Why pronouns matter in therapy

Hello. I’m Dan and my pronouns are he/him. It’s a standard way of introducing myself these days; letting people know what my name is, but also how they can refer to me. But why is that important? And what is a pronoun?

Pronouns are all about how you refer to someone. For example, someone who identifies as female may have she/her pronouns. Someone who identifies as male may have he/him pronouns. Someone who is trans, genderfluid or non-binary, may have neutral pronouns such as they/them (which can be used in the singular by the way).

You may be used to referring to someone using gendered pronouns, but it’s vital to refer to people who use non-gendered pronouns in the correct way too. Not everyone resonates with the binary definitions of gender and it’s important that this is respected.

Indeed, every single person is worthy of dignity and respect, including in the therapy room. Using someone’s correct pronouns and making an effort to get it right is a small thing that makes a huge difference. It will reassure LGBTQ+ people, and trans people in particular, that they are welcome at your practice.

Now, it’s OK to feel confused or not quite get it if this is all new to you. However, it’s certainly essential to take the time required to understand this concept and get it right. It’s all part of working in an empathetic way while utilising congruence and unconditional positive regard, which is how all therapists should work (whether they are person-centred or not).

Names and pronouns are a personal thing and as therapists, we need to build rapport and help our clients feel at ease. Using the incorrect name or misgendering can genuinely be upsetting or even distressing for a trans person, so getting it right from the outset matters. This means not making any assumptions and asking the correct questions during the initial consultation.

I always recommend that therapists have a question about pronouns and chosen names on their consultation forms. While I’ve been accused of pushing my ideology onto people, that’s not the case. It’s simply about respecting my clients and anyone who does not feel able to give that respect to their clients should explore why that is.

Having worked with many trans people over the years, I’m all too aware of the challenges faced when accessing therapeutic services. Sadly, judgemental and discriminatory therapists exist. Some people have not been referred to using their chosen name and incorrect pronouns have been used. Some people’s identities have been dismissed and some therapists have even made it very clear they do not accept trans people. This is obviously completely unacceptable, but the damage it does can mean some people don’t seek further support for years, if at all.

It can therefore mean that some trans people are very apprehensive when attending a consultation with a new therapist. It can be nerve-wracking enough without throwing in these additional worries. That is why this stuff really matters and is so important.

So, how do you find out what a client’s pronouns are? The simple thing is to ask and to ask every client. Some clients won’t know what you are talking about, but that’s an opportunity to explain it to them. If you provide an intake form that clients complete before seeing you, include the question on your form. You might also want to include a “prefer not to say” option, as of course people have a right to not disclose certain information. Also, some people may not be sure what their pronouns are.

Something else you can do is what I did at the start of this article. Introduce yourself by your name and pronouns. Immediately you will be promoting an inclusive, accessible environment.

If you are not sure what someone’s pronouns are, it’s best not to make assumptions. Instead, use the gender-neutral pronouns they/them. They can be used in the singular and you can’t go wrong by using them.

Taking this further, you may also want to look at how you write letters. If you don’t know the name of the person you are writing to, instead of writing “Dear Sir/Madam”, use “Dear Client” or “To whom it may concern”.

If you have policies, it’s a good idea to review them and remove any gendered pronouns. Quite often it’s not necessary to use gendered pronouns.

I understand that this feels like a minefield for some therapists and mistakes may happen. However, if you make a mistake, own it, apologise, and commit to getting it right next time. Most people will be forgiving to begin with, but do work on getting it right next time. Remember that you are responsible for getting it right, not your client.

The number one thing to remember is that you should always be guided by treating clients with respect and dignity. All clients deserve that. All humans deserve that. And therapists have a large part to play.