A Reflection on Pronouns from a Nonbinary Colleague

This is how my day goes.

I meet Elise for a walk before work. I don't like being up this early. I don't particularly like walking. However, Elise does, and she's my best friend, so we go for a walk. By the time we finish, I am breathless from walking and laughing, so Elise offers to buy me a drink.

We step into the coffee shop, and I follow Elise as she goes up to the counter and orders for herself. The barista, a kind-faced young man, turns to me and asks, "What would you like, ma'am?"

 I stop. My words frozen in my mouth.  I tell myself that I should be used to this. I know what most people assume when they see me. But the fact of the matter is, I am not a "ma'am", nor am I a "sir". I don't know how to explain this to a teenager who looks like he's still half asleep. I have been silent too long, and now I can hear whispers in the line behind me saying, "Is she okay?" and "Did she not hear him?"

Elise knows me well enough to order for me. "They'll have a chai latte," she says and she leads me away before I can linger on the confusion on the boy's face. He says nothing more, I say nothing still, and Elise says nothing of it. She only smiles and hands me my tea. The warmth of it helps loosen the anxiety that has knotted itself in my chest.

The barista does not see me for who I am. That's fine; he's a stranger. I can let this moment pass. Even though the thought tries to linger, I burn the bitter taste in my mouth away with an impatient sip of my latte.


At work, my boss misgenders me while giving me a compliment.

While I am presenting a new poster design, she beams at me, looks to our co-workers, and says, "She has such a great eye for detail, doesn't she? Great job, Em!"

I want to feel proud. I want to accept this compliment with grace and gratitude. Instead, my mind is buzzing, overcome with panicked static that makes me feel numb and frozen. It is a strange experience, feeling both uncomfortable in the spotlight, and incredibly unseen by someone who is supposed to know me well.

I came out as nonbinary three years ago, which was a year before I took this job. I have been using they/them pronouns for just as long. When I have the chance, I introduce myself with my pronouns. I put them in my email signature at work. I even wear them on a button on my lanyard. I am trying - in whatever small ways I can - to make this part of me known, because it is important to me and I want to be seen for who I am.

What a strange experience it is then, to have someone I have worked so close with for two years, who puts her own pronouns in her email signature, continue to overlook who I am and not even notice.


The worst part is choosing which battles to fight.

The boy at the coffee shop? I don't need to explain my gender to him. I do not know him, and I know he was not trying to be malicious. I have had people be malicious. I have listened to them scoff and ask why I can't just be "regular". I have sat quietly, shaking as they say, "You still look like a girl," or "Using 'she' is easier to me," or "Can I call you 'it?'" A coworker asked me once, "So, what's your real name?" and I had to bite my tongue to stop from saying, "What makes the name I chose for myself any less real than the one on my birth certificate?"

Then there are times, like in this meeting, where people are being kind and who know me but have shown that they still don't see me for who I am.

In all these situations, I wonder if I have done enough. If I changed something about myself, if I dressed more androgynously, or if I wore makeup again, would they be more likely to listen to me, see me, and respect me? I don't know the answer. I wonder if I should speak louder, but the thought still fills me with anxiety. Is that just asking to be ridiculed? Or worse, is it asking too much?

In the end, I know this truth: No one should be made to feel like their gender is a burden. It is not bothersome to ask for respect. It is not selfish to want to be seen.  


My coworker, Lyle, wears a button with his pronouns on it: he/him. He doesn't need to do this. Most people will look at him and assume, correctly, that he is a man. However, he still does it. He introduces himself with his pronouns, and it makes it a little easier for me to do that too.

After our staff meeting, Lyle pulls me aside to ask if I am okay. "If that happens again, would it help if I corrected her?" he asks. I nod.


The next time my boss calls me "she", Lyle calmly clears his throat.

"They", he says. "Em uses they/them pronouns. They're nonbinary."

My boss blinks, pauses for a moment, then moves on gracefully. "Thank you. It was great to have their help with this. Em's attention to detail is really amazing."

I feel something loosen in my chest. When she looks at me again, I feel seen.


Definitions included in this blog entry:

Nonbinary: A non-binary person has a gender identity that does not match the sex they were assigned at birth; they do not identify solely as a man or a woman. They may identify as both, neither, or as a gender somewhere in between. Some consider gender to be a spectrum.  (Retrieved 10/11/21 from https://www.lgbtqiahealtheducation.org/wp-content/uploads/2017/02/Providing-Affirmative-Care-for-People-with-Non-Binary-Gender-Identities.pdf).

Misgender: To mistake or misstate (a person's) gender; esp. to address or refer to (someone, esp. a transgender person) in terms that do not reflect the gender with which that person identifies. (Retrieved 10/11/21 from https://www.oed.com/view/Entry/64848599?redirectedFrom=misgender#eid).

They/Them pronouns: A gender neutral or gender inclusive pronoun is a pronoun which does not associate a gender with the individual who is being discussed.  Some languages, such as English, do not have a gender neutral or third gender pronoun available, and this has been criticized, since in many instances, writers, speakers, etc. use "he/his" when referring to a generic individual in the third person. Also, the dichotomy of "he and she" in English does not leave room for other gender identities, which is a source of frustration to the transgender and gender queer communities. (Retrieved 10/11/2021 from https://uwm.edu/lgbtrc/support/gender-pronouns/).

Androgynously: In a manner that is neither clearly [masculine] or [female], or that mixes characteristics or attributes typically associated with one or other sex distinctly. (Retrieved 10/11/2021 from https://www.oed.com/view/Entry/62681312?redirectedFrom=androgynously#eid)


Although the above story is fictional, it is based on the lived experience of transgender and nonbinary staff at VUMC. As colleagues committed to creating a respectful and equitable environment for everyone, it can be helpful to pull several key learnings from this piece.

1. Respectful use of pronouns with our colleagues is a sign that people are seen, heard, and understood. That's a need that we all have.

2. Misgendering our colleagues can affect someone's work, sense of self, trust in a colleague, provider or team which can lead to poor patient outcomes, conflict within teams and even attrition if the behavior is not addressed or the individual feels isolated for too long.

3. The intentional and malicious misgendering of a colleague, someone you supervise or someone who supervises you, is considered a form of sexual harassment at VUMC and can be reported to Employee Labor Relations and/or staff can seek support services from the SHARE Center.

4. Take actions as a helpful bystander – if the misgendering is intentional or not. Some suggestions:

  • Check-in with the person who was misgendered. Ask them if they are comfortable with you intervening or correcting the person the next time it happens.
  • If you misgender someone, quickly apologize, correct your mistake, and move forward. You can model that behavior for others.
  • Introduce yourself with pronouns, wear a pronoun button, include your pronouns in your email signature or with your name caption on zoom. The more we can normalize pronouns across the Medical Center, the more equitable, respectful, and diverse a workforce we will become.
  • Even with the best of intentions, mistakes do happen.  Research in culture change reflects that practicing change can help reduce the incidence of oppression.  For instance, try replacing your internal thoughts such as, 'She has such a great jacket on!' with gender neutral language like, 'They have such a great jacket on!' The more you practice gender neutral language, the easier it will be when you are in a workplace setting describing a colleague's accomplishment.

The Vanderbilt Program for LGBTQ Health has pronoun buttons available in their office located at 305 Light Hall. The program's staff is also available to talk and answer questions about how we can support our transgender and nonbinary patients and peers. You can email lgbtq.health@vumc.org for more information.

The SHARE Center staff would like to greatly thank this month's guest blog contributor Pepper Heifner – Associate Program Manager with the Program for LGBTQ Health for their creativity, wisdom, and advocacy.

Check out these resources to learn more about pronoun usage and how to support your colleagues:

Pronoun Buttons at VUMC: https://news.vumc.org/2021/03/17/buttons-demonstrate-wearers-pronoun-preferences/

VUMC Human Resources Anti-Sexual Harassment – Standard Operating Procedure:   https://hr.vumc.org/system/files/employee-relations/HowWeAddressConcerns.pdf

Vanderbilt University Pronoun Guidance: https://www.vanderbilt.edu/lgbtqi/resources/pronoun-guidance

Fenway Guide to Providing Affirmative Care for Nonbinary Patients: https://www.lgbtqiahealtheducation.org/wp-content/uploads/2017/02/Providing-Affirmative-Care-for-People-with-Non-Binary-Gender-Identities.pdf

About the VUMC SHARE Center: The SHARE (Sexual Harassment: Awareness, Response and Education) Center offers confidential counseling and consultation to VUMC faculty, staff, and Allied Health students who have experienced or witnessed workplace sexual harassment. The SHARE Center staff are exempt from mandated reporting of sexual harassment and all appointments are kept confidential to the extent permitted by law. We also provide education and programming about sexual harassment to the broader VUMC community in order to increase knowledge and awareness and to promote equitable relationships among colleagues. To make an appointment, you can call 615-936-1327 and request Heather Kamper, LCSW or another SHARE counselor. Follow the SHARE Center on social media through @WellVanderbilt on Twitter and Instagram. Visit the SHARE Center website: https://www.vumc.org/health-wellness/share-center