Opinion & Special Articles: Beyond Pronouns—Educating Trainees on the Impact of Language on Gender Inclusivity in Neurologic Practice

Language plays an important role in ensuring gender inclusivity within neurology. Despite progress in language inclusivity, such as the emergence of explicit pronouns, more remains to be done. Historically, sex and gender have been used interchangeably, but they are, in fact, distinct concepts. This is an important distinction particularly in the care of transgender and gender diverse (TGD) individuals, whose assigned sex and gender are incongruent. In the health care setting, TGD individuals frequently report misgendering, identity invalidation, and gender pathologizing, which have led to health care avoidance and mistrust. Ultimately, to ensure effective integration of gender-affirming language into clinical care, training should be introduced early in neurology residency and fellowship education. Through 3 case studies in epilepsy, multiple sclerosis, and stroke, we discuss language use in neurology and provide recommendations to support trainees in the use of gender-affirming language. We underscore the importance of gender-affirming language in health care equity and cultivating a safe, inclusive clinical environment. It is crucial for residents and fellows to not only be informed on cultural humility and gender-affirming terminology but also learn to avoid assumptions and seek clarification about gender identity when needed. Ultimately, trainees proficient in these skills cultivate trust in clinical relationships, reduce discrimination against TGD populations, and improve patient health outcomes in neurologic care.