A Black Trans Woman’s Dignity
A Black trans woman in her 50s is admitted. Staff keep “forgetting” her pronouns, and one comments on her body. She feels erased.
The scenario
Ms. Carter is a 54-year-old Black woman. She was assigned male at birth and has lived as a woman for over 30 years. She uses she/her pronouns and the name Serena — not the legal name still on some of her paperwork. She was admitted to your retirement home two weeks ago after a fall at home.
From the first shift, pronouns have been a struggle. Some staff say “he” and use her old name, then catch themselves. Others do not catch themselves at all. The whiteboard outside her room reads “Mr. [legal surname].” At handover, a nurse refers to her as “the trans one in 12.” This morning, during personal care, a PSW said, “I just don’t understand why you’d do that to yourself — you were probably a handsome man.”
Serena has not complained. She is polite, soft-spoken, and increasingly withdrawn. She has declined recreation twice this week. When her sister visited, Serena asked her to “check whether people here see me as a woman or as a problem.”
The challenge
What makes this hard—and what is at stake.
This is hard because more than one thing is happening at once. There is the pronoun problem, the deadnaming, the signage, the comment about her body — and underneath all of it, the experience of a Black woman wondering whether she is being seen as a woman at all, or as a curiosity. Staff discomfort with gender identity and unexamined racial dynamics pile on top of each other, and Serena is left to carry all of it alone.
The power imbalance is real: she depends on these staff for personal care, and she cannot easily leave. A manager who addresses only the pronouns but not the comment, or only the comment but not the signage, will fix the surface and miss the pattern. And if the response feels like punishment, staff may resent Serena rather than learn.
Your response
What would you do in this moment?
Take a moment to think about how you would respond. There is no “right” answer—just your thoughtful response. Type it below before you look at the possible approaches.
The fact that you are thinking about this shows you care.
Possible responses
Not “right” vs “wrong”—more helpful and less helpful. Reveal them one at a time, or all at once.
People are trying their best—including the staff in the less helpful approaches. Learning takes practice. You are doing the right thing by thinking this through.
What matters most
Key takeaways
- Get the visible things right today — name on the door, pronouns at handover, the chart. Consistency across every shift is what makes a person feel seen.
- Name the specific behaviour when you coach. “That comment about her body is not okay” is clearer and kinder than a lecture on transphobia.
- Ask the resident what would help. They are the expert on their own dignity.
- Notice when more than one form of bias is in play. A Black trans woman is navigating both racism and transphobia — address the whole pattern, not just the easiest piece.
Reflection & discussion
Conversation starters for your team huddle
These are not interrogations—they are ways to talk together about what would help.
- What would you do if you overheard a colleague refer to a resident as “the trans one”?
- Have you ever avoided a resident because you were unsure how to act? What would help you feel more confident?
- How would you respond if Serena told you she feels unseen — and you are part of the team she is describing?
- What would it look like to follow up with her in a week so she knows the change is real?
Related resources
FAQs
Keep practicing
Pronouns and Dementia: Respecting Identity