Pronouns matter: How we can do better in LGBTQ patient care

In the wake of Pride Month, I have been reflecting on how our health care system impacts the lives of individuals with identities across the gender spectrum. Sometimes, when sending a prescription to a pharmacy for any given patient, we will get a phone call that the date of birth on file with insurance does not match the date of birth we have on file. Typically, this is a clerical error that is easy to fix. What is more jarring is when a patient we know identifies as female is on file with their insurance company as being male. That one letter on a chart — M instead of F — is a stark reminder of the many daily challenges faced by those who are trying to live as their affirmed gender rather than the gender they were assigned at birth.

The World Professional Association for Transgender Health (WPATH) has made recommendations that electronic medical record systems include fields for not only assigned sex at birth and legal name, but also affirmed gender pronouns used and what name a person goes by if not their legal name. The final rules issued by the Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare and Medicaid Services (CMS) in October 2015 require EMR software certified for meaningful use to include fields for gender identity and sexual orientation.

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