How to Use Inclusive Language in Healthcare

How to Use Inclusive Language in Healthcare

For individuals who identify as lesbian, gay, bisexual, transgender or gender-fluid, going to a healthcare appointment can be a daunting experience. At clinical practices that do not prioritize inclusive care, their experiences might be invalidated many times over—by the intake forms by health history questions and by the staff’s failure to use gender neutral pronouns. 

Exclusive language in particular can be deeply painful and violating for people in this community, as it erases their experiences. To avoid further harm, some may choose to avoid healthcare altogether.

But inclusive language can be a powerful tool in validating someone’s lived experience and potentially improving their health outcomes, says Kodiak Soled, RN, MSN.


“The small shift in language really doesn’t cost us anything. And yet, it will earn healthcare providers so much currency in patient trust, which translates to better outcomes.”

— Kodiak Soled, RN, MSN


“If you start by introducing yourself as my healthcare professional with your pronouns and ask me questions with inclusive language that allow me to see my family structure or body parts in your question, I may automatically start to unclench,” she said. 

Research suggests that actively practicing inclusive care can help. For example, a Social Work in Health Care study indicates that care from a trans-affirming provider is associated with decreased rates of depression and suicidality for transgender and gender-variant individuals. 

Using inclusive language is just one part of creating a respectful environment for patients who identify as LGBTQ, but it can be a place for providers to start. 

“The small shift in language really doesn’t cost us anything,” said Soled. “And yet, it will earn healthcare providers so much currency in patient trust, which translates to better outcomes.” 

How to Use This Inclusive Language Guide

While this guide can help build a common vocabulary, providers should always allow patients to describe themselves and should follow the patient’s terminology. Some of the following terms have definitions that overlap but are presented here because they may be preferred by various individuals. By being familiar with all of the possible options, providers can create the safest, most respectful environment for their patients. 


Explore inclusive language examples for healthcare below. 


Gender and Sexual Orientation

Assigned Sex at Birth: The sex (male or female) assigned to a newborn based on their anatomy. May be referred to as birth sex, natal sex, biological sex or sex. Use assigned female and assigned male instead of biological female and biological male.

Cisgender: A person whose gender identity is the same as their assigned sex at birth. Use instead of normal, real or not trans. 

Gay, Lesbian and Queer: Commonly used words to describe an individual’s sexual orientation. 

Gender Diverse: An umbrella term describing an “ever-evolving array of labels” that individuals may use when their gender identity, expression or perception does not conform to society’s expectations.

Specific Gender Identity Terms 

Genderqueer: Refers to an individual whose gender identity falls outside the traditional gender binary. Other terms to describe this identity include gender variant, gender expansive, agender and gender creative.

Gender Minority: Describes individuals whose gender identity or gender expression differs from their assigned sex at birth. For some, this term may be preferable to gender nonconforming or others. 

Gender Nonconforming: Describes an individual whose gender expression differs from society’s expectations for males and females. 

Hijra: Term used in South Asia, particularly India, to describe trans women. Many hijras live together in communities. 

Nonbinary: Describes individuals who do not identify as a man or woman.  

Third Gender: Category of individuals who choose to identify as neither of the two traditional genders, both or a combination of the two.

Transgender (abbrev. trans): Describes an individual whose gender identity differs from their assigned sex at birth, usually used when gender diverse traits are “persistent, consistent and insistent” over time. It is also used as a categorical term for gender identities other than male and female.

Two-Spirit: Refers to the historical and current First Nations people whose individual spirits blend female and male spirits. Used by Native American LGBTQ communities as an alternative term to gay, lesbian or transgender that honors their heritage. 

Gender Dysphoria: Psychological distress that individuals whose gender identity differs from their assigned sex may experience. It can result in significant difficulty functioning in social, occupational and other settings. To learn more, visit the Mayo Clinic’s page on gender dysphoria.

Gender Expression: How an individual appears, dresses, speaks and behaves (e.g., a feminine gender expression). 

Gender Identity: An individual’s personal sense of being a man, woman, both, neither or another gender.

Intersex: An umbrella term for the variety of physical conditions in which the sexual or reproductive anatomy an individual is born with is not exclusively male or female. Often, anatomy for both or either sexes appears later in physical development of the individual. 

LGBTQ: Acronym referring to the lesbian, gay, bisexual, transgender and queer communities, as well as those who are questioning.

QPOC/QTPOC: Refers to queer people of color and queer and transgender people of color, respectively.

Queer: An umbrella term sometimes used to describe individuals who consider their gender identity or sexual orientation as outside of societal norms.

Sexual Minority: Describes individuals who identify as gay, lesbian or bisexual or those who are attracted to or have sexual contact with people of the same gender. 

Sexual Orientation: How a person describes their sexual or emotional attachment to others. Recommended instead of “sexual preference” or “lifestyle.”

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Sexual Health

Asexual: Describes an individual who does not experience sexual attraction or does not wish to act upon attraction to others in a sexual way. 

Bisexual: A sexual orientation describing someone who is emotionally and sexually attracted to individuals of their own gender and other genders. 

Gay: A sexual orientation describing someone who is emotionally and sexually attracted to individuals of their own gender. It is more commonly used to describe men.  

Lesbian: A sexual orientation describing a woman who is emotionally and sexually attracted to other women.

Men Who Have Sex With Men (MSM), Women Who Have Sex With Women (WSW): Terms used by some health professionals that focus on individuals’ sexual behaviors, rather than their orientation. Includes those who identify as straight or heterosexual.   

Romantic Orientation: Describes an individual’s pattern of romantic attraction based on gender, regardless of sexual orientation. Examples include biromantic, aromantic and heteroromantic.

Straight or Heterosexual: Describes a woman who is emotionally and sexually attracted to men or a man who is emotionally and sexually attracted to women.

Types of Romantic and Sexual Orientations 

Someone who experiences the following orientation would experience romantic or sexual attraction in the particular way described:

Aceflux/aroflux: At a capacity that that changes over time

Akioromantic/akiosexual: Do not desire those feelings to be returned

Aromantic/asexual: To no person of any gender

Biromantic/bisexual: To males and females

Demiromantic/demisexual: Only after a close emotional bond has formed

Grayromantic/graysexual: Rarely or at very low intensity

Heteroromantic/heterosexual: To person(s) of different genders

Homoromantic/homosexual: To person(s) of the same gender 

Panromantic/pansexual: To person(s) of every gender

Polyromantic/polysexual: To person(s) of multiple but not all genders

Reciproromantic/reciprosexual: Only after the other person(s) is attracted to them first

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Reproductive Health

Generally, avoid using terms that assume a pregnant person is female and married, or even partnered. Also remember there are many ways that individuals refer to people in their family structures. 

“Asking open questions and not making assumptions is always the best way to move forward,” said Soled.

Exclusive Language

  • Breastfeeding
  • Grandfather, Grandmother
  • Father, Husband, Male Partner
  • Maternal
  • Mother, Mama
  • Motherhood/Fatherhood
  • Niece, Nephew
  • Pregnant Women
  • Postpartum Woman
  • Sister, Brother

Inclusive Language

  • Chestfeeding, Nursing, Lactation
  • Grandparents
  • Non-Pregnant, Non-Gestational Parent, Family Member, Support Person
  • Perinatal
  • Birthing Person, Laboring Person, Gestational Parent
  • Parenthood
  • Niblings
  • Pregnant People
  • Postpartum Parent
  • Siblings

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Best Practices for Communication

The National LGBT Health Center advises providers to use intentionally inclusive language when taking patients’ histories. Intake forms should also be updated accordingly, and providers should refer to them regularly. This can help lessen the burden on patients to constantly reaffirm their experiences. 

Exclusive Language

  • Female or Male
  • Mother or Father
  • Husband or Wife
  • Marital Status
  • Living Arrangement
  • “What is your sex/gender?”
  • “Do you have a boy/girlfriend or wife/husband?”

Inclusive Language

  • Female, Male, Not Applicable
  • Parent or Guardian
  • Spouse or Partner
  • Relationship Status (e.g., single, married, partnered, widowed, separated, and divorced)
  • “With whom do you live?”
  • “What is your current gender identity?” “What sex were you assigned at birth?” “What are your pronouns?”
  • “Are you in a relationship? If so, can you describe the nature of the relationship?

Framing all interactions in the health setting with inclusive language is a starting point for improving patients’ experiences. The following phrases suggested by the National LGBT Health Education Center can help:

  • “How may I help you today?” (instead of tacking on sir, ma’am)
  • “What pronouns do you use?”
  • “What is your preferred name?”
  • “We ask all of our patients these questions because they are important for healthcare. However, you do not need to answer. If you would like to discuss this more, I would welcome your questions.”
  • “I’m sorry. I didn’t mean to be disrespectful. What terms are you comfortable with?” 

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Educational Resources About Providing Inclusive Care

Organizations

Webinars and Trainings

Publications

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Sources for Gender, Sexual Orientation and Sexual Health

Sources for Reproductive Health

Sources for Best Practices for Communication