Reasons for and against gender inclusive language in healthcare

This blog is part 1 in a 3-part series on gender inclusive language.
 
Language changes over time. Words fall out of use. New words become common. Language has always evolved. This is different. This isn’t simply changing a word. It’s changing identity. It’s changing the way we see gender. To some, it’s inclusion. To others, it’s erasure. For the lay person, they can easily choose their language freely and they choose their social circle. For those in healthcare, you’ll find yourself being faced with taking care of all types of people and trying to find the right words to make everyone feel respected. Do you keep with tradition or do you step back from personal identity to use more broad terms for all people?
 
Let’s look at the reasons people choose to be for or against this change.
 
 
Reasons for

1. You want to show you are LGBT affirming and you are an ally to the community. 
2. You want people who do identify differently to feel safe and comfortable with you. 
3. You want to remove any barriers that could hinder communication with your patient/client. 

 
Reasons against

1. Not everyone identifies with the same terms. What is appreciated by one person may be highly offensive to another. The alternative language is continuously changing. 
2. Health professionals need to be using clinical terms. This has gone so far as some saying we should not use the clinical terms for reproductive health because not everybody identifies with those terms. Those against this practice feel it most professional to use clinical terms.
3. Point blank asking a person their gender identity is as intrusive as asking someone their sexual orientation. It is not respectful to ask someone their pronouns. It is an intrusion on a personal matter that they may not want to share with you. Let people come out to you when they are ready. Let it be their choice and their timing. Imagine being in the closet and having someone put you on the spot by asking if you’re gay. That’s intrusive. So is asking someone their gender identity. Maybe they do identify differently. Maybe they’re trying to figure it out. Maybe they prefer to keep things private. If they want you to know, they can tell you.
4. For the people who struggle with feeling not feminine enough or not masculine enough, the question of their gender is deeply hurtful. A traditional woman who secretly thinks her face is too boyish can be upset and self-conscious for days by the simple question of her pronouns. A man who is self-conscious about the tone of his voice not being stereo-typically manly may carry those negative thoughts for years if someone questions his gender. It is wounding to question someone’s gender.
   
5. Making assumptions about people who are gay that they must not be cisgendered can be a very hurtful approach. While sexuality and gender are intertwined, they are different. Many LGB are not also part of the T or non-binary. It’s not appropriate to assume everyone in the gay community wants to be stripped of their gender pronouns. There are quite a few gay folks who are conservative on this matter.
6. You believe gender and biological sex are one in the same. It was the late 1970s when feminists started teaching gender was a social construct and could be different than the gender traditionally associated with biological sex. After thousands of years with traditional gender, this theory on gender being a social construct has been around barely 50 years. The theory has made its way through academia in America and some of the UK while the majority of the world maintains man and woman as the only two genders. Those who follow this sociological theory continue to expand the genders now holding that there are 72 (up from 58 just a few years ago). Other sources now say there are over 100 genders. It is increasingly messy and unclear.
7. You believe gender dysphoria is a mental illness and/or that gender identities contrary to biological sex are damaging to mental health.
8. You also recognize many of these people de-transition and have shared how harmful it was for people to affirm that identity. The community of people who have left the LGBT lifestyle or identity are a group that is completely ignored by those on the other side of this controversy. They will be your patients too. Listen to their voice too. If they tell you it was harmful to them to affirm what they later walked away from, listen.
9. You find it psychologically damaging to raise a child without the mainstay of gender in their identity. As a generation has infiltrated these alternative gender beliefs into their lifestyles, they are having children they choose not to assign a gender to. Babies who are neither a boy or girl are called “theybies” and young children are not given a gender identity until they decide if they want to be a boy or girl or something else or something fluid.
10. It goes against your religious beliefs. Major religions such as Christianity, Judaism, and Islam all have religious beliefs on gender and gender roles. Telling a Christian they must violate their religious beliefs as a requirement of the job is the same as telling a Muslim they must go against their beliefs to remain employed. There are also many parts of the world where gender and gender roles have deeply held cultural beliefs.

 
The above reasons are different perspectives and it’s up to you as the healthcare professional how you approach language in your patient care. You are free to choose traditional language or gender-neutral language. What happens when it’s not your choice anymore? Is it ethical for employers to require gender neutral language knowing that it goes against the religious beliefs of some employees? What about deeply held philosophical beliefs? Respecting cultural beliefs of immigrants?
 
Is it ethical to require or expect people to use this alternative language that violates their deeply held beliefs? What impact will it have on healthcare either way?
 
I stand for freedom. People are free to label themselves as they wish. They should not infringe upon other’s freedom to their chosen speech or their freedom to practice their religion. Is it ethical to require employees to use language that violates their own beliefs? No. Is it ethical to control other people? No. Insisting others use gender inclusive language is no different than insisting others use traditional language. The root is control.
 
The agenda is to erase gender as we know it. What happens when gender changes? Gender roles change. Family structure changes. The family unit changes. The family as a core pillar of society changes. With the waves of change and uncertainty, the pillars crumble. The foundations of faith and family shatter. The fruit of this plant is bitter and destructive.
 
If you are against language that erases gender, stand firm in your faith. Continue to speak the traditional language. If you need some ideas for how to respond when confronted with this matter, click here to read part 2 in this blog series.