Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

4 Tips for Using Neo and Gender-Neutral Pronouns


Becoming familiar and fluent with neo and gender-neutral pronouns takes practice. It is essential to providing affirming care for transgender, genderqueer, and non-binary patients.

Genderqueer and non-binary individuals aren’t a new phenomenon and neither are gender-neutral pronouns. Though the singular use of they/them has entered the dictionary only recently, it’s been used colloquially for many years. But they/them isn’t the only gender-neutral pronoun out there. A few other examples, considered neopronouns, include xe/xem and ze/hir (pronounced zee/zem and zee/here respectively).


Recent data shows that about one in five Americans know someone with gender-neutral (GN) pronouns, but only about half express comfort using these pronouns. Healthcare professionals aren’t exempt from experiencing discomfort with unfamiliar pronouns.




Using the wrong pronouns for someone is considered misgendering. Misgendering is referring to someone as a different gender than they are. Misgendering a genderqueer, transgender, or non-binary person is distressing for the individual and weakens the therapeutic doctor-patient relationship. It also can contribute to poorer physical and psychological outcomes for this population over the long-term.


It’s important for healthcare professionals to become familiar and comfortable using neo and gender-neutral (GN) pronouns. These five tips will help you avoid misgendering individuals and become fluent in using neo/GN pronouns.



4 tips for using neo and gender-neutral pronouns:


1. Ask, don’t assume.

Unless you’ve known someone for a long time, don’t assume pronouns based on how you perceive their gender. Avoid misgendering someone by asking what their pronouns are instead of assuming. Practice sharing your own pronouns to normalize the process.



2. Keep an open mind.

You may encounter patients using pronouns you’ve never heard of or in ways you’re not used to. Quickly integrate these pronouns as best you can. If needed, you could ask a short clarifying question such as, “I heard you use ‘ze/zir’ pronouns, can I make sure I’m using them correctly?” But be mindful not to probe for a more in-depth explanation as this could make your patient uncomfortable.



3. Practice.

Practice, practice, and then practice some more. Try telling a story using the neo/GN pronoun you just learned. Practice with the other members of your team. Warm up with a few sentences outside the presence of the patient right before seeing them. This will increase your fluency and decrease slip-ups.



3. Don’t use alternatives.

It’s easy to resort to more comfortable pronouns when the individual that uses neo/GN pronouns isn’t around. Try to avoid doing this. Just because the person can’t hear you, it’s important to continue to respect them and how they identify. Practice gently but firmly correcting others and be open to corrections yourself.



4. Look for places to normalize.

Many forms and systems, like intake forms, medical charts, and name tags, lack a space to share pronouns. Most are easy to fix. Look for opportunities in your own practice to include this important introductory information.