Blog by Matt Ellison (public speaker)
You may be surprised as to how much benefit you as a pharmacist can bring to the psychological and emotional well-being of trans people. One simple way is by knowing the correct name and pronouns to use. This can enable you to make the difference between a traumatic experience and a truly uplifting one.
As a child I developed several coping mechanisms to deal with the many difficult situations that came up for me. One of these was around being gendered female. I would reason with myself. For example, I remember one occasion, I was thirsty and wanted to buy a can of coke. I told myself “It doesn’t matter right now if I’m male or female, or whether the shop assistant calls me Sir, Madam, he or she. They’re only words and they make no difference to my ability to buy a can of coke and quench my thirst.”
These thoughts helped me cope! But in reality this is far from how it works. Those words may seem small and unimportant, but to a trans person they have a far more impactful and significant meaning than most people could ever contemplate. Psychologically there’s a vast burden of triggers attached to those words. Imagine how you feel when you’re having a bad day; it doesn’t take much for other things to also get on top of you. And for a trans person, every time an incorrect pronoun or name is used it’s a stabbing reminder of the many things that just aren’t right for them in life. It has the potential to bring up any of the hundreds of negative feelings often experienced around living in the wrong identity. This can trigger or enhance feelings of dysphoria or depression, particularly if they’re having a bad day already. And if they experience self-harm or suicidal tendencies it can enhance these too.
Passing & Outing
So as you can see being gendered correctly is important; ‘Passing’ and ‘outing’ are big issues for many or most trans people. Passing means being taken for one’s acquired gender. Outing means having one’s birth gender revealed in some public way. Remember that trans people have a legal right not to be outed.
Hormones, of course, play a huge role in successful gender transition, particularly when it comes to passing. Estrogen and testosterone produce the secondary sex characteristics that naturally occur at puberty. This can include fat redistribution and body shape, growth of breasts, facial hair, and a change in muscle mass and a breaking voice. To many trans people, it’s these changes that are the essence of transition. And these hormones need to be taken life long. So it’s inevitable that contact between trans patients and pharmacists will occur regularly.
In the pharmacy
At least initially, you may meet a trans person collecting their prescription with a name and gender marker that doesn’t match their outward appearance. These can be nerve-wracking experiences for a trans person. In their day-to-day life they may be frequently misgendered and/or outed, not only by their appearance but sometimes also because the people they’re interacting with say the wrong things – often unknowingly, but unfortunately sometimes intentionally too. This may be in a chemist, shop, or waiting area, full of strangers who can overhear.
Even if the trans person fully passes in their acquired gender, it often happens that they’re misgendered and/or outed in front of others, simply because the person dealing with them is untrained or has no experience of the difficulties transgender people face. And telephone conversations may be upsetting, if the trans person needs to identify themselves as the person on the prescription or account and their voice doesn’t seem to match.
While in transition, trans people may be more sensitive and vulnerable. Although suicide and self-harm rates are reported to be high within the trans community, it’s been shown these rates fall back into the range for the general population after successful transition. And, aside from medical intervention, what really helps to make transition successful is how the trans person is perceived and treated by those around them.
So what can you do?
As we’ve seen, names and pronouns matter a lot. Always try to use the name and, importantly, the pronouns (like she, he, her, him, or them and they for gender neutral) for the gender on the patient’s records. If in any doubt, discreetly ask the patient how they’d like to be addressed. If they ask to be called something specific (it may be different from what’s on their records), then go with that. It can do so much good to remember the delicate situation of the trans person and make that extra effort to be sensitive and tactful.
It’s inevitable that mistakes happen, but if this does occur, the best way to respond is to simply correct yourself and continue without making a fuss. By over-apologising it only makes it a bigger deal, with more people overhearing, and generally makes things worse.
And imagine how amazing it feels to be gendered correctly!
Just as being outed or misgendered can trigger very negative emotions, so each small experience of passing and being gendered correctly can have the very opposite effect. It can trigger very positive emotions, especially if early on in transition.
I remember clearly an occasion early in my transition. Standing in a queue, I could hear the shop assistant saying “Sir” or “Madam” to each person he served. I excitedly realised this was a great opportunity to test whether I passed yet. As my turn to be served came I boldly walked to the counter and expectantly waited to hear how he would gender me.
On this occasion he was clearly not sure as he didn’t gender me at all, with no use of either sir or madam. Which I guess was better than being gendered female, and was certainly a step in the right direction. But imagine my delight the very first time someone did call me sir, or used my new name Matt.
Having had some quite negative experiences with healthcare professionals along my journey, it would have made a huge difference to me for a pharmacist to be aware of the difficulties that we as trans people face. To have an encounter handled sensitively and correctly not only validates me as a human being, it also creates positive feelings, it shows this is a person who understands and is knowledgeable, but ultimately and most importantly, shows me this is someone I can trust. You really can make a huge difference!
To find out more about Matt’s work or to book him for a talk go to:
For more blogs from Matt: www.mattellison.co.uk/blog