Greater understanding will lead to more equity for patients & colleagues
Jan 4, 2022, By: Jess Crawford
- Transgender is an umbrella term that refers to anyone whose gender differs from what they were assigned at birth.
- Non-binary means different things to different people.
- Learning and reflecting about gender is a step toward more equitable care for trans and non-binary colleagues and clients.
Trans and non-binary people have existed for thousands of years, yet are rarely included in contemporary discussions about gender. For myself, a middle-class white settler born in the early ’90s, discussions about gender were basic and binary: you were male or female. As I grew up, I learned that one behaved, dressed, and had access to certain spaces based on whether they were “a girl” or “a boy.”
Throughout my four years of nursing school, graduating in 2017, I had one lone hour devoted to gender education. Perhaps this is because safety from discrimination based on gender identity and expression weren’t included in the Canadian Human Rights Act until 2017 (for context, sexual orientation was added to the list of prohibited grounds for discrimination in 1996). Nevertheless, no one explained the immense differences between sexuality and gender. I left nursing school unprepared to support, advocate, or provide equitable care for trans and non-binary people, much less to reflect on my personal intersection with gender.
My experience with gender
I’ve since had time to reflect on my experience. At birth, I was assigned female. My parents enrolled me in ballet and gymnastics, bought me dresses and dolls, and I was told to sit and act “ladylike.” Growing up as a girl, a tomboy girl, felt okay. But as I grew older, I began questioning gender, silently and embarrassingly, to myself.
It wasn’t until I started working as a registered nurse in emergency mental health that my exposure to 2SLGBTQIA+ clients permitted a shift in my awareness of gender and sexuality. 2SLGBTQIA+ is an abbreviation that means two-spirit, lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual/agender and allies, and many other diverse sexualities and genders. This list is not exhaustive and is constantly evolving.
Fast-forward a couple of years. I moved to a remote town of 5,000 people. The seclusion, with the addition of a pandemic, allowed the painful process of self-discovery. It was during this time of solitude that I came out to myself as non-binary.
My experience as non-binary
Non-binary means different things to different people. For me it means that I am not a woman, and I am not a man. I am somewhere outside, within, and beyond this binary. I also use the words trans and queer to define my gender.
Transgender is an umbrella term that refers to anyone whose gender differs from what they were assigned at birth. Not everyone who is non-binary identifies as transgender, and some people choose not to use any labels at all. It’s important to note that gender and sexuality are two very different, personal, and complex components of identity. It is also true that gender and sexuality can be fluid and change over time.
To me, non-binary means freedom, space, and exploration. It means I can live my life outside of gender roles and norms. I’ve also learned that transitioning isn’t linear or a “one-size-fits-all” experience. For me, I’ve adjusted my name, changed my pronouns, my hair, and my clothing. Other people’s experiences will be different.
I’ve also learned that coming out isn’t a single event; I’ve already gone through the ordeal dozens of times in the past year. To be myself, I am forced to constantly educate the people around me.
The seclusion, with the addition of a pandemic, allowed the painful process of self-discovery
I must educate my own doctors about my needs as a trans non-binary client. I must educate my employers and colleagues about myself and the needs of queer clients. Being non-binary also means I must carefully navigate relationships with clients: I am continually learning the boundaries of when it’s appropriate and when it’s safe for me to express my name, pronouns, and gender.
Though it’s incredibly freeing to know who I am, it’s also isolating and comes with many challenges. Given that I completed nursing school without hearing the term non-binary or having exposure to anything beyond the gender binary, I am sure many readers will be unfamiliar with the unique challenges of non-binary people, and moreover, unfamiliar with how to provide us with equitable care.
What can you do?
I encourage everyone to do research about trans and non-binary people and reflect on your own experiences of gender. If you’d like to start building safer spaces for trans and non-binary people, start by adding your own pronouns when you introduce yourself and refer to the gender-inclusive language resources like those from Rainbow Health Ontario and Trans Care BC.
Rainbow Health Ontario
Trans Care BC
Jess Crawford (they/them), RN, BScN, is a white settler currently living on Treaty 3 Territory. They have worked in Northwestern Ontario for the past 3 years providing mental health and addictions, 2SLGBTQIA+ health, and sexual health supports to youth. They are pursuing their master’s degree in nursing at the University of Manitoba in fall 2021, which will include a thesis paper exploring experiences of queer nurses and nursing students. They are also a research assistant helping to better understand how to create safe spaces to facilitate and learn anti-racism in health education as well as a teaching assistant for a gender and reproductive health fourth-year nursing class.