. Ensure bathrooms are accessible to all genders. |
. Replace binary pink and blue equipment and décor with other colours. |
Communication
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. Use gender-neutral language for health spaces (“sexual and reproductive health centre” rather than “women’s health centre”). |
. Use neutral and welcoming language for all people in education, literature and advertising materials. |
. Replace “It’s a boy/girl” on children’s cards with more inclusive messages (e.g. “Hello, my name is…”). |
Continued Professional Development
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. Ensure that the whole staff is confident in correctly and consistently using social names, when indicated, in healthcare services and records. |
. Provide training to increase environmental awareness, equity and inclusion of people of all sexes in the whole staff. |
. Consider how people’s names are used, documented and communicated among care staff members. |
. How is the phone answered? Staff must be careful not to infer the gender of the person speaking from voice characteristics. |
. Train sonographers in the use a gender-neutral language during ultrasound examinations for users and foetuses. |
Particulars in medical records and appointments
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. Ask about sexual orientation and gender identity, pronouns and preferences. |
. Take measures so that scheduling and billing for procedures and appointments do not hinder access for masculine gender people to gynaecology and obstetrics services. |
Recommendations for clinical encounters
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. Be open to your users’ experience and learning when they want to share. |
. Be knowledgeable and current on the inclusive approach to health. |
. Ask users and companions their pronouns and use them consistently. |
. Explain why sensitive questions are relevant. |
. Be sure that sensitive questions are clinically significant and not motivated by idle curiosity. |
. Refer to the child with gender-neutral pronouns, unless asked not to. |
. Refer to the biological father as the “biological father” or “gestational father”. |
. Refer to the biological father’s partner as “partner”, rather than “father” or “co-mother”. |
. Ask for the user’s preferred names for body parts (e.g., chest, birth canal, birth opening, frontal orifice, chest feeding etc.). |
. Use correct pronouns during labour (for example, referring to “father’s heart rate” rather than “mother’s heart rate”). |
. Provide support for informed feeding of newborns, including options for human breastfeeding and formula feeding. |
. Discuss contraceptive options using shared decision making. |
. Discuss the wish to resume hormone therapy, in coordination with the breastfeeding plan. |
. Do not assume reproductive desires on the basis of sexual orientation, gender identity, gender expression, assigned sex at birth or family formation. |
. When discussing hormone therapy, consider the effects of medications on fertility and wishes for current and future fertility before starting gender-affirming hormones or puberty-blockers. |
. Ask about experiences with health services and offer referrals to a multidisciplinary team and/or health care network, if necessary. |
. Provide information on trans support groups and mental health resources. |
. Avoid unnecessary and unwanted exposure. |
. Ensure that only essential staff are present during care. |
. Limit the number of cervical exams and minimise genital exposure. |
. Ensure informed consent for any physical examinations. |