To illustrate the daily erasure trans folx face in a world privileging cisgender norms, I offer my experience at the supposedly trans-positive Compass Community Clinic.
Trans people are notoriously underserviced in healthcare care, with known disparities in trans and gender minorities’ ability to access healthcare (Scheim et al., 2017). Perceived discrimination in healthcare settings contributes to healthcare avoidance and poor physical and mental health outcomes ( AMA J Ethics, 2022).
It’s all well and good to signal you are trans-inclusive, but if you don’t do the work of training cis-privileged staff, they will resort to the norms and biases which erase trans people and reinforce transphobia.
For gender minorities like me, the simple act of booking an appointment is a potential occasion of mental health damage. It feels like an act of courage each time I call for care and face possible transphobic microaggressions.
But I did it…I called and asked Belinda, the receptionist, to book an appointment, and they asked me to spell my last name. (Belinda, do you notice I use gender neutral terms since I don’t know your pronouns…it’s almost like when you don’t use gender you can’t misgender someone, can you?).
Belinda looked up my last name and asked, “Is this Maria?” I asked did I sound like someone named Maria? I said I didn’t appreciate them assuming a female name and misgendering me, especially since Compass was supposed to be a trans-inclusive clinic. Belinda apologized and said they called me Maria me because I sounded “far away.” So it wasn’t Belinda’s cisgender bias; it was a problem on my end that caused the misgendering.
First, I am not sure why Belinda thinks it is okay to read out names to strangers on the phone. Now I know someone named Maria who shares my last name is a client at Compass. Perhaps next time I ought to call and use my Maria like tones to obtain her personal info…
Other people’s confidential personal information aside, let’s get to Belinda’s othering of me…It is common practice for cisgender-biased persons to deny the harm of misgendering by employing false truth claims (like I was far away and all trans men sound like women far away, right?). Belinda’s shifting the burden to me enables them to deny confronting their bias and the harm they just did to a patient. When cis-norming people are faced with gender-based stress, such as Belinda misgendering me, they employ defensive behaviours like making false claims in an attempt to return to gender-privileged comfort. Oaster calls this cisgender fragility (2019) and defines it as “a desperation for status quo where the dominant group member no longer must even think about the target group, a return to the naiveté of privilege.”
I mean, really, I left the phone call in discomfort with the invalidation of my gender identity and also the invalidation of my lived experience being misgendered. I do not for one second believe Belinda misgendered me because I sounded “far away”. It was because she detected something feminine in my voice, and she gender-policed me into the binary. I was seeking health care, and I got a mental health crisis from my provider, harm, not good. It is not just my lived experience, but research that shows misgendering negatively affects the mental and physical health of gender minorities and impacts their future engagement with health care (Dolan et al., 2020).
I know this will impact me because I am now afraid to go into my clinic and be misgendered some more. I hope in writing this blog, healthcare providers will seriously address these harmful deficits in their care delivery and solve the problem like misgendering.
References
AMA J Ethics. 2022;24(8):E753-761. doi: 10.1001/amajethics.2022.753.
Dolan IJ, Strauss P, Winter S, Lin A. Misgendering and experiences of stigma in health care settings for transgender people. Med J Aust. 2020;212(4):150-151.e1. doi:10.5694/mja2.50497
Oaster, Zachariah Graydon, “Cisgender Fragility” (2019). Master’s Theses. 4729. https://scholarworks.wmich.edu/masters_theses/4729
Scheim AI, Zong X, Giblon R, Bauer GR. Disparities in access to family physicians among transgender people in Ontario, Canada. International Journal of Transgenderism 2017; 18(3):343-352. doi: 10.1080/15532739.2017.1323069.