I recently made a small but deliberate change at work. I added my gender pronouns—she, her or hers—to my email signature. I did this to show my solidarity with the transgender and gender-nonconforming community. Others at the New York City Health Department have done the same. For example, those who identify as male could use he, him, and his, and people who are non-binary—meaning they do not identify as a man or a woman—may use one of the gender neutral signatures like they, them and theirs.

Some may label the use of gender pronouns as political correctness gone too far. It’s just a signature ― why inject issues of gender? But my signature already implies many things. My name, “Mary,” is a female one and also Christian; my listed medical degree suggests I might be referred to formally as “Doctor”; and my title is “Commissioner.”

So the question arises: What is the impact of words?

June is LGBTQ Pride Month, and the need for allies of people who are transgender and gender-nonconforming has never been stronger. 2016 was one of the deadliest for the community, with at least 22 confirmed hate-related homicides of transgender and gender-nonconforming people, most of whom were women of color. According to the National Coalition of Anti-Violence Programs, there have been 11 murders of transgender people already in 2017 – including Mx. Bostick, a Black transgender person who lived in New York City.

The rights and wellness of this community are constantly being threatened, especially youth. The new administration has rescinded federal protections for transgender and gender-nonconforming students. These rights included allowing youth to use their chosen names, pronouns and gender markers on identification documents, providing access for youth to use restrooms and facilities that affirmed their gender identities and safeguarding private information in health and education records.

Safety is a public health issue. Denying transgender and gender-nonconforming people basic protections puts them at greater risk for violence and increases their probability for negative health outcomes. Bathrooms are of particular concern. In the study “Gendered Restrooms and Minority Stress” by Dr. Jody L. Herman, the manager of transgender research at UCLA’s Williams Institute, 54 percent of respondents reported health problems related to their lack of safety in bathrooms. Many stated that they would hold their bladders for hours to avoid public restrooms, resulting in urinary tract infections, kidney problems and dehydration.

When transgender and gender-nonconforming people do not feel safe in their workplaces, their communities or even their homes, it signals a public health crisis. We have to rethink all aspects of our relations to gender—even the automatic signatures that come up when we sign our emails.

At the Health Department, every one of our 14 buildings now has at least one all-gender restroom. We are leading initiatives to train staff to expand their understanding of gender and sexuality and to accept people outside of traditional gender norms. As part of our progressive stance, we eased requirements for those who want to change the gender marker on their birth certificate. Over 700 changes were made, compared to about 20 a year in previous years. Last year, our Bureau of Vital Statistics issued the nation’s first intersex birth certificate. We also became the first jurisdiction to have a dedicated section in our annual HIV surveillance report on transgender people. And this week, we published New York City’s first ever LGBTQ Health Care Bill of Rights, because everyone, regardless of their sexual orientation, gender identity or gender expression, deserves the right to be treated by their doctor with equality and respect.

Physical attacks and health issues can threaten a transgender or gender-nonconforming person’s life, but the prejudice they face often begins with offhanded slights or microaggressions. Similarly, the fight to respect everyone’s gender begins with small words and gestures. Pronouns are important because we cannot assume we know someone’s gender simply by looking at them. What we need now is for others to join us as active allies for transgender and gender-nonconforming people, to validate and recognize that trans lives matter.