I’m greeted with, “Good afternoon, ma’am. How can I help you?” as I walk into the office. “I’m here to see Judy,” I tell the receptionist as I question to myself exactly what about my appearance made her gender me with ma’am. “I have 3 o’clock appointment,” I continue, wondering if I should tell her I am not a ma’am and that my pronouns are they and them. I decide against it because I don’t want to give her a reason to not help me, even though her nametag says “Judy — she/her/hers.” I want to assume she’s trans-affirming, but I have been burned too many times by people who share their own pronouns, but don’t do anything when they hear someone misgender or mispronoun me.
“Fill out this paperwork,” Judy requests kindly. “Let me know if you have any questions.”
Everyone dreads the paperwork, both the clients who have to fill it out and the employees who have to enter it into the system. As a social worker, I’ve had clients wonder aloud, “Do I still use my mom as my emergency contact or should I start using my partner?” For some of us, we don’t even have the option to fill out the form with the truth.
From the honorific (Ms., Mrs., Mr., Dr.) to the inevitable sex/gender boxes, more often than not there is no choice or no space for me to answer the question honestly/accurately. I try to make excuses in my head (“Well, I bet their intake computer system doesn’t allow for write-ins” or “They probably have to ask this because funders require this specific wording.”). I’ve been on both sides of the coin. (By the way, Mx., pronounced “Mix,” is the gender-neutral honorific that I use.)
To improve the health care experience for nonbinary people, here are four things I have done as a trans-affirming member of the social work field and things I do/would appreciate as a nonbinary person:
Disclose issues as early as possible. This has always made me feel safer to enter a space rather than assuming I need to have my guard up. For example, when setting an appointment at a medical provider’s office, state: “We regret that our bathrooms are binary and gendered options because we rent and share this space. We apologize for the inconvenience and please let our staff know if you have any negative experiences in our space." You can also include information like this on your website and social media, or via an email confirmation.
Acknowledge that policies and accessibility issues are problematic. Sometimes we, as employees and service providers, don’t have the power to change paperwork, bathroom signs or computer systems, but we can verbally mention to clients that we are aware of the problem and that we are there to process any challenges they may have as a result. Sometimes we can also add descriptions on the paperwork that acknowledge the issue. For example: “Funders require you to choose between only two answers and we must mark one of the two in our computer system. We apologize for this inconvenience and are working to address the issue.” Be sure that you’re only using this language if you’re actually working to address the issue.
Host a trans 101 or trans-affirming training for your office. Ensure that all employees are on the same page. Service providers often offer opportunities for ongoing training for clinicians, case managers, etc., but don't include maintenance, receptionists and other staff who interact with clients. I facilitate trans-affirming trainings with Praxis Group, a Chicago-based consulting group that provides cultural humility trainings for teams and organizations. It has been humbling and very powerful to join teams and share best practices, legal protections and statistics — and then to witness them commit to the concrete changes they’ll make moving forward.
"Ask yourself what you can do to be more trans-affirming. Talk to your employer about what your office can do to be more trans-affirming."
Talk to leadership to change policies, paperwork, bathroom signs, computer systems, etc. that are not trans-affirming. Consider bringing in a professional, like Praxis Group, to help your workplace identify areas that they can improve to become more trans-affirming.
Some folks think of "trans-affirming" as an ominous and confusing concept, when in reality, it's quite simple. Many of us operate this way 24/7 without even thinking about it! A great first step if you’re interested in this work is to join the Andersonville Chamber of Commerce for Inclusive Hiring and Building Safe Spaces on Thursday, June 21. (Full transparency: I’m on the panel.)
Next steps? Ask yourself what you can do to be more trans-affirming. Talk to your employer about what your office can do to be more trans-affirming. Add your pronouns to your e-mail signature. Reach out to Praxis Group for a workshop or consultation. This list is infinite, as are genders.
Jes Scheinpflug, LSW, is a queer & nonbinary community organizer raised and based in Chicago. They received their BSW from Illinois State University in 2010 and their MSW from Loyola University Chicago in 2017. They are a community organizer and cofounder of Praxis Group. Their work focuses on anti-oppression education, cultivating trans-affirming communities and lifting up voices of people who are marginalized. You can follow Jes on Twitter @jshine1224.