Bioethics Blogs

When Words Matter: Medical Education and the Care of Transgender Patients

I was only there to learn how to place IV lines. But as my anesthesia attending and I gathered our needles, tourniquet, and gauze, I noticed that our patient, whom I’ll call Jamie, didn’t appear to fit into a narrowly defined version of gender. I wasn’t sure whether to refer to Jamie as she, he, or some other alternative, but imagined it could be quite hurtful if I used the wrong pronoun. I wanted to eliminate that potential for harm. Rather than draw my own conclusions about Jamie’s gender identity, I wanted to know Jamie’s perspective.

In my head, I practiced asking Jamie, “What pronouns do you prefer?” By asking about pronoun preference, I hoped I would communicate my desire to respect Jamie’s gender identity. With Jamie’s answer, I could be sure to use the right language when talking about Jamie with other providers.

But before the words came out of my mouth, I hesitated. I wasn’t entirely sure it was the right thing to say.

This uncertainty felt very familiar. As a medical student, I routinely doubt whether I’m saying the right thing to my patients. I’m not talking about when I don’t know the answer to a patient’s question about a medication side effect or surgical procedure. When those types of scenarios arise, which they regularly do, it’s easy for me to say I’m not sure. My deeper uncertainty arises in circumstances in which my words touch on a topic that is likely deeply personal for the patient, and for which the patient may have experienced prejudice, stigma, or trauma.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.