Event Summary
Image ID: Inclusive pride flag in the background, with two hands holding eachother in the foreground. Source: Photo by Lisett Kruusimäe: https://www.pexels.com/photo/hands-joined-against-progress-pride-flag-12289189/
On June 24th 2023, JCR hosted an interactive reflection and discussion event mediated by Dr. Zena Sharman on LGBTQ+ care in health rehabilitation.
Interesting questions were brought up to foster reflection and discussion amongst the participants. Some history of the physiotherapy profession was also brought to light, which highlighted the importance of understanding and interrogating (one of) our profession's origins and how it informs our practice today.
Here is a summary and some of the highlights of this event, as well as resources to further your learner found at the bottom of this post.
The first question that started us off was based on the idea of, “How do we know what we know? How do we know what we don’t know?”. Zena asked participants what they learned in formal (health rehab) education about LGBTQ+ health, and where they learned outside of formal training.
The participants were largely from North America (although some were from overseas!). There was a great mix of people: those who graduated over 20 years ago to those still in school now. We observed that there has been some positive change over the years, but not enough. The older folks reported having no training or mention of LGBTQ + health, while the more recent graduates cited having some select lectures or having it integrated throughout case-studies and the overall degree.
Participants went on to share how they furthered their education and understanding on this topic, by: self-organizing to improve curricula, taking continuing-education courses, exploring the topic on social media, and learning from people a part of the LGBTQ+ community directly.
Image ID:e photo of an empty lecture hall, with rows of chairs. Source: Photo by Pixabay from Pexels: https://www.pexels.com/photo/room-chair-lot-356065/
The overall lack of education and mention of LGBTQ+ communities and their unique health needs and realities lead us into a concept that Zena brings up in her book The Care We Dream Of - the concept that the healthcare system is not broken, it is working exactly as it is designed to. She points out that there was no prior system that provided safe and equitable care to everyone that we are trying to get back to, but that from the beginning, the healthcare system/complex was designed to specifically exclude, be inaccessible to, and be harmful to specific groups of people.
But what is the history of physiotherapy or health rehab? Were these professions of helping others also formed around violence and exclusion? The history of physiotherapy is easier to find than OT/SLP/other health rehab professions, however it is not entirely accurate at times or peaceful. The general consensus that physiotherapy was developed through treating soldiers during the world wars erases the Indigenous histories of many different countries that had individuals offering manual therapies. Furthermore, our origin in war and helping disabled bodies did not stop ableism and saneism from becoming ingrained in our practices – we are taught what “normal” bodyminds are, what they should look like, and what people's goals should be.
Additionally, Zena shared with the group that one of the biggest pushes for physiotherapists to become an officially recognized profession was made by white women working as massage therapists who wanted to distance themselves from sex workers who did “distasteful” and “nefarious things” (to quote the article [1]). It is important to note how much sex work is intertwined with queer history. It is also important to note that it is impossible to separate these [harmful and negative] aspects from the foundation of the profession with how we practice today.
It is important to name the deep entanglements our professions have with bias and oppression. Namely, our connections and foundations in ableism, white supremacy, and colonialism. These ideologies and dynamics are present throughout all health systems in North America (and likely beyond).
Image ID: a background with a rainbow on the left and dark grey on the right, with the same text as the paragraph below on it.
So, how do we reckon with the oppressive systems that we are a part of? Or the systems that we are trying to access? What can the transformation of the current systems look like? How can we practice solidarity inside and outside of our professional lives? Some things that participants brought up include:
- Adding pronouns on name badges and on our chart note signatures
- Advocate on behalf of these communities/ people/ coworkers (if the colleague/ friend
is okay with that, consent is important)
- Having a safe space to ask questions and learn about different under-serviced
communities and the barriers they may face
- Reflecting on “how do I not be a cop,” in regards to how healthcare workers can often
work as an extension of the police (with the healthcare complex being implicated with
the prison industrial complex).
Within this session, Zena also invited us to reflect on “what do you wish you knew about caring for LGBTQ+ people? If you’re a member of the LGBTQ+ community, what do you wish your care providers knew?”. Highlights of the responses include:
- I wish I knew how to make LGBTQ+ people feel welcome and comfortable in the
rehab space.
- I wish I knew more about LGBTQ+ people’s lived experiences navigating healthcare
and also more about their specific healthcare needs
- How do I initiate a conversation? Do I directly ask about their health issues? As an
educator how do I teach my students to be aware about the needs of LGBTQ+
community?
- I wish there was more knowledge about how various health conditions with sex-based
characteristics affect trans people and how we can talk about them with trans and
gender-non-conforming folks (e.g., stroke symptoms tend to present differently in
women vs men, but how does hormone therapy affect this or how do you address this
with a non-binary person?)
- How to create refuge for these communities? How to create transformation in our
communities?
- It would be huge to have care providers just have basic understanding and care
about pronouns and not assume that everyone is straight.
- I wish they knew how to use my pronouns correctly and consistently gendered me
correctly.
In the spirit of continuing the discussion… What are your answers to these questions? Or might you have questions to add yourself? What do you wish you knew, or could transform, about your profession or work place? Leave a comment to continue this important conversation.
Wrapping up the session, Zena left us with this wonderful quote to reflect on as we continue our work to build a more equitable and inclusive profession and world – for LGBTQ+ communities, our clients, our colleagues, our friends, and our neighbors:
mage ID: A soft pastel rainbowy background reading: Zoë Dodd and Alexander McClelland describe risk-taking as a path to survival: “We are in a position where our only path to survival is to bypass state imposed red tape, rules and regulations. To help our friends, families and ourselves, it is our ethical responsibility to take things into our own hands. We must undermine the barriers enforced by bureaucratic hierarchies. We must take risks, and we must act.” [2]