Compounding this problem, evidence shows that gender-diverse patients perceive discrimination in the health care environment, including experiences of explicit and implicit bias. Negative experiences in health care settings can contribute to gender minority stress and are linked with delays in seeking care and negative health outcomes.
“As health care providers, we can make a difference by providing an environment that adapts to the needs of gender-diverse patients,” says Rebecca Boswell, PhD, Supervising Psychologist at Penn Medicine Princeton Center for Eating Disorders. “Affirming a person’s identity is an important aspect of helping them feel safe. It communicates that we see, value, and respect a patient’s identity.”
“When providers introduce themselves using their name, how they identify, and their pronouns from day one, it opens the door to patients doing the same,” says Jamie Benjamin, MA, LPC, NCC, ACS, Clinical Manager of the Princeton House Women’s Program at the Princeton outpatient site. “Often, you can almost see the sigh of relief when patients realize they’re in a place where they can get the support they need.”
Using chosen names, pronouns, and terms that patients use to describe themselves can be a lifesaving intervention. The use of chosen names in transgender youth is linked to a reduction in depression, anxiety, suicidal ideation, and suicidal behavior. Providers can also:
- Ask respectfully about legal names if they do not match your records.
- Document sex as assigned male/female at birth.
- Use the patient’s chosen name, gender, and pronouns in the chart.
- Help colleagues understand chosen names and correct pronoun usage.
- Respectfully correct others when needed.
- Apologize if you make a mistake.
Penn Medicine Princeton House Behavioral Health and Princeton Center for Eating Disorders provide gender-related education and training to help team members improve cultural competency and develop a deeper understanding of gender-diverse patients. Many of these ongoing educational opportunities are extended to the greater behavioral health community.
The Princeton outpatient site also offers a weekly Safe Space curriculum focused on open discussion, interpersonal skills, and the history of LGBTQ+ rights. Benjamin recently coordinated an update of the curriculum to add more robust content, including a creative arts element, and she’s seen a positive change in patients who have participated.
“The curriculum has been such a joy to work on,” adds Benjamin. “For so long, transgender and gender-diverse individuals have felt unheard and invalidated. It’s time to set standards to change that.”
