Respecting Patient Gender Preferences in Healthcare

Patient Preferences and Demographics

Women demonstrate strong same-sex preferences for intimate procedures, with 90.8% preferring same-sex providers for gastroenterology office visits and 92.3% for colonoscopy, compared to 70% and 84.1% of men respectively 1
Embarrassment is the primary driver for women's preferences, particularly among those with higher education levels 1
History of abuse is a critical factor, with both men and women with a history of physical or emotional abuse being significantly more likely to prefer a female provider 1
Among patients expressing a preference, 92% of women and one-third of men prefer female endoscopists 1

Incorporate gender preference into routine pre-procedure screening questionnaires in a non-gendered, inclusive format 2, 3, 4
Ask sensitively and in a private environment, providing clear explanation for the relevance of the question to increase patient confidence and reduce feelings of discrimination 2, 3, 4
Record the patient's preference in the medical record in a way that future healthcare staff can access it to avoid repeated uncomfortable conversations 2, 3, 4
Information about gender preferences should only be shared with those for whom it is relevant and with patient consent 2, 3, 4

Transgender and gender-diverse patients have low confidence that healthcare workers understand their needs and fear encountering prejudice and discrimination 2, 3, 4
Routine incorporation of gender identity questions into screening reduces non-disclosure, using a two-step question asking about sex recorded at birth and current gender identity 2, 3, 4
Pregnancy can exacerbate gender dysphoria, anxiety, and depression in transgender individuals, making provider gender preference even more salient 5

Female physicians conduct longer visits, use more patient-centered approaches, and are more likely to discuss emotional issues and actively seek patient input 1
Patients of female providers report higher satisfaction with their interactions, though physician gender was not associated with male patient satisfaction in some studies 1
Respecting preferences reduces anxiety and embarrassment, which are primary barriers to seeking care for intimate health concerns 1
When transgender persons receive medically appropriate, affirming care, they experience improved mental health, reduction in suicide rates, and lower overall healthcare costs 6

Do not assume preferences based on patient demographics, as individual preferences vary widely and approximately 46-57% of patients express no gender preference 1
Do not omit asking simply because accommodating the preference may be difficult, as documenting the preference allows for future accommodation and demonstrates respect for patient autonomy 7
Avoid using legal names that differ from preferred names during clinical interactions, particularly for transgender patients 5
Do not "out" transgender patients by calling them by birth names in waiting areas or other public spaces 8

The American Society of Anesthesiologists recommends asking about gender preferences during pre-operative screening using non-gendered, inclusive questionnaires, and documenting the preference clearly in the medical record where all team members can access it 9, 10
Before sedation, explicitly inform the patient of all personnel who will be present in the operating room, including their roles and genders, and obtain explicit consent if the staffing differs from the patient's stated preference 10
Creating an open and inclusive environment during surgical procedures is important, as undergoing surgery can be a vulnerable time for any patient 10

Transgender and gender-diverse patients have low confidence that healthcare workers understand their needs and fear encountering prejudice and discrimination, highlighting the importance of using the patient's chosen name and pronouns throughout all interactions 10, 11
Pregnancy and gynecologic procedures can exacerbate gender dysphoria, anxiety, and depression in transgender and gender-diverse patients, making provider gender preference even more salient 11