With more acceptance of the lesbian, gay, bisexual/biromantic, trans, queer, etc. (LGBTQ+) community as well as more discussion and knowledge of gender identity in recent years, healthcare professionals and researchers need to change their language to include people of various genders and sexualities. Gender and sex are two different concepts and acknowledging that there are more than two of each as well as being more accepting of patients are required for respectful and safe patient-provider interactions and valid research. When researching and writing academic papers about gender, utilizing binary models of sex and gender in research erases the results and studies of marginalized groups like trans, gender non-conforming (TGNC), and intersex people. There are already issues with TGNC and intersex people being unable to easily access good healthcare and being verbally and physically assaulted. Many healthcare providers are not educated on inclusive language or how to address and treat TGNC people who need gender-affirming care, which leads to less quality healthcare availability and detached questioning from providers. Intersex people also endure discrimination and aggression. One example would be the unethical surgeries done at birth on intersex infants to ensure their bodies look “normal”.
With TGNC and intersex people existing in the population, it’s important that research includes them as well. However, most research is based on the cisnormative (the idea that everyone is cisgender and identifies with the gender assigned at birth) models of sex and gender, excluding TGNC people and people with intersex characteristics. As a result, there are inequalities in the diversity of sex and gender, not showing the clinical differences between sex and gender and diminishing how effective a treatment is for TGNC and intersex people. By not including TGNC people and people with intersex traits in clinical research, there is a cycle of healthcare providers and researchers not knowing enough about queer people to not include them in studies to properly represent their population, and queer people are neglected in terms of treatment. There is already not enough demographic knowledge about TGNC and intersex people, so having more studies neglect these marginalized groups will cause further harm. With not enough research being conducted on various genders of people, medical professionals don’t have as much knowledge or experience in treating and addressing people that are not cisgender.
One medical issue that needs inclusive language is patients lactating and giving birth with there not being enough research about people of all types of genders, especially other than cisgender women as the only group lactating. When people think of lactating and child birthing, most people (including physicians and healthcare providers themselves) often refer to the person lactating and giving birth as the mother due to cisnormativity. While lactating and childbearing people are often cisgender women, people assigned female at birth (AFAB) as well as some TGNC and intersex people can lactate and give birth. There is more focus on the main population of cisgender women only when it comes to lactating and child birthing.
To address the issue of language around childbirth and lactation not being inclusive, there are tips provided by the researchers. For inclusive language, referring to a person lactating as “anyone who is lactating” instead of “mothers” would be a better way of reference. Considering when specificity is important as well; for instance, the author of a publication could say “all participants identified as women. Sex data were not available,” to indicate that the gender of the participants was all women, but the sex they were assigned at birth is not considered in this study. Using non-gendered language over gendered language is another way to make language around childbirth and lactation more inclusive. With people that are not cisgender also requiring healthcare and medical attention, assuming someone’s gender and pronouns can be hurtful to patients. Using gender-neutral language like they/them pronouns until a participant/patient refers to themself as otherwise and using the name that they introduce themselves as is a good way to also be more inclusive of diverse patients. There are also emerging ways to refer to breast milk, saying “human milk” unless the patient says they would like to be referred to in a different way like “father’s own milk”, “parent’s own milk”, or “expressed milk”.
Using inclusive language takes time, but paying attention to how a patient or participant refers to themself as well as introducing oneself with one’s pronouns and name is a good step to encourage the patient to do so as well and let them know that the environment they are in is safe and inclusive.
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