By the end of May, 800 Central Coast emergency medicine professionals will be trained in Transgender Competent Care. Author Max Rorty is pictured teaching one such seminar.

Tyler Renner

By the end of May, 800 Central Coast emergency medicine professionals will be trained in Transgender Competent Care. Author Max Rorty is pictured teaching one such seminar.

Saving Hes and Shes

Central Coast EMTs Get Transgender Training

Friday, April 25, 2014
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Transgender people identify with a gender identity different from the sex they were born with. For example, Chaz Bono, who has written a memoir on his transgender identity, was assigned female at birth. When his family first saw him, they thought he was a girl, but as an adult, Chaz communicated to his family that he identified as male and changed his pronoun from “she” to “he” to accurately reflect his identity.

Similarly, Janet Mock (who will be speaking at UCSB on Tuesday, April 29) was assigned male at birth. Her birth certificate says male, but her gender identity from a very young age was female. “I was born a baby. As soon as I had enough agency in my life, I became who I am.” Janet Mock changed her pronoun when she was a very young person from “he” to “she.” So, when we refer to Mr. Bono and Ms. Mock, we say, “Cher is his mother” and “Her book Redefining Realness is a New York Times best seller,” respectively.

Last month, Santa Barbara County paramedics were trained on how to ask transgender and gender nonconforming people for their pronoun preference. Next month, Ventura County emergency medical team will be training, too. This skill has the potential to transform the medical experience of Central Coast residents.

Gender is part of our essential sense of self from the time that we are first able to talk, as Bono’s and Mock’s stories make clear. It can neither be confirmed nor refuted by our anatomy. Non-transgender people (also referred to as cisgender people) often assume that genital surgery is an essential part of changing one’s gender identity. But surgery is rarely necessary or desired. The goal of transition is to be seen correctly as male or female. Many transgender people demonstrate their gender identity with their clothes and hair in order to be recognized correctly as male or female. In this they resemble most of us: gender-conforming cisgender people, who also demonstrate our gender identity with our clothes and our hair. Our gender identity has nothing to do with our anatomy.

Most transgender people lead healthy, happy lives without surgery and have a gender identity that is not reflected by their sexual anatomy. This fact poses a particular challenge to medical professionals who perform physical exams because they run the risk of misgendering patients based on anatomy. They might refer to patients by the wrong pronoun; for example calling a woman “he” or calling a man “she.”

Being misgendered, or called by the wrong pronoun, is a disturbing, uncomfortable, and potentially threatening experience. Because there is a higher chance of this happening in medical settings, transgender people often report avoiding or postponing medical care. And for medical staff, it can be uncomfortable not to know how to refer to a patient. It can even lead to avoidance due to embarrassment or conflict between clinical teammates who disagree on whether to call someone “he” or “she.”

In our training, Santa Barbara and county paramedics learned how to ask patients for their pronoun preference. They were told that when any of us is uncertain of someone’s gender, it is polite to inquire what their pronoun preference is, or, literally: “My partner and I want to refer to you correctly. What pronoun should we use?”

Paramedics do critical work. Confusion, disagreement, or embarrassment about not knowing someone’s gender identity can hinder this critical work. By asking this simple question, “What is your preferred gender pronoun?” paramedics are able to focus on the essentials of patient care. Angelo Salvucci, medical director for Santa Barbara County and Ventura County Emergency Medical Services Agency, had a hand in arranging the training and was pleased with its impact: “I was struck with how receptive and appreciative the EMTs and paramedics were to get this info. They were universally engaged and soaked it all up. It speaks to the caregiver mentality in all of us in health care. This equipped them to make a few more patients’ emergency health-care experience a little less traumatic.”

Mike Taigman, American Medical Response’s general manager for Ventura County and the Gold Coast who oversaw the delivery of this training to the teams in Ventura County, said: ”It’s disturbing to learn how little legal protection transgender people have in our country. While we work toward equal rights and protection, we can do our part by making sure that members of this community receive emergency health care that is top quality, respectful, and compassionate.”

Santa Barbara and Ventura County emergency medical professionals are to be praised for their compassionate and professional care of their patients.

Max Rorty, a licensed clinical social worker, trains medical and mental-health professionals on transgender competent care. A sample of her presentations can be viewed at


Independent Discussion Guidelines

Being born and raised in California, coming to the East Coast and identifying persons based on their projected Gender rather than the bump's on the chest or bulge in their trousers was easy. Many people from the Northern Virginia area have a huge problem using the proper pronouns when addressing people of "Other than born Gender". I had taken ill during an re-qualification session at the NRA due to a defective ventilation vent for spent Gunpowder discharges. The Paramedic was assisting another downed participant who was projecting a Male persona but was born Female, the paramedics took notice of his chest and commented disparaging about the "Freak". The Staff of the NRA treated the incident with respect and spoke to the Paramedic's supervisors regarding the unprofessional demeanor they exhibited toward this one gentleman. Unpaid leave the was the result of their rude comments and disrespect in rendering service and care. During my days of Gate duty and patrol, I had often encountered drivers licenses that did not fit the appears presented between the drive or passenger and their card's photo. I used the pronouns that pertained to the person I was addressing; rather than like my co-workers who used the pronoun that fit the Card's photo and resulted in punishment by the supervisor since as a Government Contractor your at the mercy of the Government Employee you insult with improper pronouns.

dou4now (anonymous profile)
April 25, 2014 at 8:02 a.m. (Suggest removal)

Great, if I'm ever in a severe traffic accident, the paramedics first concern will be to not offend my percived gender identity.

"Excuse me, we'll take care of your severed limb in a minute. First we need to know if you'd like to be addressed as "him" or "her"."

Botany (anonymous profile)
April 25, 2014 at 8:25 a.m. (Suggest removal)

I fail to see how pronoun preference will transform medical emergency situations. If this keeps some people from going to the doctor out of fear, maybe they can afford to pay for those who would love to see a doctor but do not out of fear for not being able to afford it. Yay for the transgender plutocrats?!?!? Priorities. What's really wrong with health care, I ask you.... Hey! Over here!

spacey (anonymous profile)
April 25, 2014 at 12:49 p.m. (Suggest removal)

@Botany, the theme is serious. Yet I found myself laughing out loud at your script! But, yes, first things first?

salsipuedes (anonymous profile)
April 25, 2014 at 1:38 p.m. (Suggest removal)

Your title (Hes and Shes) should also probably include the proposed gender-neutral pronoun of choice - zhim, zhers,and zhimself!

sharpen123 (anonymous profile)
April 25, 2014 at 8:10 p.m. (Suggest removal)

Good god, I hope you're kidding about the goofy, fake pronouns? Zhim??
There are languages (Finnish is one) that have naturally occurring gender-neutral pronouns. The subject pronoun "hän" can mean either "he" or "she."
Not sure what effect, if any, this has on the Finns' gender "awareness" in daily life let alone life-threatening situations.

Aside from the concerns that often accompany the always murky areas of perceived political correctness, the last thing we need to do is introduce some form of Newspeak.

zappa (anonymous profile)
April 26, 2014 at 6:13 a.m. (Suggest removal)

zappa - I am not kidding about those proposed gender neutral pronouns!! They are already used by some.

sharpen123 (anonymous profile)
April 26, 2014 at 3:14 p.m. (Suggest removal)

Zappa: Interesting--I didn't know that the word in Finnish for he/she was almost identical to Swedish--even though Finnish is not even an Indo-European language.

I was aware that Finnish had no gender differences, which is good because they are a real pain. (And in German there are masculine, feminine and neuter so it's even worse then the simple he/she thing) Bear in mind--and as I'm guessing you probably already know--that Finnish has fifteen cases, and what is really weird is that every word has its stress on the first sylllable.

billclausen (anonymous profile)
April 26, 2014 at 5:54 p.m. (Suggest removal)

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