Improving provider-client relations: Trans-competent care

Brooke Huffman

Guest Blog Post: J. Brooke Huffman, ND is a naturopathic physician committed to helping people enhance their lives by optimizing their health. Before becoming a doctor, Brooke worked as a counselor and social worker for over a decade with children and teens, including troubled teens, foster kids, those on the autistic spectrum and with other developmental disorders. She received her doctorate degree in naturopathic medicine from the National College of Natural Medicine in 2011. Dr. Huffman is also the medical director of the People's Health Clinic, a free integrative medicine clinic she co-founded to bring natural medicine to houseless and low income people in downtown Portland.

Portland has become a hub for transgender healthcare, and we take pride in that designation. I am not personally a member of the transgender community so I cannot speak from a Trans perspective but over the last 5-6 years I have developed a specialty in providing Trans-competent care. In this article I hope to share some tips that will make things go more smoothly for you and your clients/patients. If you are new to providing competent care to Transgender folks, here are a few important tips to get you started.

Identify the preferred pronoun and use it:

When working with anyone who does not identify as cis-gender (cis-gender means their gender aligns with the sex they were assigned at birth, the opposite of Transgender) the first thing to do is ask the person’s preferred pronouns and then use those exclusively. This means use the preferred pronouns when you are speaking to the person, in all of your charting, in the back office etc. Remember that your patient may at any time request your chart notes and you can lose a lot of trust and respect if incorrect pronouns are used in their chart. If you slip up and use an incorrect pronoun, quickly correct course and apologize. Do not pretend the slip did not occur, as they have certainly noticed. Always use the patient’s preferred name in communicating with the patient or about the patient, using only legal names when necessary for billing. I always personally explain to the patient why I am using their legal name when I have to, for example when I am filling out lab forms or a prescription.

He/she vs. they/them

Gender is not just male/female for many people. Remember that some people do not identify as “he” or “she”. Instead they do not feel they fit either of those ends of the spectrum and are somewhere more in the middle. They prefer to go by “they/them” pronouns. It can be confusing at first for those who are used to thinking of “they” as a plural pronoun. Just remember we use “they“ all the time we do not know the gender of someone. For example: “Oh, someone left their bag here, I hope they come back for it.” It’s easy!

body part Verbiage

When referring to any body part that has different names depending on the persons gender, you will benefit both parties by knowing the preferred words that this person uses. Generally these are the parts of the body that are covered by a bikini. A person who identifies as more masculine may be very triggered by the use of the word “breast” for example. It’s best to use gender neutral words such as “chest” or ask the preferred name that individual uses if you need to speak about these parts.

Additional resources:

This is not an all inclusive list and if you are passionate about serving this population well I would suggest contacting the many great organizations in the Portland area for more training. These include the Q Center, Basic Rights Oregon or TransActive. They would love to hear from you requesting more information about trainings that will improving your cultural aptitude.