Language, changing names and pronouns

We asked parents and carers of trans and gender diverse children how they learned about the different terms and identities related to gender identity and diversity. We also talked to them about their children changing names and pronouns. In this section, you can read and hear what they said about:
  • Learning about different ways people identify;
  • Their child’s change of name and pronouns and how they got used to it;
  • Technical issues with changing a name within healthcare.

Language diversity

The language around gender diversity is ever changing as people look for terms and ways of describing themselves that better reflect who they are. For some of the parents we spoke to, their child coming out as trans or non-binary was an opportunity to learn about the ‘vast array’ of ways people identify, as one parent put it.
Ali talked about learning about this when her daughter entered the NHS Gender Identity Development Services (GIDS). For VM, her daughter educated her on the importance of using the right pronouns. She felt having a trans daughter has made her more sensitive to how she speaks and what assumptions she makes when talking to others. Oonagh spoke about how she educated herself about the different terms and how she thought it was inclusive to display one’s pronouns.

Ali learned about the many ways people can identify when her daughter started attending the Gender Identity Development Services.

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So, how did you first learn about the different terms and identities related to gender identity and diversity?

Basic ones Ive known since probably I was about 18. But you know, formal terms like assigned gender the being gender fluid or these things I, it was not, well the terms, until two or three years ago when my daughter started to attending the [Gender Identity Development Service]. I had a vague awareness but not in any depth before that. So it’s not until we actually started at the Gender Identity Services that I became aware of just how vast array there is.

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VM’s daughter educated her on pronouns. She feels that she is now more aware of diversity and less quick to make assumptions about others.

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How did you first learn about different terms and identities related to gender diversity?

Oh right, well, [laughs] I think she had to explain the pronoun things and then, then I got more up, I suppose it was like a learning curve and we just had to get on with it and do it. And it makes you much more aware how you, what you say to people. I find myself now saying to people, I never assume if I’m talking to a woman, I never assume her partner is a man. So and that’s the thing I always use the phrase partner until they made it very clear how they identify their partner. I just think it makes you a bit more careful. In a funny sort of way, I think it broadens your outlook onto people, because you don’t, you, you do still stereotype people, but you are much more open about how you’re going to view people. And, and I think that’s all for the best, really.

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Oonagh talks about knowing the term ‘transgender’, but was confused about the LGBTQ umbrella term and how she tried to educate herself about the use of pronouns.

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Well Ive always known about transgender being a term and but I didnt really know about the difference between transsexual and transgender. I was a bit confused about that and then, and then I was, I was with the LGBTQ umbrella, you know, the terminology. Ive tried to educate myself about what that one means. It’s, it’s confusing initially for somebody that has got no knowledge. I had some but there were a lot of people that have literally no knowledge whatsoever. So things like pronouns. Ive learned a lot about, about why it’s necessary to for example display your pronouns, to be inclusive.

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Changing names and pronouns

A trans, or gender diverse person might want to change their name, or use different pronouns that better reflect their gender identity. They might also wish to change their title. Name changes can be informal, or it can be made official when it is done by Deed Poll. For children under the age of 16 the Deed Poll name change needs to be done by parents and everyone with parental responsibility needs to agree. Changing their child’s name by Deed Poll means that parents can get all of their child’s official documents and records changed to their child’s new name, including the child’s passport and school register. Changing name and title does not change a person’s legal gender. This can only be achieved by getting a Gender Recognition Certificate.
For Georgina whose ex-partner and the father of her son was not supportive of her son’s transition, this was a reason for concern. She felt her son’s father might oppose the change of name by Deed Poll. She was also slightly hesitant about it, but said she wanted it done before secondary school.

Georgina worried her son’s father would not support the name change by Deed Poll.

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I havent done his Deed Poll yet. And the reason is partly because my ex-husband is in, let’s put inverted commas, no rus, which I think means don’t do it yet or otherwise Ill be cross. But also, right at the beginning I very much thought let’s see how long this lasts. It could well be a phase. Obviously, now were nearly four years, four years in, I think. I think it makes sense to do it before secondary school, if I’m honest, because of exams and stuff.

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Read more about what happens if only one parent supports transition. Some young people might prefer the use of singular they/them/their instead of the binary ‘he/him’ and ‘she/her’ pronouns. Others are happy to change from feminine to masculine pronouns, or the other way around when they change their name and/or socially transition.
Name and pronouns changes can be an adjustment for the family. Most parents we spoke to supported their child changing name and pronouns, but also talked about a period of getting used to the change.

It took Leigh some time to get used to her foster son’s new name, but now it is hard for her to think of him in any other way.

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Maybe eight to ten weeks I really struggled, to the point where I said, right, that’s it, nobody’s got a name. Everybody is just kids. Cause it was easier [laughs]. But no, I mean, it now I do have conversations with other people who when I refer back to how, back to my child as his birth gender, it takes me a few seconds to remember, you know, I have to access that information from deep, deep, deep in my brain, because it’s not something that I use every day now. You know, he’s just who he is. He’s just a happy, healthy, moody teenager [laughs].

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E and D found the pronoun change to be more difficult than the change of name.

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Father: Well it was, like I say, I think that was the thing that was most difficult was name not his first name change, I think was change of pronouns.

Mother: We didn’t do it. Not for a while.

Father: No, some of our friends who, who we obviously we told our close friends about this and they probably adapted quicker than we did [laughs], I think, some of them

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Once an initial period of adjustment was over, parents often said that using their child’s old, or ‘dead name’ and pronouns felt very odd. Richard said he would ‘feel really awkward’ if he used the wrong pronouns for his daughter, but could remember accidentally doing so in the past. His approach was not to draw too much attention to such mistakes.

For Richard the thought of saying the wrong name, or using the wrong pronouns for his daughter felt odd.

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If I said he’ instead of she’ in reference to my daughter, I’d feel really awkward. I think it’s something which I may have done a couple of times a few months ago, but I don’t think I have for a few years. It feels like this has been our reality for probably longer than it has, to be honest. So, the thought of saying the wrong name or saying the wrong he’ or she’ seems really distant, although I think I probably have done that, accidentally and just sort of move on from it as quickly as possible, rather than draw too much attention to it.

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The way a young person identifies and wants to be addressed might change over time. Ross’s child preferred to use ‘Mx’ as a title, but started using ‘Mr’ when they began taking hormones. Ross thought that ‘Mx’ was a good option for trans people. He also thought it could be helpful for health professionals, as it would indicate that the person in front of them might for example need a smear test that they would not be likely be offer to someone who used the male title ‘Mr.’ Many trans people who transition will use a title like ‘Mr’ either because they are male, or because they want to avoid being outed when accessing medical treatment. However, it is ultimately a young trans person’s decision what title they use.

Ross talked about how his child’s title preference has changed and how he thought ‘Mx’ might be a good option for trans people.

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They use Mx on a lot of things. They use Mr a lot more now, now theyre on hormone treatment. Pre hormone treatment they would refer as Mx or identify as Mx. The GP pointed out to us that Mx is a very, very good thing on the NHS records, because if there was ever a car crash, a nasty emergency accident and you’re rushed into a strange hospital where they don’t know you or hospital abroad for example. If your pronoun is Mx immediately it’s gonna make them look twice, because they don’t get many Mxs. If it’s Mr or Mrs, especially with my child’s situation where anatomically certainly the downstairs department will be female. If you need an emergency operation, but you’re identifying as male and on your records you’re Mr then all of a sudden they remove clothes and find that you’re not a Mr, it could delay things by seconds which could mean life and death kind of thing. And it was our GP that explained that, because they are a really good, supportive GP that looked into things and looked kind of outside the box a little bit and said, they suggested that we keep Mx for all medical records, because later in life, you’re still gonna need the smear test. And a computer that’s looking in black and white, if you’re identifying as Mr you’re not gonna be invited in for a smear test because you wouldn’t need to be. Whereas if you’re Mx the computer, even a computer is gonna go, Eh, that’s a bit weird. We don’t get many of them. So somebody’s gonna look at it more than once, which I think is a good thing, having just that option on forms, on all sorts of kind of formal things, having it as an option. It draws attention to it, which some trans people may find offensive or not want to do. But they do have free will to put Mr or Mrs, but if you don’t have the option of Mx well then youve got to choose one or the other.

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Whilst most parents and carers we spoke to respected their children’s wishes when it comes to names, titles and pronouns, not everyone did. Elijah was not supportive of his child wanting to use a different name or pronoun and thought going along with it was ‘not the correct approach.’ He described a split in school between teachers who used the new name and those who did not. It is important to note that parental support and acceptance are key to the wellbeing and mental health of young trans and gender diverse people and so is access to timely care. Denial and delaying of care causes harm.*

Elijah spoke about his child’s name change at school and how he and his wife do not support their child’s wish to change their name.

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So, some arrangements were made. Where it is at the moment, some teachers, she’s got a new, she’s got a name as such at school now. She goes by a nickname with her friends and teachers. it’s not a, yeah, I won’t go into too much detail, because it will be identifying. But she has a nickname which she uses at school. Some teachers use it and some teachers don’t. It seems to be a split between the arts and the sciences who uses it and who doesn’t. And that’s fine as her friends go. We call her naturally by her proper name at home. And we don’t use any pronouns, new pronouns. We’re quite firm on this, because from our point of view, as parents, we need to stay firm a troubled 13 year old cannot make momentous decisions about which go into a life of medicalisation and surgery. So we need to stay firm and compassionate, but firm in this. We don’t want to feed into this. Unfortunately, some elements of the school refer to my daughter as he and make a point of doing so. The health service, when speaking to some healthcare professionals they’ll make a point of saying, he. I don’t believe this is the correct approach.

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Technical issues with changing a name within healthcare

Name changes can sometimes create difficulties for electronic records and systems. Lisa spoke about how for her son, the change of name caused some technical issues and some of his medical records being lost as a result. This meant that he had to undergo an assessment that Lisa felt was unnecessary.

Lisa talked about some of her son’s medical records being lost because of the name change.

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They have lost some of his blood test results in changing his record from the earlier record to the new record in his male name. In merging those two records, the test results from the original medical record have been lost, somehow in the merge. So, that’s a technical issue, which they haven’t been able to resolve. So, we’ve lost all of his blood tests that he had done before his transition, which has made it really difficult then to demonstrate that before he started the hormone blockers, he was already at Tanner Stage 2, which is the requisite stage for endocrinology, to prescribe blockers. So, because of that technical issue, we are now finding ourselves having to undergo and assessment process which I think is unnecessary.

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Lisa also talked about how a name change within the healthcare system can lead to other issues. When her son’s name was changed, initially it was still displayed with ‘Miss’ as the title, despite it being a male name. She talked about how her and her son laughed about it. Her take on situations like that was to be understanding. She said: ‘People are gonna get it wrong sometimes and we just have to ask them to put it right and understand that not everybody gets it.’
You might also be interested to read about people’s experiences with GPs and what advice parents and carers had for health professionals.
* See for example:
Puckett, J. A., Matsuno, E., Dyar, C., Mustanski, B., & Newcomb, M. E. (2019). Mental health and resilience in transgender individuals: What type of support makes a difference? Journal of Family Psychology 33(8).
Simons, L., Schrager, S. M., Clark, L. F., Belzer, M., & Olson, J. (2013). Parental support and mental health among transgender adolescents. Journal of Adolescent Health, 53(6).
Priest, M. (2019) Transgender Children and the Right to Transition: Medical Ethics When Parents Mean Well but Cause Harm, The American Journal of Bioethics, 19(2).

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