Photo credit: Gript

HSE guide for healthcare workers urges use of “ze” pronouns

An official HSE guide for healthcare workers has urged the use of “non-binary” gender pronouns, including “they” and “ze”, if a patient requests it.

The 40-page document, entitled the HSE Rainbow Badge, is described as a “practice guide” for healthcare professionals, and was initially published in 2021. Its stated purpose is to outline the ways in which doctors and nurses should speak LGBTQI+ patients.


The HSE document claims that “biological sex” is a “spectrum” rather than a binary, saying: “Biological sex [is] a medical term used to refer to the chromosomal hormonal and anatomical characteristics that are used to classify and individual as male, female or intersex.”

It adds: “Often seen as binary, but its more accurate to view this as a spectrum. Commonly conflated with gender.”


On the topic of gender pronouns, the text says that “we all have pronouns that we go by,” and includes a list of examples, including He/Him, She/Her, They/Them, Xe/Xir, and Ze/Zir.

“Name and pronouns are a common way to communicate one’s gender and sexuality,” it reads.

“Honouring a person’s name and pronouns shows respect and is a basic acknowledgement of the person’s identity.”

It adds: “Keep in mind that some people use non-traditional pronouns to refer to themselves (they, ze). You may need to practice using these terms if you are not familiar.”

It says that medical staff must use a person’s pronouns “even if you don’t understand or don’t feel comfortable,” adding: “Do not refer to your own religious or moral beliefs about LGBTI+ people.”


However, the HSE document goes on to explain that for “gender fluid” people, it may be appropriate to not use a label at all.

“If a person’s gender is fluid, sometimes it can feel more liberating or accurate not to label oneself,” the text reads.

“For others who are questioning or exploring their gender or sexuality it may be more comfortable
not labelling or committing to one right away.”

The document defines “gender fluid” as a person whose gender identity changes from male, to female, and back and forth, depending on the day.

“Fluid(ity) describes an identity that may change or shift over time…It is described as a gender identity that is a dynamic mix of maleness and femaleness.”

The definition adds: “A person who is gender fluid may always feel like a mix of the two traditional genders, but may feel more man some days, and more woman other days.”


Similarly, it discusses the phrase “non-binary” as meaning a gender identity which is neither male nor female.

As a way of catering to “non-binary” people, the guide encourages using the title “Mx.” rather than “Mr.”, “Ms.” or “Mrs.,” saying that “Mx.” is “gender-neutral.”


The HSE guide then goes on to claim that all “cisgender” people – that is, people who are not transgender – have “privilege” within society, and are given unearned special advantages. It urges all cisgender people to “be accountable” for their “privileges,” adding: “do not justify your behaviour or defend your intentions” if you offend someone.

“Be mindful of your privilege,” the document reads, adding that the reader should “check your privilege.”

“Privilege is a term used to describe any unearned advantages that someone may have in society because of their identity or group memberships. Privilege is not something a person choses [sic] to receive or dismiss. It is automatically granted based on their identity…”

It adds that “some privileged identities include cisgender, ethnicity, male, heterosexual, disability status, religion and social class.”

It later adds that LGBT ethnic and cultural minorities face “double discrimination” as “both immigrations and LGBTI+ people,” and says that the disabled face discrimination in the form of “lack of recognition of the disabled as sexual beings.”

Gript previously reported how an HSE sex education booklet explicitly directed at 8-year-old primary school students has told children that they can identify as “a boy, a girl, neither or both.”

It claims that children may identify as “transgender,” and that transgender individuals “may want to live their lives as boys, some as girls, some somewhere in between and some as no gender at all.”

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