Evidence map›Paper›PMID 41485086›Full record

ArticleBMC health services research2026

Perspectives on gender-inclusive language in Canadian sexual and reproductive health care: findings from a modified Delphi survey.

Jennifer M Goldberg, O G Thorne, Momina Khan, Abirami Kirubarajan, Deborah M Sloboda, Riley Graybrook, Lucy C Barker, Luseadra McKerracher, Namitha Rathinappillai, Marie-Pierre Tendland-Frenette and 3 more

Abstract read
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Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Jennifer M GoldbergMcMaster Midwifery Research Centre, Department of Obstetrics and Gynaecology, McMaster University, Hamilton, ON, Canada. jengoldberg@mcmaster.ca.
O G ThorneMcMaster Midwifery Research Centre, Department of Obstetrics and Gynaecology, McMaster University, Hamilton, ON, Canada.
Momina KhanMcMaster Midwifery Research Centre, Department of Obstetrics and Gynaecology, McMaster University, Hamilton, ON, Canada.
Abirami KirubarajanMcMaster Midwifery Research Centre, Department of Obstetrics and Gynaecology, McMaster University, Hamilton, ON, Canada.
Deborah M SlobodaDepartment of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada.
Riley GraybrookMcMaster Midwifery Research Centre, Department of Obstetrics and Gynaecology, McMaster University, Hamilton, ON, Canada.
Lucy C BarkerDepartment of Psychiatry, University of Toronto, Toronto, ON, Canada.
Luseadra McKerracherDepartment of Public Health, Aarhus University, Bartholins Allé 2, Aarhus C, 8000, Denmark.
Namitha RathinappillaiLived Experience Partner, Toronto, ON, Canada.
Marie-Pierre Tendland-FrenetteLived Experience Partner, Toronto, ON, Canada.
Tai VoLived Experience Partner, Toronto, ON, Canada.
Jenna Robertson BlySouth Riverdale Community Health Centre, Toronto Community Health (MATCH) Program, Toronto, ON, Canada.
Beth Murray-DavisMcMaster Midwifery Research Centre, Department of Obstetrics and Gynaecology, McMaster University, Hamilton, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTwo-Spirit, transgender, and nonbinary (2STGNB) people in Canada face systemic discrimination in sexual and reproductive health (SRH) care, impacting their health outcomes. Language in SRH is often cisnormative and heteronormative, which can misgender and marginalize 2STGNB individuals contributing to care avoidance and distress. Gender-inclusive language (GIL) can affirm identities, but debate exists about its impact and acceptance.

methodsThis study is one part of a larger project examining GIL in SRH care. From May to November 2023, a survey was administered across Canada to clinicians and service-users including 2STGNB individuals and cisgender women. Survey topics included self-assessed competency (Miller’s Pyramid) and attitudes toward inclusive language. Data were analyzed descriptively and with Spearman’s rank-order correlations.

resultsA total of 303 participants completed the survey, including 131 clinicians and 172 service-users. Most respondents supported GIL and did not perceive it to have a negative impact on any group. Despite this support, clinicians reported greater comfort using patients’ chosen names than asking for pronouns, indicating uneven adoption of inclusive practices. 2STGNB participants identified misgendering and being relied upon to educate clinicians as barriers. Clinicians cited limitations in charting systems and fear of making mistakes as obstacles. Higher self-assessed competency among clinicians was positively associated with affirming clinical practices.

conclusionOur findings demonstrate widespread support for GIL among most clinicians and service-users. However, this support does not consistently translate into practice. Key barriers – including provider discomfort, charting limitations and undue reliance on 2STGNB patients for education – highlight the need for structural and educational interventions. To promote inclusive care environments, patient-informed training, revising of documentation forms to accommodate diverse gender identities is needed. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

Attitude of Health PersonnelLanguageReproductive Health ServicesTransgender PersonsAdultCanadaDelphi TechniqueFemaleGender-Nonconforming PersonsHumansMaleMiddle AgedSurveys and QuestionnairesGender-inclusive languagePerinatal servicesSexual and reproductive healthTransgender

Identifiers

PMID41485086
PMCPMC12790124

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.