Pronouns Are the First Step in Unconditionally Affirming Care for TGNC Patients

October 19 is International Pronouns Day, a day that seeks to make respecting, sharing and educating about personal pronouns commonplace. At Evergreen we know that using personal pronouns respectfully is an important first step in providing unconditionally affirming health care for our trans and gender expansive community.

Transgender and gender expansive folks have been historically underserved by the health care system, causing them to face worse health and wellness outcomes overall than cisgender folks do. Evergreen’s mission is to foster healthy communities by providing unconditional health care and supportive services, especially for people who have been historically underserved in health care like transgender folks. We’ve put a lot of work into not just talking the talk, but walking the walk to make sure that our trans and gender expansive community members both get the health care and services they need and feel unconditionally affirmed, welcomed, and respected while doing so.

When a transgender or gender non-conforming (TGNC) person seeks help with their health and well-being, they often have a lot to consider that most cisgender people likely take for granted. Trans folks might ask themselves before a doctor’s visit: when I get called back to my appointment, will the nurse say the right name and pronouns? Will anyone discriminate against or judge me? Will my provider be aware of my specific health needs as a trans person? Will I be able to access the gender-affirming medical care, mental health care, and supportive services I need?

Unconditional Care for TGNC Patients

For many TGNC folks, walking into a new space and having people use their pronouns respectfully is a small but important signal that they’ll be treated with respect during their visit.  Evergreen works to create this safe space as soon as a person of trans experience walks through our doors by making sure our staff is educated, trained and empowered to use pronouns and gendered language respectfully.

One key tool we use is our patient intake form. When a new patient arrives at Evergreen, they fill out a gender-affirming intake form with their preferred name and pronouns. This name and pronouns get used everywhere from the patient’s charts to the name on their medication refills.

Using our patients’ pronouns correctly is the very first step we take at Evergreen to make sure our trans and gender expansive patients feel unconditionally respected when they walk in the door. We don’t stop there, though. Evergreen is committed to serving the health and wellness of our TGNC community, so we provide many medical and mental health services and supportive services designed specifically for trans folks, including:

• Legal name and gender marker change assistance
• Hormone replacement therapy
• Linkage to gender-affirming surgeries
• Walk-in and by-appointment sexual health testing for STIs, HIV and hepatitis C
• Medical case management
• Gender-affirming mental health care
• Support groups specifically for the TGNC community
• Access to PrEP, a daily pill or bi-monthly injection for HIV prevention
• Sensitive gynecologic/pelvic care
• Clean syringes and injection works

Gender-Affirming Legal Services at Evergreen

Although we wish that every institution that TGNC folks interact with used gender-affirming intake forms, most places just aren’t there yet. TGNC folks often face hardships around being misgendered and called the wrong name in situations where they have to use legal documents showing a different name and gender marker than they present with. Going to the bank, signing a lease, or using their ID at the bar can be situations where trans folks are met with judgment, refusal of service, or even violence.

One way Evergreen addresses these hardships that disproportionately affect the TGNC community is by partnering with Neighborhood Legal Services (NLS) to offer free to low cost legal name and gender marker change services. These services help trans and gender expansive folks change their legal documents to accurately reflect their name and gender.

We sat down with Evergreen’s Supportive Services Coordinator Chris DeVoe, who uses they/them and she/her pronouns, to talk about the free legal name and gender marker services available through Evergreen’s partnership with NLS.

Anyone who receives services at Evergreen, from primary care to food pantry services, is eligible for free to low cost name and gender marker change legal services. The funding that allows these services to be free or low cost is provided by medical-legal grants, because as Chris puts it: “it shouldn’t cost thousands of dollars for you to change something that’s yours.”

Chris works with Evergreen providers to reach out to TGNC patients and refer those who are interested to NLS for legal name and gender marker change services. They put several referrals through each week.

“You call them by their name and it’s a total relaxation of: this person recognizes and respects and sees me for who I am.”

When Chris refers a patient to NLS for legal services, she makes sure that everyone involved with the process knows the correct name and pronouns for that patient.  Chris says that making sure a person’s correct pronouns are used seamlessly throughout the process is an important part of giving unconditionally affirming care for TGNC patients. “When I refer to them as their preferred pronouns and their preferred names at all times, they look like little tiny rays of sunshine because for the first time in their lives probably, someone actually paid attention.”

Some patients have the documents needed to complete their legal name or gender change readily on hand. Others don’t have access to everything they need, often due to family and housing hardships. Evergreen and NLS meet patients where they are, and will advocate for the patient and track down any documents needed to get them the care they need.

Chris knows that the work they do changes lives. She says that having a legal name and gender marker that reflects how you live in the world makes day-to-day life easier and more peaceful for TGNC people. Empowering TGNC people to use their ID in everyday situations without discomfort or fear is part of “making sure that the person feels like a whole person and is valid and is supposed to be here, that they are not an anomaly.”

Regardless of where a TGNC person is in their journey with their name and pronouns, and whether they choose to legally change them or not, using a person’s name and pronouns respectfully can make a world of difference. Chris says, “you call them by their name and it’s a total relaxation of: this person recognizes and respects and sees me for who I am.”