Elaine S. DeMeyer, MSN, RN, AOCN, BMTCN
Unlike any other time in history, oncology nurses are at the forefront of unprecedented challenges of cancer health disparity. Oncology nurses will undoubtedly lead the path to achieve health equity in cancer care. There are numerous different aspects of disparities (race, gender, location, socioeconomic status) contributing to inequality, with this article focusing on gender diversity and how nurses can focus on gender inclusion. A place to start moving toward health equity across the cancer continuum for gender inclusion is using pronouns when you introduce yourself to a patient.
Introduce Yourself Using Your Pronouns
Using your pronouns incorporates gender-affirming language into your practice to support gender inclusion. Try this type of introduction:
“Hi, I’m Jessica, your infusion nurse. My pronouns are she/her. What about you?”
Yes, this introduction might be awkward at first. It will take practice before it becomes natural and part of your everyday language. If patients think it is strange or ask about it, tell them that you want to be sure you include patients’ personal preferences about their name and pronouns. Let them know you want to make all patients feel comfortable discussing gender with their care team.
Importance of Pronouns
Personal pronouns are words that we use to refer to others in the third person, such as the traditional pronouns she/her and he/him. However, do not assume patients’ pronouns based on their appearance or sex assigned at birth—their bodies may or may not match their gender. Asking for patients’ preferred pronouns is an easy way to learn their gender identity.
Gender and sexual orientation are deeply personal to everyone, so the best thing to do is to ask the person. Using an open-ended question like “What about you?” or “How my I address you?” leaves room for the patients to answer using their preferences. When you ask, “Do you use she/her?” it limits flexibility in their answer and may make them feel uncomfortable. Also, when you use the correct pronouns, your patients know that you see them, accept them, and respect them.
Today’s Changing Norms
Different pronouns outside the traditional simple binary system of feminine (she/her) or masculine (he/him) pronouns is not new, but health equity initiatives are moving to a more inclusive array that captures gender identities outside of the binary. Below is a list of the more common pronouns (not an exhaustive list):
Pronouns Do Not Tell the Whole Story
Although using the correct pronouns is essential to respecting patients, pronouns may not tell you their gender identity. For example, a patient may be nonbinary and use “he/him” or “they/them.” Therefore, sharing your own pronouns helps initiate conversations to get to know your patients better.
Your patients may use different pronouns on different days, with other people, and in different circumstances. For example, parents may refer to the patient as he/him, but the patient’s friends may use they/them. Some parents or family members may continue to misgender their child, either purposefully or force of habit. Privately ask your patient a follow-up question, “Do you want me to use a different set of pronouns with any members of your support team?” Listen to how the patient refers to themselves or how different people on their support team use pronouns for the patient.
Just because you disclose your pronouns when you introduce yourself, does not mean that your patients will disclose theirs. However, using your own pronouns signals that you understand that a person’s pronouns may not align with their outward appearance, and that you are willing to use the pronouns they prefer. In addition, using someone’s correct pronouns helps build a trusting, therapeutic relationship critical to a partnership through the cancer journey. Every oncology nurse can work toward a more inclusive world and healthcare system by supporting gender diversity among cancer survivors, and you can do this by simply starting with your patient introduction.