Let’s Talk Pronouns


A conversation about Sexual Orientation and Gender Identity (SOGI) in health care.

Treating all of our patients with respect, dignity and compassion is central to our patient- and family-centered approach to care. As part of the rollout of our enhanced electronic health record across the UVM Health Network, we will begin asking patients to identify their pronouns and gender identity (which may differ from their legal gender) to better serve them and to ensure a welcoming space for people of all genders and sexual orientations.

Patients always have the option to decline response to these questions,but it’s important that the questions are asked to all patients without assumption. At the time this information is collected, like any other demographic data, sexual orientation and gender identity information will be woven into the patient record.

“Patients can disclose as much or as little information as they deem relevant to their care.  The important thing is that our staff sensitively ask these questions so that care can be tailored to best meet our patients’ needs,” says Stephen Graves, UVM Medical Center’s program manager of equity, diversity and inclusion.

What is SOGI?

SOGI is an acronym that stands for sexual orientation and gender identity. Sexual orientation refers to an enduring emotional, romantic, sexual or affectional attraction to another person. Gender identity refers to a person’s self-perception of their gender as female, male, both and/or neither.

“Recognizing and improving the way we communicate about sexual orientation, gender and identity (SOGI) starts with our organizational values to respect the worth and dignity of individuals in our care. This helps us be more responsive to social, physical, cultural and diversity needs of our patients. SOGI is an integral part of providing equitable care to our LGBTQ+ community,” says Graves.

Why are we asking everyone for their pronoun?

People tend to make visual assumptions regarding gender and pronouns, but we want to avoid assuming someone’s gender identity based on their appearance, name, mannerisms, etc. One respectful way we can do this is to provide patients with the opportunity to identify their gender and pronouns with us, even if they choose not to disclose this information. It’s important that we document the correct, patient-identified information, regardless of what we assume we know.

Who will ask patients about their sexual orientation?

This question should only be asked by a clinician as appropriate for clinical care and the patient’s overall experience. And patients may choose not to answer.

Kathy Mariani, MD, is a primary care physician at South Burlington Family Medicine. She describes why including information about sexual orientation and gender identity (SOGI) as part of the electronic health record upgrade will empower clinicians to provide the best care for our patients.

“A woman friend of mine once asked me, ‘What’s with you doctors? Why is it that every time I go for an annual appointment, they ask me if I need birth control? I’ve been with a female partner for 15 years.’ I told her it was a computer issue. If your doctor had a medical record that very clearly stated your sexual orientation, you wouldn’t have that awkwardness every time you go to the doctor. Our new electronic health record will help us with the foundational information so we can start having these conversations with confidence,” says Mariani.

Related: Q+A with Dr. Mariani about Sexual Orientation and Gender Identity in Health Care

Improving and unifying care across our community

Stephen Graves and UVM Medical Center’s Department for Equity Diversity and Inclusion worked closely with community organizations to ensure our approach aligned with the needs of our LGBTQ+ communities.

“People were open, honest and candid as we discussed how to build out this program. Inclusion is all about providing seats at the table to inform our decision-making process. We need to include their voices to make sure they’re heard and their questions are understood. Our community partnerships are integral and none of this could’ve happened without them,” says Graves.

We thank our community partners Outright Vermont, Community Health Centers of Burlington, Pride Center, the Transgender Youth Council at UVM Children’s Hospital and also appreciate the valuable perspective of our very own Patient and Family Advisors.

“Our doors are open to everyone,” says Graves. “This allows us to be prepared, responsive and proactive to serve diverse patient populations. Our population is changing and we need to make sure we’re changing with them to serve them best.”

To learn more about the UVM Health Network’s enhanced electronic health record, read our earlier blogs:

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