Past societal norms and formal education taught us that pronoun usage had rules based on a binary male/female and singular/plural framework. However, this framework often leads to misgendering people whose identity is nonbinary, including members of the transgender, genderqueer and gender nonconforming communities. Modern society now calls for updating the previously taught and accepted grammatical framework to be considerate of the intersections between gender, race, class and other complex layers of identity.
Christopher Lewis, MD, pediatric endocrinologist and medical director of the Washington University and St. Louis Children’s Transgender Center, joins the show to discuss the origins of gender-neutral pronouns, what they mean and how to use them.
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Gender-Neutral Pronouns: What They Mean and How to Use Them
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Learn more about Christopher Lewis, MD
Christopher Lewis, MD
Christopher Lewis, MD is a Washington University pediatric endocrinologist and director of the Transgender Center at St. Louis Children's Hospital.Learn more about Christopher Lewis, MD
Transcription:
Melanie Cole, MS (Host): Welcome. Today we’re talking about gender neutral pronouns. What they mean and how to use them. This is Radio Rounds with St. Louis Children’s Hospital. I'm Melanie Cole. Joining me is Dr. Christopher Lewis. He’s a Washington University pediatric endocrinologist and the co-director of the transgender center at St. Louis Children’s Hospital. Dr. Lewis, it’s a pleasure to have you join us again. Tell us a little bit about the origins of gender neutral pronouns. When did that begin and what are we seeing in the trends now?
Christopher Lewis MD (Guest): So the first documented use of the word ‘they’ used in the singular sense actually dates back to the 1300s in a story about a werewolf. In the 18th century is when grammarians began saying that the singular ‘they’ was an error because plural pronouns can't take a singular antecedent. However when we’re thinking about other pronounces, the word ‘you’ that we typically use nowadays in a singular fashion is actually a plural form. If we were to be truly correct in how things were done in the past we would be using words like ‘thou’ ‘thee’ in order to express a singular you. In the past, ‘you’ was a plural form of talking about others. Prior to the 17th century it was only used as a plural pronoun. Since then it has now been more accepted as a singular pronoun. When we’re thinking about ‘they’ has been used as a singular pronoun for centuries. People use the term ‘they’ frequently singularity without even realizing it. When someone calls someone on the phone and someone says, “Oh, someone’s on the phone to speak to you?” You may respond with, “Well, what do they want?” Frequently we’re not thinking about how we use singular ‘they’ in our everyday language without using it. It’s only when we know the gender or think we know the gender of someone that we then feel like we have to use the gendered pronouns of he or she.
Host: That is really interesting. Thank you for telling us how this has evolved. So if this framework often leads to misgendering people whose identity is nonbinary including members of the transgender, genderqueer, gender nonconforming communities, what would you like us to know and what would you like other providers to know and pediatricians to know about how these pronouns should be used and how it shows respect for the person that they are talking to?
Dr. Lewis: So I think you highlighted it right there. That using someone’s preferred name as well as the pronouns that they’ve asked others to use is respectful and shows them that you recognize their dignity and autonomy to go by the name of their pronouns that they have requested. I understand that people have difficulties with using variety of pronouns. There are other pronouns that exist besides he, she. And they. Even within our transgender clinic, people do make mistakes. I think that is probably one of the biggest fears that people have in related to pronouns is the fear of saying the wrong thing, using the wrong term, or accidently offending someone else. I don’t think that most of the difficulty and concern that comes from using gender neutral terminology derives from intention to be rude of malicious intent. I think it mostly stems from uncomfortabiltiy and fear of not knowing what to do or how to say things. If you do make a mistake, the best thing is just to acknowledge it, recognize it, and move on, and to practice using terms and words that aren’t gendered.
One of the things that I do in order to obtain the information from people related to pronouns and names is I may introduce myself is, “Hi, I'm Dr. Chris Lewis. I use he/him/his pronouns.” It is something that I do in interactions with patients. I do it in lectures and presentations that I'm giving. It’s also in my signature line in emails. So that when I introduce myself to others they know the pronouns that I use and am able to refer to me as such.
Host: What an amazing thing to do and what a great tip for other providers. So do you recommend Dr. Lewis that other providers not only take that lead from you but ask the question whether the person is meeting with a therapist for the first time or their pediatrician to get their normal well visit. Do you recommend that these other providers ask? Then they can help the parents educate other people around this youth to help them all understand together?
Dr. Lewis: Well, I think one of the things that needs to come into play is normalization of talking about gender and gender identity. The best way to do that is to obtain that information and then talk about it when it’s relevant. Part of our intake forms with pediatric endocrinology at large, not just with our transgender clinic, is to solicit information related to what’s called SOGI data—sexual orientation and gender identity. It is on our intake forms and we’re able to review that prior to entering with a patient. Based off of that information, we can have discussions. If we normalize that sort of data gathering then it gives the providers an ability to recognize it and to utilize it. So I think it is something that pediatrician offices should be gaining information of just so they can take care of their patients the best way that they can. When patients show up to a provider with concerns related to health or mental health support, knowing that information can ultimately result in better quality care.
Host: Well, that’s certainly true. Tell us a little bit about resources that St. Louis Children’s Hospital can provide to referring physicians to help initiate these discussions because referring providers also want to initiate this discussion with the parents and with the youth. You can guide them and tell them how to do that. Tell us a little bit about the center.
Dr. Lewis: So the center has a plethora of resources that we can provide access to. We have education lesions that go out to predominately schools but can other communities to provide information and guidance on how to provide counseling and education not only to their staff and colleagues but also to their patients as well. We can have lectures and presentations that either me or other providers and staff within our clinic go and give educational sessions to our colleagues. There's also a lot of resources at the family education center with St. Louis Children’s Hospital. So if they're wanting to get linked up to those sources as well as a plethora of online resources they can easily just get in contact with us via our transgender clinic number or email.
Host: As we conclude Dr. Lewis, do you have any final thoughts for other providers on what you would like them to know about gender neutral pronouns and helping their patients the best way that they can and when you feel it’s important that they refer?
Dr. Lewis: Well, I think that they can refer at any time because we do provide a lot of services beyond just medical, hormonal, and surgical education and access. So if there’s ever any sort of concern related to legal, social, medical, or mental health concerns, they can definitely reach out to us and we’ll be able to assist them. In terms of things that I think a pediatrician should do, I think they should not make assumptions and allow people to come to them with their concerns and meet them where they're at. Do not place your own personal ideologies in front of the patient’s care. Allow them to feel that they're receiving care in an open and welcome setting so that they are able to have that dialogue with their provide that ultimately is trying to take the best care of them.
Host: It’s great information. Thank you for all the great work that you're doing Dr. Lewis. What an amazing center. To learn more about the center for families at St. Louis Children’s Hospital, please call 314-454-2350. Or to consult with a specialist at St. Louis Children’s Hospital you can also call the children’s direct physician access line at 1-800-678-HELP. You can also visit the website at stlouischildrens.org. That’s a lot of ways to get in touch with St. Louis Children’s Hospital if you have questions and you are a referring provider. This has been Radio Rounds with St. Louis Children’s Hospital. Please remember to subscribe, rate, and review this podcast and all the other St. Louis Children’s Hospital’s podcasts. For more health tips and updates on the latest medical advancements and breakthroughs, follow us on your social channels. I'm Melanie Cole.
Melanie Cole, MS (Host): Welcome. Today we’re talking about gender neutral pronouns. What they mean and how to use them. This is Radio Rounds with St. Louis Children’s Hospital. I'm Melanie Cole. Joining me is Dr. Christopher Lewis. He’s a Washington University pediatric endocrinologist and the co-director of the transgender center at St. Louis Children’s Hospital. Dr. Lewis, it’s a pleasure to have you join us again. Tell us a little bit about the origins of gender neutral pronouns. When did that begin and what are we seeing in the trends now?
Christopher Lewis MD (Guest): So the first documented use of the word ‘they’ used in the singular sense actually dates back to the 1300s in a story about a werewolf. In the 18th century is when grammarians began saying that the singular ‘they’ was an error because plural pronouns can't take a singular antecedent. However when we’re thinking about other pronounces, the word ‘you’ that we typically use nowadays in a singular fashion is actually a plural form. If we were to be truly correct in how things were done in the past we would be using words like ‘thou’ ‘thee’ in order to express a singular you. In the past, ‘you’ was a plural form of talking about others. Prior to the 17th century it was only used as a plural pronoun. Since then it has now been more accepted as a singular pronoun. When we’re thinking about ‘they’ has been used as a singular pronoun for centuries. People use the term ‘they’ frequently singularity without even realizing it. When someone calls someone on the phone and someone says, “Oh, someone’s on the phone to speak to you?” You may respond with, “Well, what do they want?” Frequently we’re not thinking about how we use singular ‘they’ in our everyday language without using it. It’s only when we know the gender or think we know the gender of someone that we then feel like we have to use the gendered pronouns of he or she.
Host: That is really interesting. Thank you for telling us how this has evolved. So if this framework often leads to misgendering people whose identity is nonbinary including members of the transgender, genderqueer, gender nonconforming communities, what would you like us to know and what would you like other providers to know and pediatricians to know about how these pronouns should be used and how it shows respect for the person that they are talking to?
Dr. Lewis: So I think you highlighted it right there. That using someone’s preferred name as well as the pronouns that they’ve asked others to use is respectful and shows them that you recognize their dignity and autonomy to go by the name of their pronouns that they have requested. I understand that people have difficulties with using variety of pronouns. There are other pronouns that exist besides he, she. And they. Even within our transgender clinic, people do make mistakes. I think that is probably one of the biggest fears that people have in related to pronouns is the fear of saying the wrong thing, using the wrong term, or accidently offending someone else. I don’t think that most of the difficulty and concern that comes from using gender neutral terminology derives from intention to be rude of malicious intent. I think it mostly stems from uncomfortabiltiy and fear of not knowing what to do or how to say things. If you do make a mistake, the best thing is just to acknowledge it, recognize it, and move on, and to practice using terms and words that aren’t gendered.
One of the things that I do in order to obtain the information from people related to pronouns and names is I may introduce myself is, “Hi, I'm Dr. Chris Lewis. I use he/him/his pronouns.” It is something that I do in interactions with patients. I do it in lectures and presentations that I'm giving. It’s also in my signature line in emails. So that when I introduce myself to others they know the pronouns that I use and am able to refer to me as such.
Host: What an amazing thing to do and what a great tip for other providers. So do you recommend Dr. Lewis that other providers not only take that lead from you but ask the question whether the person is meeting with a therapist for the first time or their pediatrician to get their normal well visit. Do you recommend that these other providers ask? Then they can help the parents educate other people around this youth to help them all understand together?
Dr. Lewis: Well, I think one of the things that needs to come into play is normalization of talking about gender and gender identity. The best way to do that is to obtain that information and then talk about it when it’s relevant. Part of our intake forms with pediatric endocrinology at large, not just with our transgender clinic, is to solicit information related to what’s called SOGI data—sexual orientation and gender identity. It is on our intake forms and we’re able to review that prior to entering with a patient. Based off of that information, we can have discussions. If we normalize that sort of data gathering then it gives the providers an ability to recognize it and to utilize it. So I think it is something that pediatrician offices should be gaining information of just so they can take care of their patients the best way that they can. When patients show up to a provider with concerns related to health or mental health support, knowing that information can ultimately result in better quality care.
Host: Well, that’s certainly true. Tell us a little bit about resources that St. Louis Children’s Hospital can provide to referring physicians to help initiate these discussions because referring providers also want to initiate this discussion with the parents and with the youth. You can guide them and tell them how to do that. Tell us a little bit about the center.
Dr. Lewis: So the center has a plethora of resources that we can provide access to. We have education lesions that go out to predominately schools but can other communities to provide information and guidance on how to provide counseling and education not only to their staff and colleagues but also to their patients as well. We can have lectures and presentations that either me or other providers and staff within our clinic go and give educational sessions to our colleagues. There's also a lot of resources at the family education center with St. Louis Children’s Hospital. So if they're wanting to get linked up to those sources as well as a plethora of online resources they can easily just get in contact with us via our transgender clinic number or email.
Host: As we conclude Dr. Lewis, do you have any final thoughts for other providers on what you would like them to know about gender neutral pronouns and helping their patients the best way that they can and when you feel it’s important that they refer?
Dr. Lewis: Well, I think that they can refer at any time because we do provide a lot of services beyond just medical, hormonal, and surgical education and access. So if there’s ever any sort of concern related to legal, social, medical, or mental health concerns, they can definitely reach out to us and we’ll be able to assist them. In terms of things that I think a pediatrician should do, I think they should not make assumptions and allow people to come to them with their concerns and meet them where they're at. Do not place your own personal ideologies in front of the patient’s care. Allow them to feel that they're receiving care in an open and welcome setting so that they are able to have that dialogue with their provide that ultimately is trying to take the best care of them.
Host: It’s great information. Thank you for all the great work that you're doing Dr. Lewis. What an amazing center. To learn more about the center for families at St. Louis Children’s Hospital, please call 314-454-2350. Or to consult with a specialist at St. Louis Children’s Hospital you can also call the children’s direct physician access line at 1-800-678-HELP. You can also visit the website at stlouischildrens.org. That’s a lot of ways to get in touch with St. Louis Children’s Hospital if you have questions and you are a referring provider. This has been Radio Rounds with St. Louis Children’s Hospital. Please remember to subscribe, rate, and review this podcast and all the other St. Louis Children’s Hospital’s podcasts. For more health tips and updates on the latest medical advancements and breakthroughs, follow us on your social channels. I'm Melanie Cole.