NHS managers are being trained to refer to staff and patients as “they” rather than “he” or “she” to avoid offending transgender people.

Courses offered by NHS Lothian, in tandem with Scottish Trans Alliance (STA) and LGBT Health and Wellbeing, encouraged managers to use gender-neutral pronouns at home and work to try to normalise their use. In a handout of “top tips” for supporting transgender patients, staff were advised: “Don’t assume you know which pronouns and titles people prefer — ask what they prefer”; and “think about how you call for people in waiting rooms — ensure that you don’t accidentally use old names or titles”.

One senior figure at NHS Lothian who attended an hour-long session on December 6 last year said: “They were