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A term that many, mostly Spanish-speaking people choose to identify as, and it includes binary and nonbinary genders and all sexes (male, female, intersex are just a few of the options). Not everyone will choose to identify as Latino or Latina; or Latinx or Latine. Some will prefer Hispanic, or a term that reflects their country of origin such as Mexican, Salvadoran, Peruvian, Colombian, etc. Some have roots in this country for countless generations and prefer to be referred to as Americans. Some no longer speak Spanish or the indigenous language of their native ancestors... so what should we call them? 

September 2020

Chalkboard with Different Languages



The gendered nature of Spanish language is not a new change but has become the subject of many academic spaces on gender equality. No, they are not suddenly concerned with the heart, brain, or many other vital organs being masculine (el corazón, el cerebro) while the rib is feminine (la costilla; thanks to Eve, I guess). OR the kitchen being feminine (la cocina; what is this, the 1950s?). OR why plural versions are always masculinized, even if we have one-thousand flowers (las flores) and one cactus (el nopal), we would call it a field or a garden (el campo, el jardín) because this is a pointless comparison. 

It is important to not fall into the “gender trap” of Spanish. Items are not gendered according to subjects to which we have sociologically assigned a gender.  El tampón is not the patriarchy trying to control our menstruation cycles; that’s your current politicians determining the rights to your body. Spanish even genders name (el nombre), so to change an entire language's gendered nature is naive wokeness.

If you should be angry about anything, look up why we are referred to as mammals.  Linnaeus the so-called father of taxonomy was a misogynistic, classist physician who believed breastfeeding (the breast) the most valuable contribution of women to their species. Mammalia - was only the tip of the iceberg of the reclassification of womanhood around the time of its initiation. 

A better comparison on gendering in Spanish:

A classroom of twenty-four girls and one boy has veinticinco niños en total. Or it could have venticuatro niñas y un niño. Hay 25 estudiantes en este salón de clasesif you do not want to assign gender to the children and/or want to learn how to spell out numbers in Spanish. For new Spanish students, perhaps formal, neutral options should be the emphasis of initial teachings to be inclusive and respectful. It certainly takes effort on fluent Spanish speakers part to converse using neutral language in lieu of gendered, and it may not be perfect, but the message is understood. 


Latinx and its equally orthographically and phonetically troubled offspring of lxs, -xs, and its French cousins les, are problematic in Spanish and in patient care.


If it helps you get more grant money for minority-based advancement projects because Latinx is the hot new terminology then go for it. Use it clickbait for your Instagram or tweets on current Latino issues. Sell some overpriced T-shirts - capitalize on the trend if it means spotlighting even briefly the needs of a medically underserved community. 


Do not ever forget who you as healthcare workers are representing: Latinos. LATINOS who have little to no knowledge of this new word. 

Did you know that only about 3% of "Hispanic" people identify as Latinx? Does that matter to you?


If a patient brings up organically that they prefer the usage of Latinx, then by all means, refer to them to their preferred names, pronouns, and other identifying markers. If such patient comes through your care, I would assume that their medical and socioeconomic needs are met to make “Latino” an issue to address in a limited clinical encounter.


The hierarchy of needs is one that must not be overlooked when pushing the Latinx designation. 


I recall a shared clinical reflection in a past rotation: 


I met *** , a *******  with a PMH of substance use disorder, depression, and multiple MSK injuries, and a social history significant for homelessness, who presented for [MSK issues]. He was attacked at homeless shelter…. He went to have his injuries treated and imaging done. Imaging revealed no fractures, but those results were never relayed to him because his phone number (temporary ones) changes a few times since the incident. Ibuprofen did not help. He indicated at this visit that [opioid drug name] was the only thing that would help with this pain.  After a thorough MSK physical exam, the attending and resident determined that the best course for him would be PT for the likely MSK injuries, continue ibuprofen for pain, muscle relaxant and follow-up in clinic in 4 weeks. At the end of the visit, he mentioned wanting breast implants and hoping that his insurance CalOptima Medicaid would be able to pay for the majority of the cost. 

I had not asked about sexual orientation or pronouns during our brief encounter, but the resident brought the subject up. On the question of preferred pronouns, he was confused, so I clarified as to “he”, “she”, or “they” would be his preference.  *** responded that he was “a man that had sex with both men and women - and liked to cross-dress.” No interest in hormone therapy at the moment. On his mind, was the housing that finally came through, to start that day, as long as there were no surprise fees. He wanted to recover to ride his bike without acute on chronic pain. The subject of the attack was a delicate one, and he made sure to emphasize it wasn’t an “accident” when it was referred as one…

I honestly think that *** had not given much thought to preferred pronouns or the academic designations as Latinx. His life was complicated by bigger issues of safety, homelessness, poverty, and chronic health issues. Queer people of color do not have the same level of privilege as educated queer and straight students in graduate or professional studies. They are doubly marginalized, (triply if you include substance abuse with ***) everyday victims of violence. The news rarely emphasizes the death of queer Latinos in migrant camps. I hear students fight for pronouns and “Latinx” to be more inclusive... that is far too much of a generalization...  People like *** continue to be lost in the system and left out of the discussion of their self-identification in ivory towers. Sure, we added the labels of “bisexual” and “he/him/his” to his chart, neither he explicitly identified with... Nothing else had changed for ***. 



One of my favorite people ever responded eloquently as always: 

Pronouns may be low on the priority list for someone who routinely encounters bias and discrimination, who is homeless, depressed, and with a history of substance abuse. And certainly, paying attention to patient preference (or lack of interest in) pronoun use is no cause for self-congratulation, but merely a fundamental human courtesy. Further, there should be absolutely no question that all of us are implicated in the inequities of privilege and power that increasingly dominate this country. It is incumbent on all of us to use whatever influence and levers we have to ally with those fighting for a more just society, so that people in ***’s situation can benefit from real support and resources to build a more secure, safer, and happier life. That said, in my view it is important not to trivialize or dismiss language, which is also a powerful weapon to further disenfranchise and demean those who are already powerless. People of color, people who are unsheltered, people who struggle with addiction and/or mental disorder also deserve to be named who they are and referred to in ways that are congruent with their lived identity. Pronouns may not matter to some; they may matter a great deal to others, and I'm not sure this is always a function of race or class. While language cannot put a roof over someone's head or bread on their table, it can help to make them whole in their own eyes. Language can be a way of acknowledging humanity and restoring a measure of power. So my perspective is that it is both/and. *** should have a roof over his head, security from being beaten up, treatment for addiction if needed, help with depression, AND use of the name and pronouns that are consonant with how he sees himself. It may take weeks or months or years to secure housing and this goal should be pursued diligently. But language can be changed in a moment and sometimes can make a big difference as well. 

I accept the power of language to give visibility to those marginalized, but it does not require changing an entire language, one of many with a gendered structure. You give people power by letting them choose the language. For a MTF transgender, being a Latina may be a form of validation - one removed completely by Latinx or Latine. Or Latinx could be the perfect term, if they choose it. 


Yes, I do know the history on how a certain country colonized many others and imposed this Spanish language on those peoples. The language is not necessary ours by choice, but this is not an argument on that. The pending erasure of indigenous languages is a long-standing issue that is not the focus in Latinx, nor is it an ode to Nahuatl with its infatuation of x’s (FYI: The x in Nahuatl is pronounced like “shhhh” like in  "ship"  not like the x in "exit"). Spanish is one of many gendered languages, but it just happens to be the second most spoken language in the United States, right behind English. 


The anthropology or linguistics of binary opposition is a seemingly inescapable system. Binary thinking infects science (matter-antimatter), literature (protagonist-antagonist), politics (democrat-republic, lately), etc. It is a powerful classification that partly explains discrimination, in the thinking of superior-inferior categories. The binary option of sex and gender are a problem, requiring solutions bigger than Latinx. Latinx does not solve the violence against trans Latinas and trans Latinos. It gives people a new category within another binary: Latinx vs non-Latinx (Latino/Latina) or Latinx vs. Other.   


Lx gatx gorditx de Violetx se identificx como Latinx hurts my eyes and screws up both my Spanish and English lexicons. Yes, de-gendering my name and a verb was a bit extra, but this is the risk of x-ing without linguistic considerations. 

Languages evolve all the time, hence why we have questionable additions like twerk, selfie, or finna. In April 2020, Merriam-Webster introduced these words, among many others: Iatrophobia – intense fear of doctors; microtarget – tailored ads, messages based on detailed info on particular person (target). 


How is the introduction of these words to English different from Latinx to Spanish? These words are pronounceable in English. They do not violate the rules of their language. 

FYI: Latinx was added in 2018 to the English language according to Merriam-Webster. 


Let me explain more with examples. In Samoan, English loanwords* are common. However, consonant clusters violate the linguistic rules of Samoan. [I do consider Latinx a loanwords to Spanish, not a "progressive" evolution of Latino/a.]


*Loanwords are the historical acculturation of minority group’s language into the dominant language. Globalization resulted in the facilitation and increased access to information, including linguistic transfer through technological advances in communications and transportations. Trade with foreign countries in global markets and political or military presence in usually developing countries are also products of globalization that have linguistically-impacted Samoan.

As part of a team of undergraduate linguistics students, we compiled a spreadsheet organizing Samoan vocabulary from G. B. Milner’s Samoan Dictionary, enabling my research associate and I to isolate more than 400 loanwords. Uniformity was evident in quite a few of Samoan rules. The insertion of the glottal stop [ʔ] was highly predictable. It was inserted in the word-initial position when the loanword began with a vowel, as no Samoan word begins with a vowel sound. It also replaced the English [h] in most cases in the word-initial position. Consonant clusters common in English are broken up with vowel epenthesis. Voicing changes occurred when voiced phonemes in English were not present in Samoan phonology and were consequently devoiced. Usage of paragogic vowels were seen in loanwords with consonants in the word-final position. There were some discrepancies among the usage of alveolar approximant, absent in Samoan phonology but sometimes remains undeleted in loanwords from English. The vowel-heavy quality of the Samoan language was preserved in loanwords.


One of the most conspicuous changes was the epentheses of vowel sounds. They aided in meeting Samoan’s lack of multiple consonant sounds in syllable’s onset, or in other terms, consonant clusters at the beginning of syllables. The following are examples from Milner’s Samoan Dictionary: 

Table 1.

In the above examples, the English words contained consonant clusters in the onset position only. However, consonant clusters exist in English as both onsets and codas. Since Samoan syllables consist of only onsets and nuclei, a coda in an English word is transformed to a new onset, and a nucleus is created to complete the new syllable. 

On first sight the new Samoan word created from an English one appears randomly constructed, but as you can see its creation involved many considerations to its target language, and by association its speakers. 


LATINX does not attempt to fit the Spanish language nor does it represent the marginalized immigrant Latinos whose hierarchy of needs has low priority for this shiny, new Latinx status. 


Latine, while thankfully abides by the language rules, is still unnecessary and makes me wonder if you have mixed up your Spanish and French Duolingo lessons.   

Easy Answer: Ask your patient how do they describe themselves. 

Latina, Latin-descent, Hispanic, Salvadoran and Mexican, American, Bicha, and Fresa are my acceptable alternative designations for myself. 

Tell me YOURS. 


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