12 Ways to Support Gender Diversity in Healthcare Spaces
Supporting gender-diverse clients in clinical practice requires an approach that is inclusive, respectful, and informed.
Recently, the Tall Tree team sat down with Qmunity for a lunch n’ learn session on just that. Our clinicians and admins had the chance to ask questions, contribute to the conversation, and discuss ideas for making our clinical spaces more welcoming for all.
To kick off the session, one of Qmunity’s invited speakers offered a great piece of advice on creating safe spaces for open and honest discussion:
“What is learned here, leaves here. What is said here, stays here.”
So, what did we learn?
Why is gender expression important in clinical spaces?
Gender is not a binary - it goes beyond ones and zeroes. For some, the choice between the labels of “Man or Woman” can feel like a choice between two arbitrary categories. In reality, there are many ways to think about gender and to use it as a form of self-expression. For this reason, it’s important not to make assumptions based on things like:
The way a person styles or colours their hair.
If someone is wearing makeup or paints their nails.
A person’s face shape, body appearance, or voice.
The clothes a person wears.
And more…
When healthcare providers adopt approaches that welcome diverse gender expression and affirm an individual’s gender identity, it can significantly improve the well-being and mental health of their clients. Conversely, if a client feels unsafe to express themselves fully in any healthcare setting, they are less likely to seek the care they need and may be less open with practitioners about what they are truly struggling with.
With this in mind, what can we do to make our clinical spaces more inclusive?
12 Lessons for supporting gender diversity (in the clinic and beyond)
1) Offer gender-affirming care and stay informed
Gender-affirming care encompasses a range of social, psychological, behavioural, and medical interventions “designed to support and affirm an individual’s gender identity” when it conflicts with the gender they were assigned at birth. (SOURCE: WHO and AAMC)
Often, this type of care is essential to support the health and well-being of transgender and non-binary clients. This can mean providing (or referring) clients to hormone therapy, gender-affirming surgeries, and other medical interventions if sought by the client.
It's also important to recognize the diversity within gender experiences and understand that not all gender-diverse individuals will want or require physical medical interventions. Offering support for mental health and fostering gender-affirming environments to address general healthcare issues can be helpful as well.
2) Ensure your intake forms are welcoming
Language has a powerful impact on creating a welcoming environment. So do first impressions.
Be sure to use gender-neutral language in forms, documents, and communication. Encourage your front desk and admin teams to participate in gender diversity training. Give clients the option to provide their pronouns and chosen names in intake forms (in addition to any legally required or “assigned at birth” information), and make sure these are used consistently across all interactions. This practice acknowledges and respects the client's gender identity, which can significantly contribute to their sense of safety and belonging in any space. See the University of British Columbia’s recommendations for creating inclusive surveys and forms.
3) Practice introducing yourself (and your pronouns)
For many people, the pronouns they use are a significant part of their gender identity. However, not everyone may feel comfortable sharing theirs up front, especially if they are in a new environment and unsure how safe they are.
A good practice is to share your pronouns first every time you meet a new client. This sends the message that your treatment room is a safe space and that the client won’t be in danger if they choose to express their gender freely. In sharing your pronouns, you create a sense of safety that makes it easier for them to share theirs in return. At first, it may seem awkward to include this in your introduction, but it will become more natural over time. Some example introductions could sound like this:
“Hi there! I’m [NAME]. I’m a registered counsellor and nature therapist here at Tall Tree and my pronouns are she/her.”
“Welcome to Tall Tree. I’m Dr. [NAME] and I’ve been working as a Naturopathic Doctor here for just over 10 years. I prefer they/them pronouns but I will also answer to he/him pronouns on most days.”
If someone does not wish to share their pronouns, don’t push them. In general, it’s best to default to gender-neutral language for everyone unless otherwise stated (i.e. they/them). You may think that the singular use of “they” is grammatically incorrect, but we commonly use gender-neutral pronouns when referring to individual people whose gender we are unsure of (e.g. “The delivery driver left my package outside on the front porch in the rain today. They didn’t even knock to check if I was there before they left!’ or “Someone forgot their jacket at the restaurant. I’ll give it to the server in case they come back looking for it.”).
Other ways to signal your support using pronouns include: adding your pronouns to your professional bio, including them in your social media accounts, and putting them after your name in your email signature.
4) Learn (and use) gender-neutral terminology
In general, a lack of adequate descriptive language reduces visibility and understanding of anything. Increasing the language available for alternative identities and body parts could improve healthcare outcomes for patients overall.
During treatment, call body parts by gender-neutral terms (unless the client asks for specific terminology to be used). If you notice a client seems uncomfortable with the language you are using, don’t be afraid to ask how they like to refer to specific body parts on themselves. Using this language will help both of you navigate discussions comfortably. Check out these Qmunity resources for more information and terminology definitions.
5) Be clear (and caring) when requesting information for medical purposes
Sometimes, more detailed information may be required to address a client’s medical concerns in a safe and effective manner. When you need to better understand an individual’s gender identity, go about it with curiosity and kindness. Preface your questions by saying something like: “I want to know more about you because I want to help you and ensure I can give you the best care possible.” Throughout the process, make sure that any questions you ask about their gender, genitals, and identity are truly relevant to the care you’re providing.
Any time you are caring for someone who is transgender or non-binary, remember that medical transition and social transition are two different components of the process. Not everyone will choose to medically transition. Experiences during medical transition and social transition are also both potential sources of trauma for clients. So, consider that it may be difficult for them to openly discuss this before they develop a deeper level of trust with you as a clinician.
“When there are more than two options for gender in forms, I always feel more comfortable in a clinic. I don’t mind giving some medical details when it’s relevant for the clinician to know what my genitals are… but, I still want the option to pick nonbinary as my gender.” ~ Anonymous
6) Emphaze context, confidentiality, and privacy
Maintain high standards of confidentiality and privacy in your practice. This includes being mindful of the information shared in waiting areas, protecting client records, and discussing sensitive topics in a respectful and private manner.
If you update your intake forms to be more inclusive, you may include the option for inputting two different first names (the legal name for medical records and the name that people want you to use). However, just knowing the difference between a client’s legal name and used name isn’t enough. Check in with the person if/when they want you to be using their chosen name. Potential issues could be emails or mail sent with their chosen name to others or to a house address. Seen by the wrong person, these letters or emails have the potential to out them and put them in danger. In letters to other practitioners, mention the client’s legal name and chosen name (if the client has asked you to use it). Even if other clinicians ignore the chosen name, including it is a step toward normalizing the practice over time.
7) Integrate mental health support (and don’t make assumptions about what someone has been through)
From positive experiences coming out to facing discrimination or violence, the experience of queer and gender-diverse people varies widely and is unique to the individual. Adjust your practice and lead with compassion every time someone new walks through your door.
Recognize the mental health challenges that gender-diverse clients may face, including anxiety, depression, and trauma, often exacerbated by experiences of discrimination and stigma. Offer or refer clients to supportive counselling and mental health services that are knowledgeable about and sensitive to the needs of gender-diverse individuals.
8) Upgrade your physical space to be gender inclusive
The physical environment of your practice can signal inclusivity. Displaying symbols like the rainbow flag or transgender flag, having gender-neutral restrooms, hanging up infographics, and showcasing literature or artwork by 2SLGBTQIA+ artists can make gender-diverse clients feel more welcomed and affirmed. If you don’t have a gender-neutral bathroom yet, include a sign asking clients to respect people’s choice about the washroom they use.
Also, when designing clinic spaces and purchasing equipment, consider how recovering from gender-affirming surgeries might impact a client’s ability to safely use your space.
“I will always notice if there’s a rainbow flag at the door of any place I enter. I instantly feel safer. You can’t always control microaggressions from other customers… but, at least if I know that the people running the place are safe, that’s a start.” ~ Anonymous
9) Educate yourself on gender diversity and connect with community resources
Build connections with local 2SLGBTQIA+ organizations, support groups, and service providers like Qmunity. These networks can be invaluable resources for your clients and can also help you stay informed about the needs and concerns of gender-diverse communities.
Continuous education on gender diversity is crucial. This includes understanding the differences between sex, gender identity, gender expression, and sexual orientation. Familiarize yourself with current terminology and concepts related to gender diversity, and stay updated with the evolving language and understanding. Providing training for all staff members ensures that everyone can offer competent and sensitive support.
10) Reflect on your biases and ask for feedback
Self-reflection is a critical component of providing supportive care. Recognize and challenge your own biases and assumptions about gender. This ongoing process can help you become more empathetic and effective in supporting gender-diverse clients.
Remember that all trans and gender-diverse people will need different kinds of support and have varied comfort levels with the care you provide. When you do receive feedback, embrace it as a chance to improve your practice.
11) Remember that mistakes are part of learning
Don’t let the fear of making mistakes stop you from providing care to diverse people. Some common mistakes for those learning include deadnaming and misgendering. If you do catch yourself, here’s “the best way to mess up”:
When you recognize you’ve made a mistake (or someone points it out), briefly apologize and offer a commitment to getting it right in the future.
Use the correct pronouns or name as you repeat yourself.
Then, keep the conversation moving!
Most importantly, if you are corrected by someone else, remind yourself that it isn’t a bad thing! Often, if a colleague, client, or friend corrects you, it means they care about you and your relationship. People rarely correct distant connections because they don’t care enough or they don’t feel safe with the person.
Finally, if you are correcting others, always remember to be kind and assume good intent first. When people make mistakes, don’t shame them. Try to encourage the spirit of curiosity.
12) Advocate for gender-inclusive policy changes
Tolerating someone is not the same as full acceptance and support of their diverse identity. Being passively tolerant reduces access to healthcare and people’s sense of safety in clinical spaces. Encourage your organization and fellow clinicians to consider where they stand on the allyship spectrum.
Actively advocating can look like…
Continually seeking new opportunities to engage in or support activism (i.e. spreading awareness, donating, going to rallies/protests, etc.).
Seeking more education and being okay with changing goalposts as you learn more.
Supporting and sharing TV shows, movies, and books with 2SLGBTQIA+ stories.
Attending events about/for 2SLGBTQIA+ communities.
Distributing 2SLGBTQIA+ resources.
Considering the impacts of universal design (i.e. for washrooms, forms). An example of this is slanted sidewalks (which were designed for wheelchair users after WW1 - but also helped new mothers and families or people in wheelchairs for other reasons).
As a healthcare professional, it’s especially important to advocate for policies that support gender diversity within your practice, professional organizations, and broader healthcare systems. This includes policies that ensure access to gender-affirming care, protect confidentiality, and prevent discrimination based on gender identity or expression. Throughout the process, continue to unpack and embrace the complexity of gender. It's not always easy, but it's worth it!
Supporting gender diversity in clinical spaces…
Supporting gender-diverse clients requires a multifaceted approach that goes beyond mere acceptance in healthcare spaces. It's about actively creating an environment that affirms their identity, respects their experiences, and meets their unique needs. By implementing these practices in our healthcare systems, clinicians can play a crucial role in improving the mental health and well-being of individuals of all genders and sexual orientations.
At Tall Tree, we’re committed to constant learning and improvement in our practice. We want our spaces and services to be welcoming and inclusive for all. Every day, we aim to be the safest place we can be for folks seeking gender-affirming care. Please feel free to reach out to us at hello@talltreehealth.ca if you have any info you think the team at Tall Tree (and other healthcare providers) could learn from!
Are you a clinician looking for more ways to make your practice safer for all?
Trans Care BC offers free online courses to help you provide more gender-affirming care!
Please Note: The content in this blog is inspired primarily by the experiences of clinicians at Tall Tree. Our understanding of best practices has also been developed through conversations with Qmunity and other trans care advocates in the healthcare space.
Are you a client with Tall Tree seeking gender-affirming services?
Our clinicians may not be able to provide every service you require. If not, promise that we will always do our best to direct, refer, and support you in accessing any care that you may need elsewhere.
What is Qmunity?
Qmunity is a non-profit organization based in Vancouver, BC, Canada that works to improve queer, trans, and Two-Spirit lives. They provide a safer space for 2SLGBTQIA+ people and their allies to fully self-express while feeling welcome and included. Their physical spaces serve as a catalyst for community initiatives and collective strength.
If you’re suffering from bullying, isolation, or exclusion due to your queer identity, Qmunity’s resources and spaces are available to help. Or, if you’re questioning your identity or simply seeking a supportive community, check them out!
