Pronouns, DID and the NHS

[Mongoosely]

This may be a bit of a weird question but does the NHS automatically change pronouns with certain diagnoses. I don't think I have ever been asked what pronouns I prefer anywhere within the services I attend, however, I have realised that they are using They/Them in letters and it has really pissed me off.

So I do sometimes identify as "we" but I find identity switches so difficult and confusing that I/we usually go off sex (female) and try to use names when referring to people, and expect people to name us when being referred to.

I'm not sure if I being a bloody idiot though because when I raised the pronoun issue with them I was basically told that everyone with DID should be using they/them pronouns inline with the illness (which is not quite correct as what if all parts are the same sex).

Basically, am I being thick and not realising something here?

I don't know but find this an interesting question. Hopefully someone else will come along.

I was basically told that everyone with DID should be using they/them pronouns inline with the illness

I wonder if they've been advised on that by various 'representative' organisations or a Patient and Public Voice Working Group?

@EmbarrassingHadrosaurus it's potentially come from some of the more active and very vocal patients / service user movements - who have been misdiagnosed with a PD and now have a Complex Trauma diagnosis. That would actually make a lot of sense actually.

It's really annoyed me though as I had a system that worked for me.

What’s DID?

Dissociative Identity Dysregulation/Disorder

I think this would pee me off. I have a diagnosis of DID. But as I am not currently seeking any treatment I don't know know how I'd be referred to.

However, I am a woman and I'm female on my birth certificate, who that is how they should refer to me. I've also said many times when discussing the issue with healthcare staff that's it's not like I wake up on a Wednesday as a lumberjack called Kevin.

I'm aware enough of my illness and it's causes to know that whatever is going on in my head at any particular time it is still female womanly me whose head it is going on in.

And the rest of me agrees.

If I was you Id kick up a fuss and insist all your paperwork and letters to you address you correctly. If they kick back tell them it distresses all of you to be misgendered, and would they be OK with just the one complaint or should each manifestation need to complain as well?

DID

I don’t know. If I was referring to a group of multiple people then regardless of whether they were all the same sex or not I would use the pronouns they/ them to refer to the fact they were multiple people.

Obviously I appreciate somebody with DID isn’t multiple people as such, but if it presents in that way I can see why ‘they/ them’ might be used regardless of what sex/ gender each identity represented as.

They/ them is also typically used in situations where you are referring to somebody whose gender you don’t know yet (eg: when you get to see your new doctor you can tell them about your pain) so if your identity switches a lot and somebody doesn’t know whether they are talking to a male/ female identity I can also see why they might use they/ them if talking about you in the third person (obviously to your face you/ your should be fine).

If you feel that your system is multiple identities and use the terminology ‘we’ then it does make sense that somebody somewhere has assumed they should be using a pronoun that denotes plurality rather than singularity. She/ her only refers to the singularity, you wouldn’t use it to refer to a group even if the group was made up entirely of females, so if you identify as multiple identities that is probably why a plural pronoun is being used. It’s not about sex/ gender so much as singular/ plural.

Sorry, just to add I am not saying you should accept the usage of the pronouns they/ them. It is completely reasonable to want to be referred to as she/ her in line with your biological sex and your birth identity/ name etc. Just because you have DID and some patients prefer they/ them doesn’t mean you should be forced into using it too. I can see why some might wish to be identified in that way but it shouldn’t be a one size fits all and you should have the right to challenge this and to ask to be referred to in the way that suits you.

@MolkosTeenageAngst

The OP is one person. A woman. A female. She had those markers on her NHS file. The other identities don't have separate files.

They should only be referring to her as that. No they no him etc. The OP uses we in discussions with healthcare providers because it is useful in her conversations when discussing multiple personalities.

The fact that they don't seem to have even bloody asked her is I think what's pissing her off.

And to add even if i did wake up on Wednesdays as a lumberjack called Kevin. They shouldn't be listening to what he's saying as he's not actually the patient.

It is the fact I have never been asked and it has been assumed that has pissed me off - but also the fact that when I raised it they started questioning whether I actually had DID as "everyone with DID uses they/them". I've had my diagnosis for a very, very long time but it is still very controversial so aligning my pronoun choice into diagnostic criteria 12 years down the line has hit a nerve.

I don't even know how I can get it changed now, I didn't realise pronouns were even recorded in the NHS and have no idea who I would contact to get it rectified.

@Mongoosely complain to the department to get it corrected. If that doesn't work contact your hospitals PALS

And as a DID person myself, nope never have I ever used they, so you can correctly tell them they are talking out of their backside.

Also on further thinking...

This actually goes against the treatment I got, which was more geared towards making sure they knew that I knew I was only one person.

Surely by using they just because you've got a DID diagnosis is actually feeding into it. Rather than making sure you know it's not the norm and that deep down you are actually one whole person who for whatever reason finds the different parts of their personality and coping mechanisms compartmentalizes more than most people.

This actually goes against the treatment I got, which was more geared towards making sure they knew that I knew I was only one person.

Yes, this has been the same for me - several years of convincing me I was actually only one person in fact (was not in a good place when I started treatment, I spent most of the first few years telling them I had Super Powers apparently). I am going to write that into the letter too.

Did you find treatment helpful?

@Mongoosely I think I found being believed to be useful. And the fact that they confirmed my understanding of what I thought had happened to cause the dissociation.

I'm kinda jealous of the super powers mind.

They shouldn't be automatically assuming anything about their patients as an homogenous group.

And yes point out that they are actually potentially undoing any progress you may have made by giving your alternates a power they shouldn't have.

You may have to remind them that you and you alone are their patient. They are supposed to be treating and stopping what is going on in your head not celebrating it.

'They' and 'them' is, and always has been, the word use when trying to not specify whether the person is a 'he' or a 'she'. For example, on MN when a poster doesn't want to identify much about their partner, they will just say 'they' and 'them'. ("They phoned me and I told them...") This is how the English language works and this has been the way it's done since long before this whole 'pronouns' thing became a popular issue. It's just a way to avoid using a specific pronoun, presumably because you said you've never given them your pronouns.

(FWIW I know this isn't a popular idea but I do believe it's down to individuals to offer their pronouns if this is something important to them, rather than expect people to ask and be upset when they don't? So maybe just tell them what you want them to say?)

(Also, I wouldn't be surprised if a lot of professionals start to use 'they' and 'them' more often these days to avoid causing offence and accidentally calling a 'he' a 'she', for example.)

@Boiledbeetle I am struggling to come to terms with my diagnosis, your posts are incredibly helpful, thank you. I don’t wish to be anything other than what I have always been which is a woman, female at birth. I had read about alters presenting differently which frightened me, I don’t feel like I need to say we or they, its extremely uncomfortable for me, it’s early days so not always in charge or completely aware of switching, I’m learning my system. I think to keep reminding myself that DID is a protective mechanism is probably the best thing I can do right now as I’m finding it all very overwhelming.

@LarryBlackmonsCodpiece

I've found it helpful to look at why I disassociate. The different situations that cause different parts of my personality or coping mechanism to come to the front.

It was the realising that there was actually some logic and order to it that helped me.

Plus the fact that no matter what part of me other people are seeing on a particular day it's still me. I'm still the one going to prison if I do something wrong that I don't later remember.

I also had to have a word with myself. So I, and this sounds nuts written down, I basically called a meeting and got all bits of me to agree certain rules. The main one being all parts kept notes if things.

How bizarre and confusing. It sounds like the affirmative model of care demanded by trans ideologues. How does an individual struggling with dissociation benefit, when the fact that she physically remains an individual regardless of her mental state, is ignored?

I won’t pretend to know anything about real DID beyond that it’s rare and makes a lot of sense as a coping strategy for life after trauma (sort of like an extreme form of subconscious compartmentalisation).

what I have been paying attention to, however, is the rise of online disorder claimers, self diagnosers who become outspoken activists and engage with stakeholder sessions and advocacy charities, skewing the needs of sufferers towards those who perhaps don’t actually have the disorder at all (but may have something with similar symptoms that could’ve been made as a differential diagnosis by a decent professional and would’ve been at a different point in time.

This is happening all over the mental health and SEN spectrum, but the most obvious example is in the ‘Tourette’s on TikTok’ phenomenon. Loads of the people claiming to have Tourette’s online actually have functional tics that look like Tourette’s but as Tourette’s can be diagnosed using objective measurements, it’s possible to sort out the real Tourette’s from the tourettes-ish people (they aren’t exactly faking, it’s more like they are misdiagnosing themselves)

This has been happening in Autism & ADHD circles, in gender Dysphoria circles and judging by the number of teens saying they have DID online, is potentially affecting you too.

the people claiming these disorders probably have anxiety/depression/undiagnosed SEN of some sort but as they don’t actually have the claimed disorder, they don’t benefit from the treatments that are usually used to help genuineness sufferers.

so while you will benefit from help in reintegrating your alters into a whole self, the ‘new presentation’ of DID doesn’t benefit from that and instead through advocacy groups changes the way the disorder is approached, eg convincing professionals to view them as a ‘plural’.

so best case scenario, admin ti the clinicians have decided to stick to a neutral ‘they’ without considering the impact on people with DID, who really need the reminder that they are one person and worst case scenario, a load of people with some sort of disorder but not DID have convinced admin to change policy in a way that harms people with DID.

either scenario needs a stern letter!

Here’s an article about the ‘new Tourette’s’: pubmed.ncbi.nlm.nih.gov/34424292/

and here’s one re: DID

www.inputmag.com/culture/dissociative-identity-disorder-did-tiktok-influencers-multiple-personalities/

And a general one about tiktok influences on mental health awareness/misplaced identification with symptom descriptions:

www.refinery29.com/amp/en-us/2021/03/10328745/mental-health-self-diagnosis-tiktok

@TheClogLady

Thanks for the info. That is actually horrifying to read!

They can't treat DID properly if they collude with the suffer.

This riding roughshod over illnesses that have nothing to do with gender ideologies has to stop.

Oooooh I'm bloody annoyed now!