Respectful Care for Trans Patients in HOF

The door of the HOF clinic is often the first stage at which a trans patient decides whether to come back. A wrong name at the front desk, a curious question in the medical history or an opinion about identity can end the relationship before any procedure. The reverse also holds: a welcome without stumbles builds trust and supports safer care. This guide gathers simple practices in communication, record keeping and clinical assessment, at the level of general guidance. It does not replace your professional board's rules, the applicable legislation or specific training in trans health.

Principles of welcoming

The starting point is the same as for any patient: listening, respect and information. A few practices help put that into action.

• Name and pronouns. Ask how the person prefers to be addressed, and use it in the schedule, at the front desk, in the room and in the patient record.
• Do not presume. Do not assume identity, orientation, desired procedures or the stage of any process.
• Leave curiosity out. Ask only what has a clinical purpose, and explain why.
• The same clinical quality. Assessment, consent, guidance and follow-up follow the standard for any patient.
• Privacy. Watch who can hear the conversation, how the schedule is called out and what appears on screen.

Chosen name and patient record

The chosen name (called "social name" in Brazil) is the name by which the person identifies and is known. In health care practice, there are rules governing its use, and the professional should check those that apply to their situation and to the service. Some useful guidelines:

1. Record the chosen name prominently in the patient record and in the schedule.
2. Keep the legal name where needed for documents and billing, with guidance for restricted use.
3. Train the team not to expose the legal name at the front desk, in calls and in messages.
4. Use the same name on consent forms, prescriptions, instructions and communications.
5. Ask the patient how they prefer to be contacted by phone and message.

Information about gender identity and health is sensitive personal data and deserves extra care under the LGPD (Brazil's personal data protection law). Limit access, avoid sharing it with third parties without need and note only what is useful. The reasoning on privacy is in explaining privacy to the HOF patient.

Medical history with a clinical purpose

The medical history may include questions about hormone therapy, prior surgeries and earlier procedures, because these factors have a clinical effect: skin, fat distribution, bleeding risk, interaction with medications and history of injected products.

Some trans people have previously had products injected without supervision. Asking with warmth and without judgment is decisive for safety.

Concerns and planning without stereotypes

Each person has their own goals. Some seek to soften features associated with one gender, others to reinforce other features, others only the care any patient would seek. The professional should not presume anything.

• Listen to the concern and ask the patient to describe it and point it out in the mirror.
• Avoid imposing a "female face" or "male face" standard. Describe measurements and proportions objectively.
• Explain what injectables can and cannot do. Bone structures, for example, only change through surgery.
• Align expectations honestly, including about limits and the need for stages.
• Respect the person's pace and the decision not to proceed.

There is specific content on planning: see facial feminization with injectables and male orofacial harmonization. For the conversation, there is HOF consultation with a trans patient. The planning content, indications and management are decisions for the licensed professional, in line with their professional board's rules.

Consent, images and data

Informed consent follows the standard for any patient, with extra attention to image authorization. Face photos of a trans person can carry greater privacy and safety implications. Record the authorization specifically, explain the use of each image and respect a refusal. Anonymization is only effective when the face is not identifiable, which rarely happens in HOF photos, so using them in promotion requires express authorization and caution. See consent and LGPD for photos.

Team and environment

The patient's experience depends on every point of contact. Simple items that make a difference:

1. Train reception and staff to use the correct name and pronouns.
2. Have intake forms with a field for chosen name and pronouns.
3. Avoid calling the patient aloud by their legal name in the waiting room.
4. Provide restrooms and spaces that cause no embarrassment.
5. Have a channel for patients to report discomfort without exposure.

When a mistake happens, acknowledge it simply: "Sorry, I'll fix that right now." A short apology and a quick correction are worth more than long explanations.

How to talk to the patient

Where Harmy fits in

Common mistakes

1. Getting the name wrong and justifying it with the ID. If the legal name is needed for some record, explain the reason, but use the chosen name in conversation.
2. Asking questions out of curiosity. If the question does not change clinical management, it does not need to be asked.
3. Presuming the goal. Not every trans patient seeks the same procedures, and not every procedure sought is related to identity.
4. Exposing information at the front desk or in messages. Watch who is listening and who can see the screen.
5. Offering procedures beyond the concern. That conveys that the person's face needs correcting.

When to seek specific training

Those who treat this population often benefit from specific training in trans health, which covers clinical, ethical and communication aspects beyond what fits on one page. Courses from recognized institutions, professional board material and reference services are good sources. Always check a course's provenance, as in facial harmonization course: how to evaluate, and update the team periodically. Competence in respectful care is part of clinical quality, not an optional extra.