Finding gender-affirming healthcare providers can be difficult. Many providers lack knowledge and training on the needs and experiences, can be discriminatory, and often have no indication when entering the facility that the provider is gender-affirming.
Gender-affirming care is any care in which a member of the LGBTQ+ community has their needs properly met, feels safe, and comfortable, and feels their gender is respected.
Dr. Alex Jimenez (He/Him) believes that members of the LGBTQ+ community are treated with respect ,dignity, and above all, ensure that they receive the needed medical care they deserve.
Can healthcare professionals implement an inclusive and positive approach for gender affirming healthcare for non-binary individuals?
Introduction
When it comes to many individuals looking for the right healthcare options for their ailments and general well-being, it can be scary and challenging to some, including many individuals within the LGBTQ+ community. Many individuals need to research when finding positive and safe healthcare facilities that listen to what the person is dealing with when getting a routine check-up or their ailments treated. Within the LGBTQ+ community, many individuals do find it difficult to express what is affecting their bodies due to past traumas of not being seen or heard due to their identities, pronouns, and orientation. This can cause numerous barriers between them and their primary doctor, leading to a negative experience. However, when medical professionals provide a positive, safe environment, listen to the person’s ailments, and be non-judgmental to their patients, they can open the doors to improving inclusive healthcare wellness within the LGBTQ+ community. Today’s article focuses on one identity within the LGBTQ+ community, known as non-binary, and how inclusive healthcare can be optimized while benefitting many individuals dealing with general aches, pains, and conditions within their bodies. Coincidentally, we communicate with certified medical providers who incorporate our patients’ information to provide a safe and positive experience in inclusive healthcare. We also inform them that there are non-surgical options to reduce the effects of general aches and pain while restoring their quality of life. We encourage our patients to ask amazing educational questions to our associated medical providers about their symptoms correlating with body pain in a safe and positive environment. Dr. Alex Jimenez, D.C., incorporates this information as an academic service. Disclaimer
What Is Non-Binary Gender?
The term non-binary is used within the LGBTQ+ community to describe a person who doesn’t identify as a male or female within the gender identity spectrum. Non-binary individuals can even fall under various gender identities that make them who they are. These can include:
Genderqueer: An individual who doesn’t follow the traditional gender norm.
Agender: An individual who doesn’t identify with any gender.
Genderfluid: An individual whose gender identity is not fixed or can change over time.
Intergender: An individual who identifies as a combination of male and female.
Androgynous: An individual whose gender expression combines masculine and feminine traits.
Gender Non-Conforming: An individual who doesn’t conform to society’s expectation of gender identity.
Transgender: An individual whose gender identity is different from their assigned gender at birth.
When it comes to non-binary binary individuals looking for healthcare treatment for their ailments, it can be a bit of a challenge as many individuals who identify as non-binary within the LGBTQ+ community have to deal with the socio-economic impact when getting treatment, which can lead to unnecessary stress when going in for a routine check-up or getting their ailments treated. (Burgwal et al., 2019) When this happens, it can lead to a negative experience for the individual and make them feel inferior. However, when healthcare professionals take the time to be properly trained, use the correct pronouns, and create an inclusive, positive, and safe space for individuals who identify as non-binary, it can open the doors to creating more of an inclusive awareness and lead to more appropriate care for the LGBTQ+ community. (Tellier, 2019)
Optimizing Your Wellness- Video
Do you or your loved ones are dealing with consistent pain in their bodies that makes it difficult to function? Do you feel stress in different body locations that correlate with musculoskeletal disorders? Or do your ailments seem to be affecting your daily routine? More often than not, in today’s ever-changing world, many individuals are researching safe and inclusive healthcare treatments to reduce their ailments. It is an important aspect to many individuals within the LGBTQ+ community, as finding the appropriate care they need can be stressful. Many healthcare professionals must provide the best possible healthcare and interventions within the LGBTQ+ community to understand the health disparities that they are experiencing. (Rattay, 2019) When healthcare professionals create a negative experience with their patients within the LGBTQ+ community, it can cause them to develop socio-economic stressors that can overlap with their pre-existing condition, creating barriers. When disparities are associated with socio-economic stressors, it can lead to poor mental health. (Baptiste-Roberts et al., 2017) When this happens, it can lead to coping mechanisms and resilience that can correlate with serious implications for the person’s overall health and well-being. However, all is not lost, as many healthcare professionals are integrating into safe, affordable, and positive healthcare spaces for individuals who identify as non-binary. We here at Injury Medical Chiropractic and Functional Medicine Clinic will work on reducing the effects of health disparities while raising awareness to continuously improve positive and inclusive experiences for non-binary individuals seeking inclusive healthcare. Check out the video above to learn more about optimizing wellness to improve your health and well-being.
How To Optimize Non-Binary Inclusive Healthcare?
When it comes to inclusive health care for non-binary individuals within the LGBTQ+ community, many healthcare providers must honor the individual’s gender identity while creating a positive and trusting relationship to reduce the ailments they are experiencing. By making a safe and positive experience for their patients, LGBTQ+ individuals will start to address to their doctors what issues they are experiencing, and it allows the doctor to come up with a personalized health care plan that is catered to them while improving their health outcomes. (Gahagan & Subirana-Malaret, 2018) At the same time, being an advocate and systemically improving, including gender-affirming care, can lead to positive results and benefit LGBTQ+ individuals. (Bhatt et al., 2022)
References
Baptiste-Roberts, K., Oranuba, E., Werts, N., & Edwards, L. V. (2017). Addressing Health Care Disparities Among Sexual Minorities. Obstet Gynecol Clin North Am, 44(1), 71-80. doi.org/10.1016/j.ogc.2016.11.003
Bhatt, N., Cannella, J., & Gentile, J. P. (2022). Gender-affirming Care for Transgender Patients. Innov Clin Neurosci, 19(4-6), 23-32. www.ncbi.nlm.nih.gov/pubmed/35958971
Burgwal, A., Gvianishvili, N., Hard, V., Kata, J., Garcia Nieto, I., Orre, C., Smiley, A., Vidic, J., & Motmans, J. (2019). Health disparities between binary and non binary trans people: A community-driven survey. Int J Transgend, 20(2-3), 218-229. doi.org/10.1080/15532739.2019.1629370
Gahagan, J., & Subirana-Malaret, M. (2018). Improving pathways to primary health care among LGBTQ populations and health care providers: key findings from Nova Scotia, Canada. Int J Equity Health, 17(1), 76. doi.org/10.1186/s12939-018-0786-0
Rattay, K. T. (2019). Improved Data Collection for Our LGBTQ Population is Needed to Improve Health Care and Reduce Health Disparities. Dela J Public Health, 5(3), 24-26. doi.org/10.32481/djph.2019.06.007
Tellier, P.-P. (2019). Improving health access for gender diverse children, youth, and emerging adults? Clinical Child Psychology and Psychiatry, 24(2), 193-198. doi.org/10.1177/1359104518808624
Cisgender has nothing to do with an individual’s sexual orientation. Therefore how do sex and gender differ and where does cisgender fall within the spectrum of gender identities?
Cisgender
Cisgender is a segment of the larger spectrum of gender identities. Also referred to as “cis,” it describes an individual whose gender identity corresponds to the sex they were assigned at birth. Therefore if an individual assigned sex at birth is female and identifies as a girl or a woman they are a cisgender woman.
The term describes how a person sees themselves and helps others communicate more accurately and respectfully.
Although many individuals may identify as cisgender, a cisgender person is not typical nor has qualities or characteristics that inherently differentiate them from a person of other gender identities.
Cisgender women commonly use the pronouns she and her.
A common mistake is using the term cis-gendered.
The proper usage of the term is cisgender.
Sex and Gender Differences
The terms sex and gender are often used interchangeably, however, they are not the same.
Sex is a biological and physiological designation based on an individual’s sex chromosomes and sexual organs.
This includes an individual’s genitals and sex organs.
It also encompasses secondary characteristics – like body size, bone structure, breast size, and facial hair – that are regarded as female or male.
Differences
Gender is a social construct that refers to roles and behaviors that society assigns as being masculine or feminine. The construct infers behaviors that are accepted or appropriate based on how an individual behaves, speaks, dresses, sits, etc.
Gender titles include sir, ma’am, mister, or miss.
Pronouns include him, she, he, and her.
Roles include actress, actor, prince, and princess.
Many of these suggest a power hierarchy of who has it and who does not.
Cisgender women often fall victim to these dynamics.
Sex
Refers to an individual’s chromosomes and the way that their genes are expressed.
Typically described in terms of male and female characteristics or the sex assigned at birth.
Gender
A social construct.
Refers to the social roles, behaviors, and expectations considered and/or deemed appropriate for men and women.
Historically defined as masculine and feminine, however, definitions can change as society changes.
Gender Identities Glossary
Today, gender is viewed as a spectrum where an individual might identify as one gender, more than one gender, or no gender. The definitions are often subtle and can often overlap, co-exist, and/or change. Gender identities include:
Cisgender
An individual whose gender identity matches their assigned sex at birth.
Transgender
An individual whose gender identity does not align with their assigned sex at birth.
Non-binary
An individual who feels their gender identity cannot be defined.
Demigender
An individual who experiences a partial, but not full/complete connection to a particular gender.
Agender
An individual who feels neither male nor female.
Genderqueer
Similar to non-binary but infers refusal of societal expectations.
Gender-neutral
Non-binary similarities but focuses on abandoning gender labels.
Gender fluid
An individual who experiences multiple genders or shifts between genders.
Polygender
An individual who experiences or expresses more than one gender.
Pangender
An individual who identifies with all genders.
Third gender
Third gender is a concept in which individuals are categorized, either by themselves or by society, as neither male nor female, not transitioning.
They are a different gender altogether.
Twin gender
A Native American term describing someone who is male and female or of two spirits simultaneously.
Cis Woman Identity
The terms cis woman or cis female are used to describe individuals who were assigned female at birth and identify as a woman or female. For cisgender woman, this means their gender identity aligns with their primary sex organs and secondary sex traits that include:
Higher pitch voice.
Wider pelvis.
Broadening of hips.
Breast development
It can also involve cisnormativity – a concept that everyone identifies as the gender they were assigned at birth. This could inform how a cis woman is expected to dress and act. An even more extreme concept is gender essentialism – this is the belief that gender differences are rooted purely in biology and cannot be changed. However, even cisnormativity beauty standards can influence the perceptions of transgender women that end up reinforcing gender stereotypes. (Monteiro D, Poulakis M. 2019)
Cisgender Privilege
Cisgender privilege is the concept that individuals who are cisgender receive added benefits compared to individuals who don’t conform to the gender binary norm. This includes cisgender women and men. Privilege happens when a cisgender individual assumes they are the norm and consciously or unconsciously takes action against those who are outside the definition of masculine and feminine. Examples of cisgender privilege include:
Not being denied work and social opportunities because of not fitting into the boy’s or girl’s club.
Not having to have sexual orientation questioned.
Not being denied healthcare due to provider discomfort.
Not fearing that civil rights or legal protections will be taken.
Not worrying about being bullied.
Not having to worry about attracting questioning looks in public.
Not being challenged or questioned about the clothes being worn.
Not being demeaned or mocked because of pronoun use.
Gender identity and sexual orientation are not the same.
A cisgender individual can be heterosexual, homosexual, bisexual, or asexual and so can a transgender individual.
Being cisgender has no correlation to an individual’s sexual orientation.
Chiropractic Care After Accidents and Injuries
References
Clayton, J. A., & Tannenbaum, C. (2016). Reporting Sex, Gender, or Both in Clinical Research? JAMA, 316(18), 1863–1864. doi.org/10.1001/jama.2016.16405
Monteiro, Delmira and Poulakis, Mixalis (2019) “Effects of Cisnormative Beauty Standards on Transgender Women’s Perceptions and Expressions of Beauty,” Midwest Social Sciences Journal: Vol. 22: Iss. 1, Article 10. DOI: doi.org/10.22543/2766-0796.1009 Available at: scholar.valpo.edu/mssj/vol22/iss1/10
Moleiro, C., & Pinto, N. (2015). Sexual orientation and gender identity: review of concepts, controversies and their relation to psychopathology classification systems. Frontiers in Psychology, 6, 1511. doi.org/10.3389/fpsyg.2015.01511
Gender transitioning is the process of affirming and expressing an individual’s internal sense of gender rather than the one assigned at birth. How can learning the aspects of gender and gender transitioning help support the LGBTQ+ community?
Gender Transitioning
Gender transitioning or gender affirmation is a process through which transgender and gender-nonconforming individuals align their internal gender identity with their external gender expression. It can be described as a binary – male or female – but can also be non-binary, meaning an individual is neither exclusively male nor female.
The process can involve aesthetic appearances, changes in social roles, legal recognitions, and/or physical aspects of the body.
Social affirmation – dressing differently or coming out to friends and family.
Legal affirmation – changing name and gender on legal documents.
Medical affirmation – using hormones and/or surgery to change certain physical aspects of their body.
Transgender individuals can pursue some or all of these.
Barriers
Gender transitioning can be obstructed by various barriers that can include:
Cost
Lack of insurance
Lack of family, friends, or partner support.
Discrimination
Stigma
Addressing All Aspects
The process does not have a specific timeline and is not always linear.
Many transgender and gender-nonconforming individuals prefer gender affirmation to gender transitioning because transitioning is often taken to mean the process of medically transforming the body.
An individual does not have to undergo medical treatment to affirm their identity, and some transgender people avoid hormones or gender-affirming surgery.
Transitioning is a holistic process that addresses all aspects of who a person is inwardly and outwardly.
Certain aspects of transitioning may be more important than others, like changing one’s name and gender on their birth certificate.
Reevaluation and revision of gender identity can be continual rather than a step-by-step, one-way process.
Exploring Gender Identity
Gender transitioning often starts in response to gender dysphoria which describes the constant sense of uneasiness that occurs when the gender an individual was assigned at birth does not match how they experience or express their gender internally.
Some individuals have experienced symptoms of gender dysphoria as early as 3 or 4 years of age. (Selin Gülgöz, et al., 2019)
Gender dysphoria can be largely informed by the culture that surrounds the individual, specifically in cultures where strict codes determine what is masculine/male and feminine/female.
Unease Expressed in Different Ways
Dislike of one’s sexual anatomy.
A preference for clothes typically worn by the other gender.
Not wanting to wear clothes typically worn by their own gender.
A preference for cross-gender roles in fantasy play.
A strong preference for engaging in activities that are typically done by the other gender.
Dysphoria
Gender dysphoria can fully emerge during puberty when awareness about how an individual’s body defines them creates internal distress.
Feelings may be amplified when an individual is described as a tomboy, or a sissy, or is criticized and attacked for acting like a girl or acting like a boy.
During puberty, the physical changes can cause long-standing feelings of not fitting in and may evolve into feelings of not fitting in their own body.
This is when individuals can undergo a process referred to as internal transitioning and begin to change how they see themselves.
Gender transitioning/affirmation becomes the next step. Transitioning is not about changing or recreating oneself but about expressing their authentic self and asserting who they are socially, legally, and/or medically.
Social
Social transitioning involves how a person publicly expresses their gender. The transition can include:
Changing pronouns.
Using chosen name.
Coming out to friends, family, coworkers, etc.
Wearing new clothes.
Cutting or styling hair differently.
Changing mannerisms like moving, sitting, etc.
Changing voice.
Binding – strapping the chest to hide breasts.
Wearing breast and hip prosthetics to accentuate feminine curvature.
Packing – wearing a penile prosthesis to create a penile bulge.
Tucking – tucking the penis to conceal a bulge.
Playing certain sports
Pursuing different lines of work.
Participating in activities that might typically be seen as male or female.
Legal
Legal transitioning involves changing legal documents to reflect the individual’s chosen name, gender, and pronouns. This includes governmental and non-government documents that can include:
Birth certificates
Social Security ID
Driver’s license
Passport
Bank records
Medical and dental records
Voter registration
School ID
Provisions allowing for changes can vary by state.
Some states only allow changes if bottom surgery – genital reconstruction is performed.
Others will allow the changes without any form of gender-affirming surgery.
Medical transitioning typically involves hormone therapy to develop some of the male or female sex characteristics. It can also involve surgery to change certain physical aspects combined with hormone therapy.
Hormone therapy assists individuals to physically look more like the gender they identify as.
They can be used on their own and can also be used before gender-affirming surgery.
Hormone therapy takes two forms:
Transgender Men
Testosterone is taken to help deepen the voice, increase muscle mass, promote body and facial hair, and enlarge the clitoris. (M S Irwig, K Childs, A B Hancock. 2017)
Transgender Women
Estrogen is taken as well as testosterone blockers to redistribute body fat, increase breast size, reduce male-pattern baldness, and reduce testicle size. (Vin Tangpricha 1, Martin den Heijer. 2017)
Surgery
Gender affirmation surgery aligns an individual’s physical appearance to their gender identity. Many hospitals provide gender-affirming surgery through a transgender medicine department. Medical procedures include:
Facial surgery – Facial feminization surgery.
Breast augmentation – Increases breast size with implants.
Chest masculinization – Removes contours of breast tissues.
Tracheal shaving – Reduces the Adam’s apple.
Phalloplasty – Construction of a penis.
Orchiectomy – Removal of the testicles.
Scrotoplasty – Construction of a scrotum.
Vaginoplasty – Construction of a vaginal canal.
Vulvoplasty – Construction of the outer female genitalia.
Roadblocks
Transgender individuals are protected from public and private insurance discrimination under federal and state laws, including Medicare and Medicaid. (National Center for Transgender Equality. 2021)
Medicaid programs in nine states do not cover gender-affirming medical treatments, and only Illinois and Maine offer comprehensive standard care recommended by the World Professional Association for Transgender Health/WPATH. (Kaiser Family Foundation. 2022)
Medicare also has no consistent policy regarding the approval of gender-affirming surgery.
Others report family or partner disapproval as the main reason why they discontinue gender affirmation. (Jack L. Turban, et al., 2021)
If you know someone who is transgender or is considering transitioning, learning about gender and gender transitioning and how to be supportive is a great way to be an ally.
Enhancing Your Lifestyle
References
Gülgöz, S., Glazier, J. J., Enright, E. A., Alonso, D. J., Durwood, L. J., Fast, A. A., Lowe, R., Ji, C., Heer, J., Martin, C. L., & Olson, K. R. (2019). Similarity in transgender and cisgender children’s gender development. Proceedings of the National Academy of Sciences of the United States of America, 116(49), 24480–24485. doi.org/10.1073/pnas.1909367116
Irwig, M. S., Childs, K., & Hancock, A. B. (2017). Effects of testosterone on the transgender male voice. Andrology, 5(1), 107–112. doi.org/10.1111/andr.12278
Tangpricha, V., & den Heijer, M. (2017). Estrogen and anti-androgen therapy for transgender women. The Lancet. Diabetes & endocrinology, 5(4), 291–300. doi.org/10.1016/S2213-8587(16)30319-9
National Center for Transgender Equality. Know Your Rights in Health Care.
Kaiser Family Foundation. Update on Medicaid coverage of gender-affirming health services.
Center of Medicare and Medicaid Services. Gender dysphoria and gender reassignment surgery.
Transgender Legal Defense and Education Fund. Health insurance medical policies.
National Center for Transgender Equality and National Gay and Lesbian Task Force. Injustice at Every Turn: A Report of the National Transgender Discrimination Survey.
Turban, J. L., Loo, S. S., Almazan, A. N., & Keuroghlian, A. S. (2021). Factors Leading to “Detransition” Among Transgender and Gender Diverse People in the United States: A Mixed-Methods Analysis. LGBT health, 8(4), 273–280. doi.org/10.1089/lgbt.2020.0437
Gender identity is a wide spectrum. Can learning the language used to describe various gender identities and non-binary pronouns help explain the difference between gender expression and help in inclusivity?
Non-Binary
Non-binary is a term used that describes individuals who do not identify exclusively as male or female. The term addresses various gender identities and expressions that are outside of the traditional gender binary system, which categorizes individuals as either male or female.
Definition
Non-binary individuals are those whose gender identity and/or expression fall outside of the traditional binary categories of a man or woman. (Human Rights Campaign. (n.d.))
Some non-binary individuals identify as a blend of male and female; others identify as a gender different from male or female; some do not identify with any gender.
The term “non-binary” can also be “enby”/phonetic pronunciation of the letters NB for non-binary, although not every non-binary individual uses this term.
Transgender individuals and non-binary individuals are two distinct groups that are related.
There are some transgender/trans individuals who are non-binary, however, most transgender individuals identify as either male or female. (National Center for Transgender Equality. 2023)
To understand the difference, it can help to know the meanings of transgender, cisgender, and nonbinary: (GLAAD. 2023)
Transgender
An individual who identifies with a gender different from the one assigned at birth.
For example, someone assigned male at birth/AMAB, but identifies as a female is a transgender woman.
Cisgender
An individual whose gender identity follows the one they were assigned at birth.
For example, someone assigned female at birth/AFAB and identifies as a woman.
Non-binary
An individual who identifies with a gender outside the traditional binary of male and female.
This can include individuals who identify as genderqueer, agender, or genderfluid and others.
Using Pronouns
Using non-binary pronouns is a way to show respect and validation for an individual’s gender identity. Here are some recommendations on how to use pronouns: (National Center for Transgender Equality. 2023)
Ask for the individual’s pronouns
It’s recommended to avoid assuming an individual’s pronouns based on appearance or stereotype.
If unsure of someone’s pronouns, ask respectfully.
“What pronouns do you use?”
“Can you share your pronouns with me?”
Practice using the pronouns
Once you know an individual’s pronouns, practice using them.
This can be accomplished by using their pronouns when referring to them in conversation, emails, written forms, and/or other types of communication.
If you make a mistake, apologize and make the correction.
Gender-neutral language
If unsure of an individual’s pronouns, or if someone uses gender-neutral pronouns like they/them, use gender-neutral language instead of gendered language.
For example, instead of saying he or she, you can say they or their name.
Continue Learning
Learn as much as possible about identities and pronouns to better understand and support the LGBTQ+ community.
Injury Medical Chiropractic and Functional Medicine Clinic wants to help create a more inclusive and affirming environment for everyone.
How can healthcare professionals provide a positive and safe approach for gender minority healthcare for the LGBTQ+ community?
Introduction
In an ever-changing world, it can be challenging to find available treatments for body pain disorders that can impact a person’s daily routine. These body pain disorders can range from acute to chronic, depending on the location and severity. For many individuals, this can cause unnecessary stress when going in for a routine check-up with their primary doctors. However, individuals in the LGBTQ+ community are often thrown under by not being seen and heard when treated for their pain and discomfort. This, in turn, causes many problems for both the individual and the medical professional themselves when getting a routine check-up. However, there are numerous positive ways for LGBTQ+ community individuals to seek inclusive gender minority healthcare for their ailments. Today’s article will explore gender minorities and the protocols for creating an inclusive gender minority healthcare environment safely and positively for all individuals. Additionally, we communicate with certified medical providers who incorporate our patients’ information to reduce any general pain and disorders a person may have. We also encourage our patients to ask amazing educational questions for our associated medical providers about their referred pain correlating with any diseases they may have while providing an inclusive gender minority healthcare environment. Dr. Jimenez, D.C., incorporates this information as an educational service. Disclaimer
What Is Gender Minority?
Are you or your loved ones dealing with muscle aches and strains after an excruciatingly long day at work? Have you been dealing with constant stress that stiffens your neck and shoulders? Or do you feel like your ailments are affecting your daily routine? Often, many individuals in the LGBTQ+ community are researching and looking for the right care for their ailments that best suits their wants and needs when seeking treatment. Gender minority healthcare is one of the important aspects of the LGBTQ+ community for individuals seeking the treatment they deserve. When it comes to creating an inclusive, safe, and positive healthcare environment, it is highly important to understand what “gender” and “minority are being defined as. Gender, as we all know, is how the world and society view a person’s sex, like male and female. A minority is defined as a person being different from the rest of the community or the group that they are in. A gender minority is defined as a person whose identity is other than the conventional gender normality many people associate with. For LGBTQ+ individuals who identify as a gender minority, it can be stressful and aggravating when seeking treatment for any ailments or for just a general check-up. This can cause many LGBTQ+ individuals to experience a high rate of discrimination in the healthcare setting that often correlates to poor health outcomes and delays when seeking care treatment. (Sherman et al., 2021) This can create a negative environment in the healthcare setting as many LGBTQ+ individuals deal with unnecessary stress and barriers to accessing inclusive healthcare. Here at the Injury Medical Chiropractic and Functional Medicine clinic, we are dedicated to creating a safe, inclusive, and positive space that offers dedicated care for the LGBTQ+ community by using gender-neutral terms, asking important questions, and building a trusting relationship in every visit.
Enhancing Health Together-Video
The Protocols Of An Inclusive Gender Minority Healthcare
When assessing inclusive gender minority healthcare for many individuals, building a trusting relationship with any patient who enters through the door is important. This allows many people within the LGBTQ+ community to be treated with dignity and respect and ensure they receive medical care like everyone else. By making these efforts, many healthcare systems can ensure the LGBTQ+ community their rights to adequate and affirming healthcare services that are provided for them. (“Health disparities affecting LGBTQ+ populations,” 2022) Below are protocols that are implemented for inclusive gender minority healthcare.
Creating A Safe Space
Creating a safe space for every patient for treatment or general check-up visits is important. Without it, it can cause health disparities between the patient and healthcare professional. Healthcare providers must be prepared to identify and address their biases so that it does not contribute to healthcare disparities that many LGBTQ+ individuals have experienced. (Morris et al., 2019) It’s already stressful enough for LGBTQ+ individuals to get the treatment they deserve. Creating a safe space in a clinical practice gives individuals a setting of respect and trust as they fill out their intake forms that include different gender identities.
Educate Yourself & Staff
Healthcare professionals must be non-judgmental, open, and ally to their patients. By educating staff members, many healthcare providers can undergo developmental training to increase their cultural humility and improve healthcare outcomes for the LGBTQ+ community. (Kitzie et al., 2023) At the same time, many healthcare providers can use gender-neutral language and ask what the patient’s preferred name is while validating and utilizing appropriate mental and health screenings. (Bhatt, Cannella, & Gentile, 2022) To this point, many healthcare providers can significantly and positively impact the individual’s experience, health outcomes, and quality of life. Reducing the structural, interpersonal, and individual stigma that many LGBTQ+ people experience can become a way to demonstrate respect not only to the individual but also to the doctors and staff members who receive it. (McCave et al., 2019)
Basic Primary Care Principles
The first thing that many healthcare providers should do is to honor the individual’s gender identity and consider what kind of information or examination for the individual to receive the care they deserve. The attainable standard of health is one of the fundamental rights of every human being. Being an ally can create a trusting relationship with the individual and provide them with a customizable treatment plan they can receive. This offers a safe environment for the individual and is cost-effective while getting the necessary treatment they deserve.
References
Bhatt, N., Cannella, J., & Gentile, J. P. (2022). Gender-affirming Care for Transgender Patients. Innov Clin Neurosci, 19(4-6), 23-32. www.ncbi.nlm.nih.gov/pubmed/35958971
Kitzie, V., Smithwick, J., Blanco, C., Green, M. G., & Covington-Kolb, S. (2023). Co-creation of a training for community health workers to enhance skills in serving LGBTQIA+ communities. Front Public Health, 11, 1046563. doi.org/10.3389/fpubh.2023.1046563
McCave, E. L., Aptaker, D., Hartmann, K. D., & Zucconi, R. (2019). Promoting Affirmative Transgender Health Care Practice Within Hospitals: An IPE Standardized Patient Simulation for Graduate Health Care Learners. MedEdPORTAL, 15, 10861. doi.org/10.15766/mep_2374-8265.10861
Morris, M., Cooper, R. L., Ramesh, A., Tabatabai, M., Arcury, T. A., Shinn, M., Im, W., Juarez, P., & Matthews-Juarez, P. (2019). Training to reduce LGBTQ-related bias among medical, nursing, and dental students and providers: a systematic review. BMC Med Educ, 19(1), 325. doi.org/10.1186/s12909-019-1727-3
Sherman, A. D. F., Cimino, A. N., Clark, K. D., Smith, K., Klepper, M., & Bower, K. M. (2021). LGBTQ+ health education for nurses: An innovative approach to improving nursing curricula. Nurse Educ Today, 97, 104698. doi.org/10.1016/j.nedt.2020.104698
Gender is a concept with many facets. Everyone has a gender expression. Can learning about gender expression help healthcare professionals provide better and more effective treatment plans for the LGBTQ+ community?
Gender Expression
Gender expression refers to the ways that individuals present their gender identity and themselves. This can be clothing, haircuts, behaviors, etc. For many, there can be confusion between what society expects from their gender and how these individuals choose to present themselves. Gender expression is constructed from the culture that surrounds it, meaning that there may be a shared social expectation about gender. It can also mean that the same feminine hair or clothing style in one setting could be seen as masculine in another.
Society tries to regulate expression by making women wear certain kinds of clothes, and men other kinds, in order to participate in school, work, and when in public.
When cultures enforce gender norms it is known as gender policing, which can range from dress codes to physical and emotional punishment.
Creating a safe space for all genders requires awareness of these explicit or implicit gender norms so policing can be prevented. (José A Bauermeister, et al., 2017)
Research has shown that there are increased rates of discrimination against transgender and gender-nonconforming individuals compared with bias against those who are LGBTQ. (Elizabeth Kiebel, et al., 2020)
Health Care
Gender expression can and does affect access to and quality of health care.
Individuals with a gender expression that is different from what is expected for their assigned sex at birth may experience increased bias and harassment from providers. (Human Rights Watch. 2018)
A significant percentage of patients feared health workers would treat them differently because of their expression. (Cemile Hurrem Balik Ayhan et al., 2020)
Minority stress has been shown to play an important role in health imbalances. (I H Meyer. 1995)
Research suggests that gender expression is a part of the minority stress described by cisgender sexual minorities and gender minorities. (Puckett JA, et al., 2016)
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The effects of gender expression are different depending on a person’s sex, gender identity, and their setting.
However, doctors do need to know a person’s sex that was assigned at birth to be able to do proper screening tests, like screening for prostate or cervical cancer.
One way to be more affirming is for the doctor to introduce themselves first, using their own pronouns.
Health workers should ask everyone what name they prefer to be called and what pronouns they use.
This simple act invites the patient to share without creating awkward uneasiness.
Each person chooses how to present themselves to the world, and we respect all. We at Injury Medical Chiropractic and Functional Medicine Clinic will work to address the effects of minority stress on health disparities and raise awareness of the ways to continually improve positive experiences for LGTBQ+ individuals seeking inclusive health care for neuromusculoskeletal injuries, conditions, fitness, nutritional, and functional health.
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References
Bauermeister, J. A., Connochie, D., Jadwin-Cakmak, L., & Meanley, S. (2017). Gender Policing During Childhood and the Psychological Well-Being of Young Adult Sexual Minority Men in the United States. American journal of men’s health, 11(3), 693–701. doi.org/10.1177/1557988316680938
Kiebel, E., Bosson, J. K., & Caswell, T. A. (2020). Essentialist Beliefs and Sexual Prejudice Toward Feminine Gay Men. Journal of homosexuality, 67(8), 1097–1117. doi.org/10.1080/00918369.2019.1603492
Human Rights Watch. “You Don’t Want Second Best”—Anti-LGBT Discrimination in US Health Care.
Ayhan, C. H. B., Bilgin, H., Uluman, O. T., Sukut, O., Yilmaz, S., & Buzlu, S. (2020). A Systematic Review of the Discrimination Against Sexual and Gender Minority in Health Care Settings. International journal of health services: planning, administration, evaluation, 50(1), 44–61. doi.org/10.1177/0020731419885093
Meyer I. H. (1995). Minority stress and mental health in gay men. Journal of health and social behavior, 36(1), 38–56.
Puckett, J. A., Maroney, M. R., Levitt, H. M., & Horne, S. G. (2016). Relations between gender expression, minority stress, and mental health in cisgender sexual minority women and men. Psychology of Sexual Orientation and Gender Diversity, 3(4), 489–498. doi.org/10.1037/sgd0000201
How can physicians create a positive experience for LGTBQ+ individuals seeking inclusive health care for muscle pain?
Introduction
Finding proper treatment for many body pain conditions should not be challenging when numerous factors and conditions can impact a person’s lifestyle. When it comes to these factors can range from their home environment to their medical conditions, which then harms their well-being and not being heard when informed about their situation. This can cause barriers to be built up and causes the individual not to be seen or heard when seeking treatment for their pain. However, many individuals within the LGBTQ+ community can seek numerous personalized solutions to improve their general well-being and have a positive experience that suits their needs. This article explores how inclusive health care can positively impact the LGBTQ+ community and how non-surgical treatments like chiropractic care can be incorporated into a person’s personalized inclusive health care plan. Additionally, we communicate with certified medical providers who integrate our patient’s information to reduce general pain through inclusive healthcare treatment. We also inform them that non-surgical treatments can be a positive experience for them to minimize general body pain. We encourage our patients to ask amazing questions while seeking education from our associated medical providers about their pain conditions in a safe and positive environment. Dr. Jimenez, D.C., incorporates this information as an educational service. Disclaimer
What Is Inclusive Health Care?
Have you been dealing with constant stress that is causing pain in your body? Do you feel like there are barriers that are preventing you from getting the relief you need from your pain? Or are many environmental factors preventing you from getting back your health and wellness? Many individuals seeking treatment for general pain or conditions affecting their health and wellness will often research which care treatment suits their wants and needs in a positive and safe manner while being inclusive. Healthcare treatments like inclusive health care can provide a positive and safe outcome for members of the LGBTQ+ community. Inclusive health care can help many healthcare professionals establish an inclusive code of conduct within the LGBTQ+ community to improve health-specific outcomes. (Moran, 2021) Now inclusive health care is defined as removing barriers to health care services that should be equally accessible and affordable to many individuals regardless of age, sexual orientation, and gender identity. For many people within the LGBTQ+ community, many individuals identify as gender minorities. A gender minority is an individual who identifies as gender non-conforming and whose gender identity or expression differs from the conventional gender binary. Inclusive health care is an important aspect for the LGBTQ+ community as it can benefit people in getting the treatment they deserve.
How Does Inclusive Health Care Benefits The LGTBQ+ Community?
Regarding inclusive health care, many healthcare providers must respect their patients and their needs when coming in for a general check-up. Since many individuals in the LGBTQ+ community are already dealing with enough stress, especially young people, it is important to have a calm, safe, and non-judgmental environment promoting safety and inclusion. (Diana & Esposito, 2022) There are many ways that inclusive health care can provide beneficial results to the individual and health care provider. Some may include:
What pronouns the individual preferred
What the individual wants to be identified
Being respectful of the patient’s needs
Building a trusted relationship with the individual
When individuals in the LGBTQ+ community have inclusive health care in a positive environment, it can create a positive experience for them as it can improve mental health and general well-being and make a huge impact that can be life-saving. (Carroll & Bishop, 2022) The Injury Medical Chiropractic and Functional Medicine Team is committed to building a positive and safe space for individuals in the LGBTQ+ community that need inclusive health care to reduce pain-like symptoms through personalized treatment plans.
How Can Chiropractic Care Transform Pain To Relief-Video
With many individuals looking for the right kind of treatment for general pain and discomfort, many people will look into non-surgical therapies. Non-surgical treatments can be beneficial for many individuals in the LGBTQ+ community as it is safe and can provide individuals with an understanding of what is impacting their bodies. Non-surgical treatments like chiropractic care, spinal decompression, and MET therapy can alleviate pain-like symptoms associated with musculoskeletal disorders through a personalized treatment plan catered to the person. Many health professionals who are respectful and provide a supportive environment for LGBTQ+ individuals seeking inclusive health has been reported an increase in their confidence, and a decrease in their anxiety, which can potentially decrease uncertainty for future visits. (McCave et al., 2019) Creating a safe, positive environment for individuals seeking inclusive health care can help them reduce the pain they have been experiencing while easing their minds. The video explains how non-surgical treatments like chiropractic care can help reduce musculoskeletal pain associated with stress and help realign the body out of subluxation. Additionally, these small changes in creating a safe and inclusive environment when receiving health care can make a lasting and positive impact on many individuals. (Bhatt, Cannella, & Gentile, 2022)
Utilizing Beneficial Treatments For Inclusive Health Care
When it comes to non-surgical treatments being part of inclusive treatment, it is critical to reduce the health disparities and to ensure that many LGBTQ+ individuals receive the needed medical they deserve. (Cooper et al., 2023) Since many individuals face unique health challenges, from body and gender dysmorphia to common muscle strains associated with musculoskeletal disorders, many individuals can seek non-surgical treatments like chiropractic care. Chiropractic care can help meet the individual’s needs by supporting their musculoskeletal health and general well-being. (Maiers, Foshee, & Henson Dunlap, 2017) Chiropractic care can reduce musculoskeletal conditions that many LGBTQ+ individuals have and can be aware of what factors are affecting their bodies in a safe and positive environment. Non-surgical treatments can be combined with other therapies in inclusive health care for LGBTQ+ individuals. They can provide a safe environment in the clinic and improve their care quality by being cost-effective. (Johnson & Green, 2012) Inclusive health care can help make LGBTQ+ individuals a safe and positive space to make them get the treatment they deserve without negativity.
References
Bhatt, N., Cannella, J., & Gentile, J. P. (2022). Gender-affirming Care for Transgender Patients. Innov Clin Neurosci, 19(4-6), 23-32. www.ncbi.nlm.nih.gov/pubmed/35958971
Carroll, R., & Bisshop, F. (2022). What you need to know about gender-affirming healthcare. Emerg Med Australas, 34(3), 438-441. doi.org/10.1111/1742-6723.13990
Cooper, R. L., Ramesh, A., Radix, A. E., Reuben, J. S., Juarez, P. D., Holder, C. L., Belton, A. S., Brown, K. Y., Mena, L. A., & Matthews-Juarez, P. (2023). Affirming and Inclusive Care Training for Medical Students and Residents to Reduce Health Disparities Experienced by Sexual and Gender Minorities: A Systematic Review. Transgend Health, 8(4), 307-327. doi.org/10.1089/trgh.2021.0148
Diana, P., & Esposito, S. (2022). LGBTQ+ Youth Health: An Unmet Need in Pediatrics. Children (Basel), 9(7). doi.org/10.3390/children9071027
Johnson, C. D., & Green, B. N. (2012). Diversity in the chiropractic profession: preparing for 2050. J Chiropr Educ, 26(1), 1-13. doi.org/10.7899/1042-5055-26.1.1
Maiers, M. J., Foshee, W. K., & Henson Dunlap, H. (2017). Culturally Sensitive Chiropractic Care of the Transgender Community: A Narrative Review of the Literature. J Chiropr Humanit, 24(1), 24-30. doi.org/10.1016/j.echu.2017.05.001
McCave, E. L., Aptaker, D., Hartmann, K. D., & Zucconi, R. (2019). Promoting Affirmative Transgender Health Care Practice Within Hospitals: An IPE Standardized Patient Simulation for Graduate Health Care Learners. MedEdPORTAL, 15, 10861. doi.org/10.15766/mep_2374-8265.10861
Moran, C. I. (2021). LGBTQ population health policy advocacy. Educ Health (Abingdon), 34(1), 19-21. doi.org/10.4103/efh.EfH_243_18
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