Dane Whicker, PhD, has advocated for members of the lesbian, gay, bisexual, transgender, queer, intersex (LGBTQI+) communities since the age of 14. So when we asked him for his EDI Spotlight interview how people at Duke could support LGBTQI+ (especially transgender) colleagues, loved ones, and patients at Duke, it’s not surprising that he had plenty to share.
In the spirit of celebrating Pride 365, Whicker offered the following tips for how you can make a difference for LGBTQI+ people at Duke on your own, within your unit or workplace, tips for inclusive one-on-one interactions, and navigating other situations. He also offers resources for people interested in further learning.
On Your Own
Consider introducing yourself and sharing your pronouns, even if they are “she/her/hers” or “he/him/his.” Doing so normalizes the process for everyone rather than imposing the responsibility for people with pronouns beyond the gender binary. If this is unfamiliar to you or you would like to learn more you can do that here: https://students.duke.edu/belonging/icr/csgd/pronouns/
Update your Duke email address to match your name: “Manage Email Settings” and click “edit” on your “Preferred Email Address” (https://idms-web-selfservice.oit.duke.edu/accounts)
Assess your language for gender bias and gendered language (e.g., “Ladies and gentlemen,” “both genders,” or “you guys”). When addressing groups of people, even if you perceive that they may all appear to have the same gender identity, it is best not to use gendered language. Examples of more inclusive greetings include “Good Evening, everyone” “Hello,” and even the Southern “y’all!”
Honorifics: Be careful about using “ma’am” and “sir” – do not make assumptions.
Once you learn someone’s pronouns, then you can use a congruent honorific:
- She/Her --> “Ma’am,” “Ms.”
- He/Him --> “Sir,” “Mr.”
- They/Them or other pronouns --> Use person’s name (e.g., “Sam”), “Mx.” (typically pronounced “Mix” in the US) - if the person indicates they use a nonbinary title.
Update your own name and pronoun settings, and choose where they appear using Duke’s Identity Management Self-service: See “Manage Name and Pronoun Settings” (https://idms-web-selfservice.oit.duke.edu/)
As an ally, think about adding positives as well as reducing negatives. For the past 10 years, research in this area has primarily focused on using a “minority stress” model, and how we can reduce the unique additional stigma and stress felt in the everyday lives of LGBTQI+ people. This model has been helpful, but is missing a key component: “social safety.”
- “Social safety” includes 3 components: inclusion, protection, and social connection.
- Efforts to improve the well-being of the LGBTQI+ community should find ways to build these values as well reducing stigma and stress.
- We are now shifting our focus from “excess stress” to include “a lack of social safety.”
Understand the current political environment. You can show your support of members of the LGBTQI+ community by understanding the added stressors trans/nonbinary people and their loved ones are facing right now due to an unprecedented number of sociopolitical attacks that have real-life consequences.
Over 650 anti-LGBTQI+ bills have been introduced in states across the country in 2023 alone. For reference:
- 2022: 315 anti-LGBTQI+ bills were introduced
- 2021: 268 anti-LGBTQI+ bills were introduced
- 2020: 185 anti-LGBTQI+ bills were introduced
These bills result in LGBTQI+ people losing access to essential health care; being barred from public accommodations like bathrooms; not being able to alter official forms of identification to reflect name, gender markers, and current photo; being barred from speaking about LGBTQI+ history, sexual orientation, gender identity, etc.; forced “outing” at schools, banning books; and removing legal protections from discrimination.
In North Carolina, three anti-LGBTQI+ bills have been passed that significantly impact LGBTQI+ people. Governor Cooper has vetoed all 3 of these bills, but the vetoes are expected to be overridden:
- HB808 bans all physicians and other medical prescribers from providing evidence-based, best practice gender affirming medical care for trans/nonbinary minors, even with parental consent; only patients who have started treatment by August 1, 2023, will be eligible to continue treatment with agreement from parents and medical providers.
- HB574 bans transgender girls and women from playing on girls and women’s sports teams from middle school through college (including private schools and universities, like Duke). Violations would be reported to the NC General Assembly.
- SB49 bans discussion of sexual orientation, gender identity, and sexual activity from kindergarten – 4th grade in any curriculum or classroom materials.
The collective impact of these bills is likely to impede Duke’s recruitment and retention efforts for many valuable students and employees, particularly those who identify as LGBTQI+ or who have family members who identify as such. Recently hired employees and students who are LGBTQI+ or with loved ones in this community, may also be experiencing a loss of safety since their decision to come to Duke, and in some cases bringing their families with them.
For more details, see:
Improving Your Unit or Workplace
The process of making a unit, department, center, or institute more inclusive and welcoming to members of the LGBTQI+ community will vary from place to place. However, there are some guiding principles that remain the same. When thinking about making positive changes, ask yourself the following questions:
How can I make my LGBTQI+ colleagues feel more included in the workplace?
- Do LGBTQI+ people ‘have a seat at the table’ and know that their perspectives are valued?
- If not, can I extend them an invitation?
- What are the barriers?
- Is my environment a place where LGBTQI+ people feel safe being their authentic selves? Has our unit/workplace reviewed any survey results to provide relevant data?
- Is my work culture living by Duke’s nondiscrimination policy?
- How can I signal safety to LGBTQI+ people?
- Am I willing to be an upstander, ally, or co-conspirator with my LGBTQI+ colleagues?
- Do LGBTQI+ people in my community feel connected with others?
- Do LGBTQI+ people feel like they are part of the group and not alone?
- Are there mentorship opportunities available for LGBTQI+ people to connect with other LGBTQI+ people?
- Do people make efforts to engage with LGBTQI+ people and find shared lived experiences?
Be open as an LGBTQI+ person, ally, or both. For many communities, and this is especially true for those in the LGBTQI+ community, you can help make the world a safer place by being outwardly visible as a member of that community and as an ally.
Make changes to your environments that will make LGBTQI+ feel welcome and safe. Examples may include posting signage using the Duke Health Pride Logo; Duke’s nondiscrimination policy; have reading materials and brochures that represent sexual and gender diverse populations.
Interacting with LGBTQI+ Colleagues
Be mindful of people who have intersectional identities or LGBTQI+ people with multiple minoritized identities (e.g., Black transgender women), who are likely experiencing distress from racial discrimination, gender discrimination, and the unique discrimination that stems from holding all these unique identities together.
Recognize the impact that your LGBTQI+, and particularly trans and nonbinary colleagues are likely experiencing right now due to ongoing discrimination and the burden that this carries.
Check-in with your colleagues who may be affected by the current sociopolitical climate – either personally, because they have a loved one (e.g., a child, sibling, parent, spouse, etc.) who is directly impacted, or because their patients may be impacted. If within your limits, offer to help out. When people are in distress, they may not have the capacity to know exactly what they need or what would be helpful.
Consider offering specific suggestions/examples of how you would be willing to help:
Instead of “how can I help you?”
- “Can I take your call for tonight/a few hours?”;
- “Would it be helpful to reschedule our meeting for a different time?”;
- “Can I bring you dinner/send a GC for food delivery?”;
- “You have a lot going on right now… can I take (X) off your plate?” etc.
Increase awareness of accommodations available to those with gender dysphoria. In North Carolina, those with diagnosed gender dysphoria, which includes many trans and nonbinary individuals, are legally entitled to accommodations under federal ADA law. Accommodations may include any of the following (based on individual needs):
- Access to gender-inclusive or all gender restrooms.
- Having your name and pronouns used throughout Duke.
- Having your name and pronouns reflected on your ID badge or other forms of identification.
- Access to medical leave and time away for related medical care.
Go to Disability Management Services (https://access.duke.edu/) to begin this process at Duke.
Use the person’s name and pronouns. The best source for this information is the person themselves… If the person’s name and pronouns are not listed (i.e., in Zoom, on a badge, nametag), consider asking the following:
- “What name do you go by?”
- “Can you remind me of your name?”
- “What pronouns do you use?”
- “I want to make sure I am addressing you correctly. Would you mind sharing your name and pronouns?”
Advocate for inclusive changes in your unit or group, be honest with any members of the LGBTQI+ community who ask if there is still room for improvement. Painting an overly rosy picture to someone who then joins a unit or department may expose them to microaggressions or a harsh environment--or lead them to develop trust issues with you as an ally and/or advocate.
In the Health Care Setting
Describing someone in a meeting or waiting room - instead of assigning a gender to someone you do not know, describe them by location and attire:
- Instead of “that man/woman over there,” say “the person wearing jeans and a red button-down; third chair from the left.”
Review the forms you are using in your workplace:
- Are trans/nonbinary identities included on intake forms?
- Are after-visit summaries and other communications coming from your clinic populated using the patients “preferred” or chosen name vs. their legal name?
Make sure that patients are completing the Sex and Gender Questionnaire in MyChart, ideally before patients arrive at your clinic, so that information about the name and pronouns they use and other important information about their identities are already available.
Do not assume that someone who identifies as straight and cisgender does not have important loved ones in their lives, who are part of the LGBTQI+ community.
- We now know that ~20% of people born after 1997 (i.e., “Gen Z”), identify as LGBTQI+.
- This means that many (if not most) of your colleagues may have children, spouses, or other family members who identify as part of the LGBTQI+ community.
Dealing with Microaggressions
If you deadname (call a person by their name assigned at birth, as opposed to their chosen name) or misgender (e.g., use pronouns that are not aligned with the person’s gender identity) someone:
Apologize, correct, and move-on. Do not dwell or make a big apology; it will only add discomfort, and potentially make the person who was misgendered feel like they need to comfort you, which is not their job.
If you realize in the moment, say: “I’m sorry, I meant (insert correct name/pronoun).”
If you realize your mistake afterward, apologize privately:
- Deadnaming: “(Insert correct name), I am sorry. I just realized that I called you by the wrong (name/pronoun) in that meeting.”
- Misgendering: (If pronoun was misused) “I know you use (insert correct pronouns)!”
Allyship - If you notice that someone else is being deadnamed or misgendered, correct the person who is deadnaming or misgendering by saying:
- Deadnaming: “(Insert pronoun) goes by (insert correct name)”
- Misgendering: “(Insert name) uses (insert correct pronouns) pronouns.”
Duke’s CTSI has a helpful list of Sexual Orientation and Gender Identity (SOGI) Training Resources, such as guidance for inclusive communication, mental health and LGBTQI+ Resources for children and families.
Duke’s Center for Sexual and Gender Diversity also offers support and resources for students, faculty, and staff:
Research related to minority stress and social safety:
- Diamond, L. M., & Alley, J. (2022). Rethinking minority stress: A social safety perspective on the health effects of stigma in sexually-diverse and gender-diverse populations. Neuroscience & Biobehavioral Reviews, 138, 104720.