TOP 39 - Provider Attitudes and Practices on Pronoun Use in the Pediatric Emergency Department

Publication Number: 4741.TOP 39

Hannah Grierson, Icahn School of Medicine at Mount Sinai, Brooklyn, NY, United States; Morgan Bowling, Icahn School of Medicine at Mount Sinai, New York, NY, United States

Background: Affirming a patient’s name and pronouns is a core element of gender-affirming care and is linked to improved mental health among transgender and gender-diverse (TGD) youth (Hoffman et al., 2022). Pediatric emergency departments (EDs) often serve as first contact points for adolescents in crisis, yet studies show inconsistent pronoun documentation and limited provider training (Jacobs et al., 2022; Adams et al., 2023). While electronic health record prompts and staff education improve inclusive practices, provider-level factors shaping comfort, attitudes, and barriers in pediatric EDs remain underexplored. Understanding these factors is essential to inform education and policy that promote equitable, gender-affirming care.

Objective: To examine how provider demographics—including role, training, and identity—relate to attitudes, comfort, and perceived barriers in asking for and using patient pronouns in pediatric emergency settings. Secondary aims include evaluating the effect of prior gender-affirming care training on confidence and identifying interest in further education or institutional protocols.

Design/Methods: This cross-sectional, anonymous national survey targets pediatric emergency medicine (PEM) attendings, fellows, pediatric and emergency medicine residents, and advanced practice providers. The REDCap-hosted survey will be distributed via program directors, professional societies, and listservs. Domains include demographics, attitudes and practices, comfort and barriers, and prior training. Quantitative data will undergo descriptive, bivariate, and multivariable analyses to identify predictors of comfort and support for pronoun use. Open-ended responses will undergo thematic analysis to characterize challenges and solutions. Data collection is complete as of November 2025, with analysis and dissemination planned for December 2025 through early 2026. This study is IRB-approved as exempt through the Mount Sinai Institutional Review Board (STUDY-25-00861).