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Guideline for the sensitized handling of patients

How can I deal with patients in a discrimination-sensitive way?

 – A guide – 

Discrimination-sensitive treatment of patients enables all people to seek health care. This guide is intended to serve as an impetus for doctors and therapists to take a more critical look at their work.

It is about dealing with patients, about the design of one’s own practice and about one’s own commitment outside of work. 

Table of contents

Do I use gender-appropriate and sensitive language in speaking and writing?

How do I address my patients on my website? Do I also try to reflect all genders in the spoken form as much as possible? Are my questionnaires, forms and information materials gendered? Do I use gender-sensitive or gender-neutral language?

Why is this important?

Using only the masculine form (“generic masculine”) as it is with grammatical gender languages (e.g. German) is still the common way in various languages. However, this excludes >50% of the population and does not actively include them.

Studies show that much stronger masculine images are created in the mind when only the masculine is used. When both feminine and masculine forms are used, it is much more reflective of the reality of society. Language creates reality, so it is important to give all people their place in our language as well. An article on the website of the United Nations explains in more detail what possibilities there are to make language more neutral and inclusive.

Wie gendere ich respektvoll

Inklusives gendern kann in Schriftform auf unterschiedliche Weise stattfinden:

  • Gender-Stern (Patient*innen)
  • Gender-Gap (Patient_innen)
  • Doppelpunkt (Patient:innen)
Auf diese Weise können mehr Menschen im gesprochenen oder geschriebenen Wort inkludiert werden als beim generischen Maskulinum oder dem allgemeinen Verwenden von binären Bezeichnungen. Die Verwendung des generischen Maskulinums ist im Grunde auch eine Form des Genderns.  Im Gegensatz dazu wird die Verwendung von neutralen Begriffen entgendern genannt.  
 
Beispiele für geschlechtsneutrale Begriffe:
 
  • Studierende
  • Mitarbeitende 
  • Fachkräfte

Beim Sprechen kann ebenfalls die Doppelnennung verwendet werden. Außerdem kann eine kurze Pause beim Erreichen des Gender-Sterns/Gender-Gaps gemacht werden (also Patient – Pause – innen). Das ist in der deutschen Sprache schon bei vielen anderen Wörtern sehr geläufig und nennt sich Glottisschlag. So wird auch beispielsweise beim Wort “Spiegelei” eine Pause zwischen Spiegel und Ei gemacht. Beim Gendern funktioniert es genau gleich. 

Fest steht: Gendern ist Übungssache. So ungewohnt es am Anfang sein mag, schon nach kurzer Zeit fühlt es sich sehr normal an und schafft einen viel bewussteren Umgang mit Sprache. Dieser Leitfaden soll auch nur ein Hilfsmittel dafür sein, sich mit der eigenen Sprache auseinander zu setzen. Weitere Informationen findest du beispielsweise in diesen Büchern: 

Thema Suchmaschine:

Gerne wird als Gegenargument für Gendern auf der Website die schlechtere Auffindbarkeit über Suchmaschinen genannt. Viele geschlechtsneutrale Begriffe und Begriffe mit Gender-Symbol (wie *, :, _) haben im Vergleich zu aktuell noch geläufigeren Begriffen eine “bessere Auffindbarkeit”, wenn man diese auf der Website verwendet. Suchmaschinen sind aber durch Menschen gefüttert.

Mittlerweile haben diese auch das Gendern erkannt und verstehen teilweise schon sehr gut, dass es Begriffe mit der Nutzung von Gendersternchen etc. gibt. Zeitlich bedingt sind die Begriffe, vor allem die im generischen Maskulinum häufiger in Verwendung, dementsprechend tauchen bei männlich konnotierten Berufsbezeichnungen die häufigsten Suchergebnisse auf. Deshalb werden auch weiblich konnotierte Berufsbezeichnungen vergleichsweise schlechter gefunden. 

 

Gerne wird als Gegenargument für Gendern auf der Website die schlechtere Auffindbarkeit über Suchmaschinen genannt. Viele geschlechtsneutrale Begriffe und Begriffe mit Gender-Symbol (wie *, :, _) haben im Vergleich zu aktuell noch geläufigeren Begriffen eine “bessere Auffindbarkeit”, wenn man diese auf der Website verwendet. Suchmaschinen sind aber durch Menschen gefüttert.

Mittlerweile haben diese auch das Gendern erkannt und verstehen teilweise schon sehr gut, dass es Begriffe mit der Nutzung von Gendersternchen etc. gibt. Zeitlich bedingt sind die Begriffe, vor allem die im generischen Maskulinum häufiger in Verwendung, dementsprechend tauchen bei männlich konnotierten Berufsbezeichnungen die häufigsten Suchergebnisse auf. Deshalb werden auch weiblich konnotierte Berufsbezeichnungen vergleichsweise schlechter gefunden. 

Diese Thematik zu Umgehen ist unter anderem auch möglich, indem sich mensch auf die Praxis und den Fachbereich bezieht: Praxis für Dermatologie, Praxis für Zahnmedizin. 

Durch das gesellschaftliche Verständnis und der Wichtigkeit der Inklusion ist es eine Aufgabe für jede einzelne Person, bei sich selbst anzufangen. Denn durch die Anpassung der Sprache lernen Suchmaschinen mit und es ist kein “Verlust” zu befürchten. 

How is the content presented on my website and other online channels? 

The language and images I use on the practice website can influence how I am perceived by patients. 

This again includes the point mentioned above:

  • How do I user gender-neutral language on the website?
  • Do I include or exclude people based on the words I choose? 

How can I be an Ally? 

To briefly explain: 

An Ally is an ally who is aware of their own privileges and wants to support other people who do not share those privileges. 

The level of support can vary. 

Ask yourself:

  • Do I note on my website that all people are welcome (and not just “included”)?
  • Do I perhaps have a Pride sticker or other groups on the practice door or entryway?
  • Do I display info materials that adequately present realities of life outside of the white cis-heteronormative reality?

Why is this important?

The explicit presentation of well-known symbols of the LGBTQIA*, but also other communities, the same applies to information materials, can be meaningful signs that in a practice the perception and interest for inclusive work can be there. This can be shown by explicit mentioning and by symbols like stickers, rainbow flags etc.. But also information material from counseling centers that also do community work. In addition, this brings more security for patients that they can show themselves to you without fear of conscious or unconscious discrimination.

How is my practice designed?

Is my practice a place where everyone can feel comfortable? For example, do I offer gender-neutral restrooms? As a gynecological practice, do I make sure that I do not only address cis women*? 

Accessibility:

  • Is my practice accessible for people with visual impairments or if they are dependent on a wheelchair, for example?
  • Are there orientation aids for blind and visually impaired people?
  • If the entrance to the practice has steps: Is there the possibility of adding a ramp or can home visits be explicitly offered if the practice cannot be reached?
  • Is the website designed with userfriendly in mind? Is the website readable with a screen reader? 

Cis is the opposite of trans*. Cis people are therefore anyone who identifies with their assigned gender.

Non-binarity is a gender identity and can be used when one does not identify with either the male or female gender. In addition, many other gender identities exist (agender, genderfluid, genderqueer, …). With which gender one identifies is always a self-definition. 

Do I regularly educate myself and my practice team (if any)?

How do I treat people respectfully and sensitively? In 2018, the German Aids Federation published a video series on the different experiences of trans* people and people with an international background in practices.

https://youtube.com/playlist?list=PLuH6iwplsOSKA0TGDp4pKdAM7wx7howVu

In these videos, with the help of re-enacted scenes, the microaggressions that arise during a visit to a practice and the concerns of the patients concerned are shown. This reflects exactly what sensitive and respectful doctors and therapists should avoid in their own dealings with patients.

Professional        

Do I attend professional events to educate myself in medical fields that would be particularly relevant to the specific groups of people (queer community, BIPOCs, AHDS…)? 

Online there is a wide range of events, especially critical ASta groups advertise on social media for events on relevant topics e.g. “gendering in medicine”. At the same time, there are various continuing education centers throughout Germany. 

Personal approach

Do I deal with the topic in my private environment? How do I talk about the interests of the LGBTQIA* community in my own environment? Do I address other people’s microaggressions? Do I intervene when I see discrimination against others in front of me? Do I talk to people in the community, read books that address the issue, and take a critical look at my own behavior? Especially in large cities, there are more and more courses or events on how to deal with people in a sensitized way. 

For psychotherapists

Have I taken further training in sexual and/or gender identity or to become a sex therapist? 

How do I hire practice staff? Do I make sure to build a diverse team? 

Questions you should ask yourself when creating job postings and for website presentation:

Are my job postings characteristic neutral?

Are my job descriptions characteristic-neutral (“young team”, “German as native language”, “agile team”, etc.)? Certain descriptions can discourage certain groups of people from even submitting an application because they do not see themselves in the group described.

Do I make sure the job description is diverse and inclusive?

Do I make sure the job description is diverse and inclusive? Are there job titles that can be used in a gender-neutral way? Do I point out the now very common variant of (m/f/x)? Do I make sure that no group of people feels excluded by my job posting? Is it also possible to send anonymous applications (without name, age, photo)?

Personal development

Do I want potential applicants to have already dealt with the topic themselves? Do I ask this in an interview? How do I prepare for an interview?

Microaggressions

Do I recognize subconscious microaggressions in myself toward People of Color or perceived members of the LGBTQIA* community in the hiring process?

Microaggressions are perceived assaultive statements in everyday language. This involves consciously or unconsciously sending pejorative messages. These can be subtle, but also explicit.

Presence

How do I present myself and, if applicable, the practice team on the website? You can find more information here in a guide to the non-discriminatory hiring process from the Anti-Discrimination Agency of the Federal Republic of Germany.

Do I advocate for the political interests of LGTBQIA* and other communities?

On the one hand, I can participate in events that cater to the LGBTQIA* community (CSD/Pride Parade with political discussions, online events by large organizations like LSVD/ HOSI, etc.). Do I have resources to organize my own events? Can I donate regularly to an organization to support their work within the LGTBQIA* community? 

In addition, I can advocate for initiatives or legislative changes to be made in favor of the LGTBQIA* community (Ex. Transsexual Law, Adoption Law, Inheritance Law, Simplification of Blood Donations…). 

There are counseling centers, especially in the larger cities, which are a good point of contact for people who want to seek help. 

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