“You Matter” – embedded in the sidewalk of the brand new Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA – View on Flickr.com
I was impressed by the reaction I received to posting this article on Facebook, and since I don’t rely on free social networks for archiving conversations, I’m reposting here.
Here’s what I said in my intro:
Even though this info has been just a Google-search away (“LGBT Style Guide”), it has been widely ignored by the press and the health professions, who of all people should get this right.
Nice that Time Magazine makes it “real.”
The other part is that we’re talking about real people, not “surgical candidates,” appreciative of Mara Keisling’s comments within, and all the people who tirelessly work to teach us, all we have to do is # listen
Thanks to other active listeners / allies I work with who’ll appreciate. And yes, I will correct you, and you won’t get defensive because you’re motivated to learn and correct mistakes.
The responses ranged from frank transphobia to very personal descriptions of what it’s like to have gender dysphoria in society today.
A few points based on what I’ve learned / am learning:
Transphobia is as unacceptable as homophobia – I delete those comments – There’s a school of thought that says offensive comments should be left online to promote freedom of speech and prove that transphobia exists.
I disagree with that approach, and I’m supported by the literature on unconscious bias, which says that leaving those comments up just perpetuates bias..
I have found plenty of examples of media outlets that agree with me, such as Harvard Business Review (see: The comments are respectful, too, in Changing Gender on the Job – Harvard Business Review | Ted Eytan, MD). We also don’t need reminders that transphobia exists in society. It’s easy to find.
To manage the freedom of speech argument, notification of the deletion is posted, which is what I did in this case. It’s up to all of us to create an environment where all people are respected. What you permit you promote.
Using the right terminology isn’t that hard – The style guides are clear, consistent, and easy to follow.
I try whenever possible to put a human term before and after the word “transgender” – it’s going to be necessary for a long time. So I will say “transgender person health care” or “people who are transgender.” Disk space is cheap, I don’t mind typing an extra word in the interest of dignity.
We should not put responsibility on people who are transgender (or LGBTQ for that matter) to (a) come out to anyone (b) educate on diversity (c) make sure everyone uses the right terminology/pronouns – For this I’ll just quote from the UK Army LGBT presentation on Unconsious bias that I loved so much If the UK Army can get it right, I think we can, too.
“if there is a bisexual/gay/lesbian/transgender* person in your unit, their fitting in is dependent on how open your unit is to diversity. It is NOT based on how hard they try to fit in.”
*actual quote said “bisexual” – I’ve edited it for inclusion
I actually remember once, in my past, a very well meaning person in a position of power to me, who asked why I didn’t reveal my sexuality to her when she made assumptions about it.
This can place a person in a vulnerable situation if they decline to answer a personal question, in the setting of societal bias or threat.
Gender identity is protected health information. Ask people what their name and pronouns are, but don’t ask about identity unless you have a need to know.
Don’t get defensive. Again, more good advice:
If you get defensive, notice it and accept the discomfort of unlearning and relearning
This requires a desire to know, motivation to become informed, willingness to correct mistakes
The corollary to this is don’t assume someone is offended. If you learn and change your behavior, people will appreciate it.
When people are willing to teach, be open to learning – a colleague posted a detailed description in the first person. Feel free to read it. People just want to be respected as human beings, and so many of these conversations have at their core the idea that someone isn’t human.
If you ask, you learn
I so loved this quote from the Deborah Frank, MD, at the Grow Clinic at Boston Medical Center. She works with parents of children whose lives are threatened by a failure to thrive. It’s relevant everywhere.
KP Project Lantern is starting in 2015, which will provide lots more learning opportunities for myself and our health system around transgender person health, with the assistance of our world-famous Innovation Consultancy (@KPInnovation). We’re looking forward to it, and I’ll share more info here.