Here's why it's crucial to make sure you're calling everyone by their chosen name.

By Maggie O'Neill
July 28, 2020

Many of us are assigned a name at birth or early on by our parents or caregivers and don't really think much of it—we go through our lives introducing ourselves by that name, responding to it, and labeling our social media accounts with some variation of it.

But for transgender people—or those whose personal identity and gender don't align with their birth sex—their given names don't always line up with how they see themselves, and they often choose another name that's more fitting. It seems simple enough, but in choosing a new name for themselves, transgender individuals run the risk of being "deadnamed"—an often hurtful and potentially dangerous occurrence for anyone who has chosen a different name.

But what does it mean to deadname someone—and how can you avoid doing that and causing unnecessary harm? Here's what gender and sexuality experts say about what deadnaming is, how it affects those who are deadnamed, and what we all can do about it.

What is deadnaming?

Put simply, deadnaming is “not using someone’s chosen name,” Samantha Busa, PsyD, clinical director of the Gender and Sexuality Service at NYU Langone Health’s Department of Child and Adolescent Psychiatry, tells Health. For the most part, deadnaming affects transgender individuals who have chosen to go by a new name when someone—intentionally or unintentionally—uses the name they no longer identify with.

It's also important to use the correct terminology when referring to someone's chosen name. “We’re trying to move away from ‘preferred' [name]," Caroline Salas-Humara, MD, medical director of the Transgender Youth Health Program at NYU Langone’s Hassenfeld Children’s Hospital, tells Health. That's because "preferred" signals the assumption that non-transgender people have a choice in how they address transgender people, which isn’t true. There’s a correct name and an incorrect name, and the use of “preferred” frames the conversation in a misleading way. “It’s definitely more accurate to say ‘chosen name’ [and] ‘pronouns,’” Rodrigo Heng-Lehtinen, deputy executive director of the National Center for Transgender Equality, tells Health.

Deadnaming can happen in one of two ways: verbally or on paper, Dr. Salas-Humara says. The verbal instance is pretty simple to explain; it happens when someone slips and uses the individual’s old name (or intentionally refuses to use their chosen name) in a conversation.

The second instance of deadnaming—on public records or other documents—is often more formal and may be especially challenging to deal with. It can be difficult to go through the process of changing your name at every office that keeps your records. School systems, banks, doctor’s offices—the list of institutions that have your name on file are countless, and it can be extremely difficult to correct your name at all of those different places, due to financial concerns and safety reasons, among other barriers, especially if you haven’t come out to everyone.

A prime example of deadnaming is the interaction between nurses and patients in waiting rooms, Heng-Lehtinen says. Because nurses will use the name on medical forms, it's very possible that they'll call out a transgender individual's incorrect name in a waiting room—which then forces that person to respond in order to gain access to the doctor they've come to see. In that situation, the nurse unintentionally deadnames and outs the transgender person.

What effect does deadnaming have on transgender individuals?

On a very basic level, deadnaming is unkind. “When someone refuses to use a person’s chosen name, it signals disrespect. It signals they think the other person doesn’t really matter,” Heng-Lehtinen says. “When you’re trans, [deadnaming] feels so dismissive.”

Of course, it goes deeper than that, too—those who are deadnamed often have higher instances of depression, as well as suicidal ideation and behaviors. "We know the use of the deadname can be associated with poorer mental health outcomes," Dr. Busa says.

Research published in the Journal of Adolescent Health in 2018 backs up Dr. Busa's claim. The paper's authors collected data from 129 people aged 15 to 21, all of whom were transgender or gender nonconforming. Seventy-four of the 129 individuals used a chosen name that differed from the name they were given at birth. The paper's authors found that the use of one's chosen name (as opposed to their deadname) was linked to "a 29% decrease in suicidal ideation, and a 56% decrease in suicidal behavior." The authors also note that the use of the chosen name helps decrease health concerns transgender people are prone to: "For transgender youth who choose a name different from the name given at birth, use of their chosen name in multiple contexts appears to affirm their gender identity and lower mental health risks known to be high in this group."

While the psychological effects are pretty straightforward, less obvious (but just as detrimental) are the potential effects of deadnaming on physical health. For instance, Heng-Lehtinen says, if a doctor’s office won’t use a patient’s chosen name, “it makes that person less likely to access services in the future. [These are] tangible consequences—stopping that person from accessing medical care." This could contribute to the many health disparities within the LGBTQ community, like an increased risk of sexually-transmitted infections, substance abuse, mental health conditions, and eating disorders.

How to avoid deadnaming someone—and what to do if you've been deadnamed

There’s a huge difference between accidentally deadnaming someone and refusing to acknowledge their chosen identity. Accidentally deadnaming someone could come from a place of uncertainty—but when you’re uncertain about which name you should be using to address someone, it’s best to simply ask them, Heng-Lehtinen says. That means avoiding making a conversation unnecessarily awkward by speaking or writing in an unnatural way to avoid using someone's name.

The best option: If you're unsure about a person's chosen name, ask them in private. That way, you can let them tell you in a safe space so you don't unintentionally out them to others. The quick and simple fix also helps to protect the the other person's safety. (If you use the wrong name in front of people to whom the transgender individual hasn't come out yet, you could potentially put them in an unsafe situation.)

If you do accidentally use the wrong name, it’s important to quickly apologize and move on. “Mistakes do happen. When a mistake is made, quickly apologize,” Dr. Salas-Humara says. What you shouldn’t do is launch into an elaborate speech about how you’re trying to use the correct name, thus putting the emphasis on yourself. A simple apology with something like “I’m doing my best” will suffice. But that apology is crucial—you might feel uncertain about whether or not you should acknowledge the mistake but you definitely should, Heng-Lehtinen says. Here’s why: If you don’t, the transgender individual you’re addressing won’t know if it really was an accident or if you were intentionally ignoring their chosen identity.

On the flip side, if you are transgender, there are a few steps you can take to decrease your chances of being deadnamed, Heng-Lehtinen says. "The more you can do in advance, the better," he says. For instance, if you're enrolling in classes and you know your deadname is likely to appear on your professors' attendance sheets, email them ahead of the first class to clarify your chosen name. The key here is to give people advance notice, Heng-Lehtinen says, explaining that it might take them awhile to change your name in their computer system, not because they're being disrespectful to the trans community, but because they simply don't know how to go about changing a student's name.

And if you're in a situation where you're repeatedly being deadnamed by someone, such as a health care provider, Heng-Lehtinen offers this: "I would say not to be afraid to say something." This can be tricky in settings like doctor's offices, he adds, explaining that there is oftentimes a power dynamic between patient and provider. It could be helpful to practice what you'll say before you go to the appointment, since it might be nerve-racking to try to articulate your thoughts in the moment. "Try to anticipate that nervousness and get out ahead of it; rehearse with yourself in advance, [and] be ready with a sentence." Two more tips: Bring a friend who always refers to you as your chosen name, and, if you can, make sure you have a document with your chosen name on hand, even if it's not a legal document. A student ID card, for example, might do the trick. "It does demonstrate to your provider this is worth taking seriously," Heng-Lehtinen says.

This also underscores the importance of providers—or any service-based profession, really—checking to make sure they're using a person's chosen name and being mindful of how they're collecting information, Heng-Lehtinen says. In this case, verbal acknowledgement of a name change can be safer than blindly following what's been written down on a form. The fix in doctor's offices could be as simple as having the receptionist who checks people in confirm that they want to go by the name that comes up on the check-in screen or appears on their chart.

Really, the issue of deadnaming boils down to respect, education, and awareness. In learning the right way to address someone—and then actually doing it correctly—we all can make this world a safer and more inclusive place for everyone.

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