronouns. For example: When your patient arrives for an appointment, take steps to make them—instead of him or her—comfortable. This language choice helps meet the needs of those who don’t identify as he or she. In addition, opt for other gender-neutral terms such as partner or significant other.
The Associated Press advocates the use of inclusive language and gender-neutral writing to reach diverse populations and, in 2019, the Merriam-Webster dictionary expanded the definition of they to include a single person whose gender identity is nonbinary.
2. Keep content clear and simple
Using they, them, and their for singular pronouns not only makes language more inclusive but also shorter, simpler, and less awkward. Your patient education should be outlined by clinicians and written by medical writers using plain, health literate language so that it’s actionable and easy to understand—always the goal.
3. Conduct regular content checkups
Your patient education should support you as recommendations change—often at breakneck speed. It should be reviewed regularly for clinical updates as well to reflect new understandings of the diverse society we live in. A good rule of thumb is that content is reviewed at least every 24 months, and through a multi-tiered, standardized medical review cycle.
4. Continue content conversations
Continue dialogue with broader stakeholders—such as patient advocacy groups or diversity councils—across your organization as the pace of change for inclusive language is rapidly accelerating.
5. Look to content leaders for consensus
Follow the guidance of industry associations like the Health Care Education Association (HCEA) and the American Academy of Family Physicians (AAFP) for consensus on how peers in other organizations are adjusting their language and policies to be more inclusive.
6. Go beyond words to build on inclusion
Make sure patients see themselves in your education. Collaborate with your creative team to ensure you’re featuring visuals that offer a diverse and inclusive perspective to reflect your patient population.
1 Geiger A, Graf N. About one-in-five U.S. adults know someone who goes by a gender-neutral pronoun. Pew Research Center. https://www.pewresearch.org/fact-tank/2019/09/05/gender-neutral-pronouns. Published September 5, 2019. Accessed July 7, 2020.
2 Lykens J, LeBlanc A, Bockting W. Healthcare experiences among young adults who identify as genderqueer or nonbinary. LGBT Health. Volume 5, Number 3, 2018. https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC6016091&blobtype=pdf.
3 James S, Herman J, Rankin S, Keisling M, Mottet L, and Anafi M. (2016). The report of the 2015 U.S. transgender survey. https://www.transequality.org/sites/default/files/docs/USTS-Full-Report-FINAL.PDF. Published 2015. Accessed July 6, 2020.
4 Drexel Now. The more you know: How better understanding of transgender and nonbinary biology benefits those patients. https://drexel.edu/now/archive/2020/May/Trans-Nonbinary-Healthcare-Access. Published May 22, 2020. Accessed July 7, 2020.