LGBTP+ Community

Termionology: LGBTQIA2S+

-Lesbian: women like women

-Gay: men like men

-Bisexual: like both genders (also pansexual)

-Transgender: identify other than sex at birth

-Queer: refers to sexuality and gender

-Intersex: medical term for sex characteristics that don’t match; don’t always feel part of communty; lot find out later in life

-Asexual: no sexual drive/activity

-Two Spirit: indigenous, male and female energy or 3/4th gender

Terminology

-genderqueer

-gender dysphoria

-Genderqueer: Fluid gender experience where someone may consider themselves male and female or reject that concept all together.

-Gender Dysphoria: Clinically significant distress caused by someone’s assigned birth gender not matching what they identify as (*ex: if don’t like breast tissue)

things to avoid saying

-Hermaphrodite

-gender reassingment surger → gender afirmming care

-biological M/F → sex assigned at birth

-preffered pronouns → pronouns

-Quers is a slur

-”dead naming”

wheel of power/privilege

-be aware of your power dynamic

• ex: you as a PT have more education

-lot of complaints come from either sexual midconduct or sending inappropiate messages

Inclusive language

Don’t make assumptions

-Ask pronouns

-Gender neutral terminology

• Parent vs mom/dad

• Partner vs wife/husband, gf/bf

• Genital tissue vs penis/vulva

• Everybody/folks vs ladies and gentleman

Repair process if/when make mistake

-Apologize as quickly as possible

-Don’t make it about you; I feel statements have no place here

-Using inclusive language isn’t a skill to be acquired, but an ongoing, lifelong process

barriers to care

-Fear of discrimination: Racism, Ableism, Transphobia

-Medical trauma (*trans people having uncessary genitel and internal exams; colored and gay men experimented on)

-Lack of family support: Mental illness (if whole family supportive same mentel illness as generel popluation, if not higher sucice and issues)

-Unemployment or underemployment

-binding

-packing

-tucking

-Binding: Using compression to flatten out chest tissue

• safe for up to 8 hours; make sure using appropriate material; can be expensive

• Can you educate the patient on ways to bind that help decrease thoracic pain?

-Packing: Wearing padding or a phallic object in the front of pants (*careful where put your hands)

• After a stroke can you help a pt find an easier way to hold an STP? “stand to pee device”

-Tucking: Moving the penis and testicles out of the way to create a flat mound between the legs

• When a patient has skin irritation can you discuss gaffs with them instead of the pt using tape?

trans youth

-Puberty Blockers: Reversible (*meant to be temporary)

-Surgery is rarely performed under the age of 18

-Detransition rate is 1- 2%

-Gender dysphoria starts at age 6-7 for half of trans people

treating trans youth

-May be packing, binding, tucking

-Be mindful of unique social stress and mental health concerns

-Bone density concerns if not appropriately loading bones: We can help with this!

• if hormonal support; also less sport participation

trauma informed care

-Universal Precautions: Approach every patient as if they have a history of trauma

• -Consent: Explain why you need to do a test or ask sensitive questions. Then ask for permission Ask permission to put gender identity in medical chart

-Use appropriate language

-Avoid medical curiosity: Only ask questions about surgeries, hormone therapy, ect if relevant to care (*ex=estrogen and low bone density)

what can we do generelly

-Use pronouns on your email signature, website, and name tag

-Ensure that your intake paperwork has a spot for pronouns and gender

-Get involved!: Join your state board, APTA special interest groups, teach a class

-Be a good ally: Continuing education, read books, follow queer folks on social media

-Read the resources provided

-Stand up for marginalized communities Everyone deserves quality PT

final thoughts

-Everyone deserves high quality PT

-You will treat queer patients

-It is your job to make people feel comfortable

-Terminology is always changing, keep educating yourself