Exploring pronoun badges in clinical education: Medical students’ experiences and perspectives

Objective: Transgender and gender-diverse (TGD) individuals face significant discrimination in healthcare settings, often avoiding necessary care due to anticipated bias. To foster inclusive environments, initiatives such as providers wearing pronoun badges have been proposed. However, limited research exists on the impact that health care providers using pronoun badges has on patient and provider experiences. Furthermore, the attitudes of medical students, who will comprise a large part of the clinical workforce in the coming years, towards pronoun badges remain unclear. This study aimed to explore medical student experiences and perspectives on using pronoun badges for a year of clinical work. Setting/Methods: Pronoun badges were distributed to 132 medical students at Harvard Medical School and, after a year of clinical work, students were surveyed about their experiences using the badges. Results: Of 132 eligible students, 65 [49.2%] responded; most respondents (59 [90.8%]) obtained a pronoun badge, and 48 [81.3%] of those who obtained badges wore them consistently. Among badge wearers, 45 [93.8%] planned to continue. An inductive thematic analysis revealed three themes in the responses: reasons to use badges (signalling allyship); reasons to abstain (concerns about patient misunderstanding or personal comfort); and impacts of badge use (fostering conversation). While some negative feedback was reported, most students viewed pronoun badges as effective allyship tools. Conclusions: Pronoun badges were well-received by medical students, with most finding them to be a meaningful way to create affirming clinical environments. The badges served as conversation-starters, signalling inclusivity to patients and staff. However, non-use by both cisgender and TGD students highlighted the importance of personal agency and safety in pronoun disclosure and highlighted the complexity of identity and allyship in medical settings. We suggest that institutions should offer, but not mandate, pronoun badges. While pronoun badges provide an early step towards building TGD-inclusive clinical environments, they must be coupled with broader institutional support for LGBTQ+ inclusivity.