Massage Therapy Journal Summer 2025

Summer 2025 • 61

for health care workers; lack of research on LGBTQIA+ health-related issues; restrictive health benefits; and fear due to stigma, discrimination and institutional bias in the health care system. 33,34 Although many strides have been made, there still remains a great stigma attached to “coming out.” Non-binary individuals have only recently become a gender marker in some countries, but not all. A gender marker is a way to represent a person’s gender identity, often on government-issued IDs. The most common gender markers are “F” for female, “M” for male, and “X” for non binary, intersex or other gender identities. The data available likely does not account for those unable to express their gender for fear of retribution or discrimination. Indeed, reports on homophobic and transphobic hate crimes are rising in the US and the UK, which may be reasons why LGBTQIA+ individuals may feel unsafe in disclosing information. 35,36,37 How to Create an LGBTQIA+ Inclusive Practice: Reducing Barriers It is important to reduce barriers for LGBTQIA+ individuals so that everyone has equal access to high-quality care. Indeed, LGBTQIA+ clients may not feel comfortable disclosing information relating to their health and body. To reduce this barrier, practitioners must understand the specific health needs of LGBTQIA+ people and create an environment that empowers them to feel safe enough to come into our practices and share their health information. There are a number of ways this can be achieved. 38,39,40,41 • Post and participate in practices of welcome and acceptance in your office and on your website/social media marketing platforms . LGBTQIA+ individuals report they often search for subtle cues to determine acceptance. Post LGBTQIA+ symbols and posters of ethnically and racially diverse transgender or same-sex couples. Post a nondiscrimination statement that includes gender identity and sexual orientation. The American Medical Association

and does not discriminate based on race, age, religion, ability, marital status, sexual orientation, or gender identity.” Be sure to have the cultural knowledge to follow it up so as to prevent a potentially traumatic experience for LGBTQIA+ clients. Provide waiting room magazines about the LGBTQIA+ community. Support observance of LGBTQIA+ Pride Day and National Transgender Day of Remembrance. • Use gender-inclusive language . Use clients’ preferred names and pronouns during conversations. Once the terms are established, a note should be made in the client record to follow the description pattern for future visits. Electronic records may require modification to provide appropriate terminology. Pronouns are words we use to refer to a person’s gender. For example, he/him/his and she/her/hers . Some people may prefer gender neutral language and use pronouns such as they/them/their. When in doubt, use they/them/their. Share your pronouns when introducing yourself and include this information in emails on social media platforms. • Apologize promptly for any mistakes . There is a learning curve to becoming skilled at having conversations. You may make mistakes. If this happens, apologize promptly and make the necessary corrections. • All gender restrooms . Design restrooms to be used by people of all genders, regardless of their assigned sex or gender identity. Mark single occupancy restrooms as all gender or gender inclusive, or post a sign stating all are welcome to use the restroom stall of their choice if your business has only female and male restrooms. • Use gender-inclusive intake forms . Include a space for pronouns, which range from she/ her/hers and he/him/his to genderless pronouns such as they/them/their. Include a space for clients to indicate the name they want to be called, as those may be different from their legal names or the names on insurance policies. Do not use terms like preferred pronouns or preferred names on forms or in communications, as these suggest an element of flexibility or

recommends this statement: “This office appreciates the diversity of human beings

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