Creating A Gender-Inclusive Environment: A Guide For SLPs And Clients
Author: Jesse Nerenberg, Reg. CASLPO, Speech-Language Pathologist
Date: Wednesday, November 20, 2024
While transgender rights have come a long way over the past few decades, with increased visibility, legal protections, and broader acceptance, recent political movements and governments have unfortunately started to push back against these gains. In various places, legislation has been introduced or passed that restricts access to gender-affirming healthcare, limits the rights of transgender individuals to participate in sports, and curbs protections in schools and workplaces. It is an especially critical time to support and advocate for the transgender community.
Creating a welcoming and gender-inclusive environment is essential for Speech-Language Pathologists (SLPs) and their clients. As speech-language pathologists (SLPs) at Well Said, we often interact closely with individuals from diverse backgrounds, including transgender clients. Building a space that affirms all gender identities not only enhances our therapeutic work but also ensures that all clients feel respected, seen, and understood. Here’s a look at how SLPs and clients of SLPs can make our practices more gender-inclusive.
Gender inclusivity means creating a safe, affirming space where individuals of all gender identities feel comfortable and respected. For transgender clients, inclusive practices extend beyond pronouns and names to the language we use, the forms we fill out, and the types of communication goals we set. As SLPs, we must recognize that every individual has the right to identify and express themselves authentically without fear of judgment or misunderstanding.
Clients and families who are supportive of transgender individuals can also play a key role in fostering this inclusive atmosphere. Clients who advocate for themselves or a loved one benefit from knowing what they can expect in a gender-affirming SLP setting. Let’s explore several strategies to create a more gender-inclusive environment for everyone involved.
1. Learn and Use Affirming Language
Respecting the language preferences of transgender clients is foundational to an inclusive SLP practice. This means using the correct name and pronouns at all times, even if they differ from those that may be indicated in medical records.
Clients can advocate for themselves by sharing their pronouns and name preferences upfront. If you’re not sure how to bring this up, simply saying, “I use she/her pronouns. What about you?” can open the conversation in a gentle and respectful way. For the clinicians at Well Said, we have built this into our intake form that is sent out before our initial consultations, allowing clients to let us know how they wish to be addressed before even meet.
For us, it’s important to avoid assuming a client’s gender or pronouns based solely on appearance or based on the legal name they have provided for insurance purposes. Gender-neutral language in everyday interactions, such as using terms like “partner” instead of “husband” or “wife,” can help set the tone for inclusivity from the start. As well, I tend to ask more open-ended questions such as “how would like to be addressed?” or “How do I pronounce your first name?”. In a case where a client’s name identification on zoom did not match their legal name provided on their intake form, I defaulted to the neutral term “my friend” when I asked how they wanted to be addressed in their sessions.
As well, I always make a point to never call Gender-Affirming voice work “therapy”. The word therapy suggests a disorder of some sort and being transgender is not a disorder. I use the term voice “coaching” or “training” in these cases.
2. Inclusive Documentation and Forms
As a client, it’s okay to request that forms reflect your identity accurately. If a form doesn’t align with your identity, feel free to ask if changes can be made, as we are always open to feedback on improving our inclusivity practices.
The identification fields of our client files include a space for pronouns and name preferences. So while we may need to have a client’s legal name on file for insurance purposes, I consider it to be one of my fundamental duties as a clinician to make sure that preferred names are displayed on the file and that all communications uses a client’s preferred name and pronoun.
Gender-affirming coaching involves addressing the unique communication needs that transgender individuals might have. For some clients, this may involve voice and communication training to help them feel that their speech reflects their gender identity. This could mean working on vocal pitch, resonance, intonation, speech rate, and non-verbal cues that align with how they wish to present themselves.
If you’re a client, don’t hesitate to let your SLP know what goals are most important to you. Open communication about your voice and communication desires can help us create a personalized and effective training plan. The journey to find your authentic voice can be a long road, and we as clinicians are committed to not only be your guides but provide emotional support and encouragement during this period of exploration and learning.
It’s also important for SLPs to remember that not all transgender clients seek voice modification or gender-related communication therapy. Some may be perfectly content with their voice and just want support in other areas. An inclusive approach means respecting each individual’s choices and ensuring that their goals are fully understood. At Well Said, we have had transgender clients for which aligning their voice with their gender identity was their priority, while for others their transgender status was in no way related to their goals.
Even with the best intentions, mistakes can happen. If an SLP or staff member misgenders someone or uses an incorrect name, a quick apology and correction can go a long way. Avoiding defensiveness is key; instead, acknowledge the mistake, correct it, and move on.
Clients can also feel empowered to kindly correct a provider or support person if a mistake occurs. If a friend or family member inadvertently misgenders you, gently remind them of your correct pronouns or preferred name. Over time, these small interactions help normalize inclusive language and make everyone more aware of their words.
Creating an inclusive environment is a collective effort, and it can be helpful to involve support staff, family members, and other caregivers in fostering inclusivity. For example, a few months ago, I noticed that our online clinical platform when sending out emails would use the legal name of clients in the subject heading (unless it was changed manually beforehand). I flagged this in our weekly staff meeting and our Director of Service enthusiastically and graciously corrected the situation by reaching out to the company and looking into the software settings that could be tweaked to change the subject lines to preferred names. By approaching this as a team, we were able to create a more welcoming and inclusive environment for all our clients, transgender or otherwise.
Clients, family members and partners can help by supporting each other’s identities and advocating for inclusivity both inside and outside of sessions. Family support has a significant impact on transgender individuals, particularly in affirming their gender identity and reducing feelings of isolation or misunderstanding.
Some transgender individuals may not feel comfortable disclosing their gender identity or transition status to everyone they interact with. As SLPs we will always respect each client’s privacy and avoid discussing their gender identity with others unless given explicit permission.
Similarly, clients may feel more comfortable knowing that their SLP maintains confidentiality. It’s okay to ask for clarity our privacy practices if you have concerns. This mutual respect for privacy helps build trust between the client and the SLP.
Inclusivity doesn’t stop once the session ends. SLPs, clients, and family members can all advocate for broader acceptance and inclusivity within their communities. This might mean advocating for transgender inclusivity in schools, workplaces, or local policies.
SLPs can also help by writing articles to spread awareness or advocating for the importance of an inclusive approach in all spaces. I consider it my duty, as someone who works with members of the trans community, to stand up for wider gender inclusivity whenever I see the opportunity to do so. This includes gently, but firmly, educating people I come into contact with in my day to day life about the importance of standing up for Trans Rights.
Creating a gender-inclusive environment is a vital part of providing compassionate, effective, and respectful care for all clients. By making mindful choices in our language, documentation, and practices, we can foster a safe space where transgender clients feel valued and empowered.
Clients and families play an important role in this process, too. By advocating for inclusive language and affirming identities in sessions and beyond, they help create an environment where everyone can communicate and connect authentically.
For all of us, the journey toward inclusivity is ongoing. By committing to learn and improve, we contribute to a world where everyone can communicate freely, comfortably, and confidently. Gender inclusivity in our sessions is not only an ethical responsibility but a fundamental aspect of effective, client-centered care. Together, let’s continue building spaces where all voices are celebrated.
To speak with a psychotherapist or one of the speech-language pathologists at Well Said: Toronto Speech Therapy, schedule an initial consultation by clicking the link below or calling (647) 795-5277.