Staff Discomfort with Intersex Identity
An intersex resident in their 40s hears a staff member say “that’s not natural” and “God made you one way.” They feel judged and unsafe.
The scenario
Alex is 46 and intersex — born with sex characteristics that do not fit typical definitions of male or female. They use they/them pronouns. They are in your long-term care home recovering from a long illness and need help with personal care and medication management. They are private about their history but have shared what staff need to know for their care.
During a personal-care moment, a PSW who has been kind in other ways suddenly goes quiet, then says, “I am sorry, I just — I do not understand this. That is not natural. God made you one way for a reason.” Another staff member, hearing this, says nothing and looks away. Alex freezes. The care continues in silence.
That evening, Alex tells a nurse they trust: “I do not feel safe here. I do not know who thinks I am a mistake.” They ask whether that PSW will be on their care team again. They have not told their partner what was said.
The challenge
What makes this hard—and what is at stake.
This is hard because it sits right at the line between personal belief and professional duty. The PSW was not being cruel for the sake of it — they were expressing a sincerely held belief in a moment that felt uncomfortable to them. But a resident’s body is not the place to work that out, and “God made you one way” told a real person that who they are is a mistake.
The stakes are safety and trust. Alex is now scanning the team for who else might think this way. If the manager handles it as “everyone is entitled to their beliefs” and nothing changes, Alex learns that belief outranks their dignity here. If the manager punishes harshly without a conversation, the PSW may resent Alex and the team may close ranks. The path through is to separate belief from conduct clearly and kindly.
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
- You cannot police belief, and you should not try. You can and must hold the line on conduct: every resident gets respectful care from every team member.
- A resident’s body and identity are never the place to work out your discomfort. Keep it out of the care.
- When a resident says they feel unsafe, act the same day, tell them what you did, and follow up to prove it held.
- Do not ask the person who was harmed to be “understanding” about being told they are a mistake. That takes the wrong side.
Reflection & discussion
Conversation starters for your team huddle
These are not interrogations—they are ways to talk together about what would help.
- How would you separate a colleague’s sincere belief from their professional conduct in a conversation?
- Have you ever felt uncomfortable caring for someone and not known what to do with that feeling?
- What would you say to a resident who told you they felt like “a mistake” in your home?
- How can our team support staff who are struggling without making residents pay for it?
Related resources
FAQs
Keep practicing
When Family Doesn’t Accept a Resident’s Identity