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)
Better Training
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.
Revolutionizing Healthcare
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. https://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. https://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. https://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. https://doi.org/10.1037/sgd0000201
Chiropractor, Dr. Alexander Jimenez examines being able to have sex despite having back pain.
The results of SpineUniverse’s national survey on Sexual Satisfaction and Back Pain (read the article Back Pain and Its Impact on Sexual Satisfaction for survey results) indicate that back pain is ruining the sex lives of many people.
It is vital to consider that behind the numbers are real individuals, while the statistical results of the survey are very important. People who care about their partner’s and about their sexual gratification satisfaction. People who are now frustrated and even depressed regarding the impact of back pain on their sex lives.
What exactly can they do to better their situation?
Most specialists agree that three tips can allow you to have better sex� even with back pain:
Tip # 1: Talk It Out
For many people, talking about sex comes for others, their faces turn red even thinking about possibly referring to sex.
Nonetheless, you as well as your partner have to locate a method to discuss your back malady, and the way that it will impact-� or already does change�your relationship.
Take the time to talk through the five dilemmas below:
Back pain: How intense is the pain? Where does it hurt? What moves or increase or positions alleviate the pain?
Sex drive: Is your back pain killing your sex drive? Then you’ve got to discuss this, if it is. If you do not clarify why and simply begin avoiding having sex, you�re your relationship with your partner can be damaged. It’s more straightforward to identify that it is a problem, and never simply theirs �and then find a solution together.
Emotional Impact: What does back pain do to your emotions? Do you feel less appealing to your own partner? Depressed?
Physical Limitations: Living with back pain means living with physical constraints in multiple facets of your daily life. What physical constraints would you now need to work about during sex?
Intimacy: What physical and nonphysical steps can enhance familiarity? (Yes, familiarity means more than sex.) Within the limits caused by back pain, what else can you do to feel close and connected?
Tip # 2: Practical Changes
Here we go, the nitty gritty details of what to do (or not do). (It is ok in case you skipped ahead to this part, but make sure to return and browse the remaining post.)
Position Matters
It may not be the sexiest thing to think about, but you have to remember your diagnosis. Have you got spinal stenosis? A herniated disc? Degenerative changes in your spine? Because what is causing your pain affects how your body reacts to different positions, your analysis is vitally important during sex. For example:
If you have spinal stenosis, your back pain will probably get worse if you arch your back during sex.
Your pain will probably improve should you bend forward during sex when you have a disc herniation or degenerative disk disorder.
So if you’re able to identify which positions naturally lessen your back pain, you can then accommodate your position during sex to help make the experience less painful, given your specific state. For example:
Men that have degenerative disk disease may locate their back pain is decreased by lying with a pillow placed under their low back, while their partner straddles them.
Change The Place
As we’ve learned from Hollywood films, sex does not occur merely in a bed. And perhaps being out of bed will actuality help lower your back pain. For example:
In case you like lying in your back during sex, a solid surface, such as a rug on the floor, may be more comfy for you.
But remember, back pain is individual, if you are on a soft mattress, and perhaps your pain is less during sex. You are required to figure out what’s best for you and your partner.
Rest Your Back
Back pain is frequently made worse by your muscles becoming tense as well as knotted around the region that was painful. Going in a hot tub before sex, having a soothing massage, and sometimes even just using heat or ice packs on the affected region can all ease away muscle pains just before sex.
For more practical tips about sex and back pain and more details on sexual positions go to Sex & Back Pain.
Tip # 3: Speak To A Medical Specialist
We know, talking about sex together with your doctor isn’t the most appealing notion (unless your doctor is Dr. Ruth). But think of this: When Viagra first became available, many men were too embarrassed to talk about erectile dysfunction using their doctor. Subsequently Bob Dole appeared in among their advertisements, and that made it more easy to talk to your physician about sex. (Maybe the thinking was�’If Bob Dole, a politician, can declare he has a problem, maybe I can, too!’)
Besides, physicians have heard it all and they’re prepared to help. Your physicians care about all facets of your physical and emotional well-being; they won’t pity, judge or mock you. So take a deep breath, push past the potential embarrassment, and confer with your physician about how back pain is affecting your sex life. Often, physicians can give advice that is really useful. By way of example, even just a modest change in a medication can make a major difference to your pain.
Because Sex Is More Than�
Sex is more than just the sum of its own physical parts�it’s more than a formula of physical steps that lead to the “perfect” experience. Lots of that which we see in films and on TV these days makes sex the pinnacle of a relationship, the one thing that clearly defines you as a couple (think Grey’s Anatomy).
However, for the vast bulk of people, sexual satisfaction depends on numerous variables, not just physical performance. Factors for example emotional connectedness, a bouquet of flowers sent for no reason, attentive listening, saying thank you for the small things, or sending the kids to Grandma can add to sexual gratification.
And your back pain limits none of those things. You can still have a satisfying, intimate relationship�back pain or not.
Most people don�t go to a chiropractor for a better sex life, but that extra benefits is a pretty happy accident. �People come in with back pain, but after adjustments, they come back and tell me their sex life is so much better,� says Jason Helfrich, co-founder and CEO of 100% Chiropractic. �It�s no surprise to us�it�s amazing what the body will do when you take away the pressure on the nervous system.�
And what are those amazing feats, exactly?
Let�s start with what a chiropractor really does. Every function in your body is controlled from the nervous system, but when vertebra are off position�known as a subluxation�the nerves traveling between your brain and your muscles can become blocked, compromising your body�s ability to function as it needs to. Every chiropractor�s goal is to remove these subluxations, since they can both cause pain and impede feeling, Helfrich says.
But these fixes help more than just back pain. The lumbar region (your lower back) is a huge hub for the nerves that extend into your reproductive regions. Removing lumbar subluxations can improve nerve flow to your sexual organs, increasing things like blood flow to your clitoris or, for your husband, the penis.
The flow of nerve signals is a two-way street, though, meaning that adjustments also allow your organs to send messages to the brain more easily. This means that you not only do you become physically aroused faster, but your brain also registers that ready-for-action, heightened sense of pleasure more quickly, so you move past the mental obstacles that may be keeping you from orgasming, Helfrich explains.
The other key adjustment area for a better sex life?
Right below your brain stem, around the vertebrae known as C1 and C2. �Libido and fertility require a delicate balance of estrogen, progesterone, and other hormones, many of which are released in the upper cervical and neck area,� he explains. If there are any blockages right out of the brain, the impingement up there will have an effect all the way down.
Even your fertility is affected by the nerves and hormones coming out of the spine, as they control your reproductive cycle.
But beyond all of the physiological benefits of tweaking your spine to perfection, chiropractic adjustments can also simply give your muscles more range of motion. This means you can try previously impossible positions under the sheets.
�We want to improve people�s health, and health is about living life as its intended. Having a great sex life is huge part of that,� Helfrich adds. No arguments here!
Most people don�t go to a chiropractor for a better sex life, but the extra benefit is a pretty happy accident. �People come in with back pain, but after an adjustment, they come back and tell me their sex life is so much better.�
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