One of the Irish State’s leading official mental health authorities is urging staff to use gender pronouns such as “xe/xem/xyr” and to learn about genders such as “omnisexual”, “panromantic”, “demi-girl” and more.
The Mental Health Commission, which is an Irish State agency, says it exists to establish “high standards and good practices” when it comes to the provision of mental health services in Ireland.
STATE AGENCY GUIDANCE ON PRONOUNS AND IDENTITIES
In a document released this year entitled “Guidance for Staff working in Mental Health Services on the Care and Treatment of LGBTQIA+ People”, the Commission says its goal is to help healthcare professionals support “LGBTQIA+” people, adding that the ‘+’ signifies “inclusivity to all sexual and gender identities.”
TRINITY COLLEGE COMMISSIONED TO REVIEW “BEST PRACTICE” INTERNATIONALLY
It is claimed that “following a tender process”, Trinity College Dublin was commissioned to conduct “an in-depth evidence review” of “best practice and policy” internationally, led by Professor Louise Doyle.
“The MHC also undertook an extensive public consultation process to inform the document,” they add.
POWER, PRIVILEGE AND “MICRO-AGGRESSIONS” FRAMEWORK
The document states that staff should use “affirmative approaches and inclusive language, and have “an understanding of LGBTQIA+ relationships, terminology and subcultures.”
“[Staff should] be grounded within a framework of cultural humility which encourages ongoing reflection of one’s own power and privilege, personal biases and heteronormative and cisgender assumptions and the impact of these on LGBTQIA+ service users,” the report states, adding that individuals must be careful to avoid “micro-aggressions”.
“LGBTQIA+ people may look for visual indicators of safety and inclusion,” it adds.
VISUAL CUES: FLAGS AND “INTERSECTING IDENTITIES”
The report says mental health services should make their inclusivity visible to service users through clear and deliberate visual cues.
It states that “an inclusive mental health setting needs to show that it is inclusive in the first instance through the means of visual cues”, and outlines a range of measures it says can help communicate a welcoming environment.
These include the prominent display of rainbow posters or flags, particularly those reflecting “intersecting identities”. The report refers to the use of the intersectional pride flag, which it says incorporates black and brown stripes to represent marginalised non-white people, alongside the blue, white and pink colours of the transgender flag, which it says “may send a clearer message of welcome to transgender service users”.
LANYARDS, PRONOUN BADGES AND AFFIRMING POSTERS IN WAITING ROOMS
The report also recommends the use of rainbow lanyards and rainbow name badges, including the display of staff pronouns. It calls for the availability of LGBTQIA+ information leaflets, including contact details for LGBTQIA+ helplines and other support services.
In addition, the report advises that posters depicting diverse families and same-sex couples should be readily visible, and that services should display an explicit affirming message in a prominent location, such as a waiting room or reception area, to demonstrate that the service is inclusive.
RECRUIT LGBTQIA+ STAFF AND EXPAND GENDER OPTIONS ON DOCUMENTS
They also urge the recruitment of LGBTQIA+ staff to increase visibility, and that documents should have more gender options than just male or female to ensure inclusivity.
“Mental health services should assess their clinical documentation (both paper and electronic), including assessment forms, demographic forms and admission forms, to ensure they are inclusive of LGBTQIA+ people,” it reads.
REPLACE “MALE” AND “FEMALE” WITH FREE-TEXT GENDER FIELDS
The report sets out a number of practical measures aimed at making services more inclusive for LGBT service users.
It recommends replacing binary “male” and “female” options on admission forms with a free-text field for gender. It says sex at birth should be collected separately and only where it is clinically necessary. The report also advises staff to ask open-ended questions such as “what are your pronouns?”, “how do you describe your sexual orientation?” and “how do you describe your gender?”, allowing service users to define their own identities.
“MOTHER” AND “FATHER” TO BE REPLACED WITH “PARENT 1” AND “PARENT 2”
For forms involving children and young people, the report suggests replacing references to “mother” and “father” with “parent 1” and “parent 2”, noting that some service users may have two mothers or two fathers.
REMOVE MR/MS/MRS – ADD “MX” OPTION
It further recommends removing titles such as Mr, Ms and Mrs from letters, referrals and other documentation where they are not necessary, and modifying software systems so titles can be left blank. Where a title is required, the report advises including the option “Mx”, which it says is used by some non-binary people.
STAFF ASKED TO LEARN EXTENSIVE LIST OF SEXUALITY AND GENDER TERMS
The document asks staff to familiarise themselves with a number of terms, including “androsexual”, “agender”, “aromantic”, “asexual”/”ace”, “aroace”, “bisexual”, “BIPOC”, “bi-erasure, “cisgender”, “demi-girl”, “demisexual”, “gender fluid”, “genderqueer” “gynosexual”, “hate speech, “heteroflexible”, “heteronormative”, “heterosexism”, “omnisexual”, “pansexual”, “panromantic,” “queer”, “transmasculine”, “transfeminine”, “microaggressions,” “internalised homophobia,” and much more.
NEOPRONOUNS LISTED AS ALTERNATIVES TO “HE” AND “SHE”
They also list a number of “neopronouns” which can be used as an alternative to “he” or “she”, such as “they,” “xe/xem/xyr”, “ze/hir/hirs”, and “ey/em/eir”.
CLAIMED MENTAL HEALTH GAP AND CAUSES
“There is a significant body of research that has consistently demonstrated that LGBTQIA+ people experience a disproportionate burden of mental health difficulties compared to the general population,” the report reads, claiming that this is in part due to a lack of support from healthcare practitioners.