There is a nationwide push to recognize preferred pronouns chosen by transgender individuals. Although respecting a person's identity is part of reverent patient care, it is not sufficient to address the many challenges of helping trans patients in the perioperative setting.
First, we must recognize the trans community has a fraught relationship with the medical community. Most trans people have experienced some amount of discrimination, intentional or not, before, during, or after their transition. This can range from simple misgendering to dismissal of their trans nature as a phase or mental illness. One trans woman I interviewed was repeatedly asked if she was a sex worker, HIV positive, or drug addict – questions rarely directed to cisgender women of the same demographic. There is also the phenomenon of the “trans broken arm,” in which any medical finding is attributed to a patient's being trans while more commonplace causes are dismissed....
