Table 3

Practice points for individualised care

Practice pointExamples
More inclusive and specific language on intake forms
  • Ask about gender identity and pronouns with ‘check all that apply’ options, as well as a write-in option

  • Ask about which body parts people have and hormones used rather than assuming, but only ask when relevant

  • Ask about intersex identity and details of intersex diagnosis

  • Avoid binary language and assumptions about patients’ bodies or sexual activity

Consent
  • Ask permission before discussing topics with patients and letting patient know why that topic will be discussed (Eg, if a patient asks about STI-testing, ‘In order to gauge which tests to order, may I ask some questions about your recent sexual history?’)

  • On intake forms, provide preface before asking about sensitive topics (eg, To introduce our organ inventory we included: ‘To ensure that you are screened in a way that is appropriate for you, we ask ALL people about which body parts you CURRENTLY have.’)

  • Ask what name and pronouns a patient would like to use (and provide opportunities to change this information at each visit)

  • Allow patients to provide the words they want providers to use for their bodies

Education/attitude
  • Provider education on trans-inclusive care (eg, knowledge about breast cancer risk for individuals who have had top surgery; knowledge about impact of hormones in area of expertise)

  • Willingness to look for answers to questions of transgender and intersex patients and follow-up when unsure of answer

Stream-lined medical records system
  • Prior to each appointment, provide the option for patients to complete screening forms online re their body parts, hormone-use, and surgery history

  • Patient form is accessible to provider during the patient visit and should prompt provider to initiate relevant conversations (eg, if patient is over 21 years old and has a cervix and has not had a pap smear in 3 years, medical record system should prompt provider to initiate that conversation)

  • Community-generated recommendations for clinical intake and screening processes that are more inclusive of and relevant to the experiences of transgender, non-binary and intersex people.