Massage Therapy Journal Summer 2025

62 • Massage Therapy Journal

AMTA Continuing Education

that someone’s identity is less than valid. Our names and pronouns are not suggestions and are not preferred over something else. These are inherent to who we are. Include the term partner in addition to spouse. Include boxes for information about hormone treatments or gender reassignment surgeries. This option allows people to share or not share information that is often deeply personal. Make a note of their chosen name and correct pronouns in your scheduling and billing platforms so that others who may interact with your client in your practice use the current name and pronouns. 42 • Practice active consent . Active consent is permission related to a specific statement and the client must show consent by “actively” agreeing or disagreeing. Use statements such as “My hand is on the lower back. Are you comfortable with my hand there?” “How does that pressure feel for you?” Allowing clients to actively consent and have control over what touch they receive at various points helps calm the nervous system down and increases feelings of safety. • Use gender-neutral draping, language and scents . Drape all clients the same way. Consider your language in the massage room. Chest, not breasts. Sides, not hips. Have neutral or unscented options in massage products, and allow clients to make scent-related choices. • Respect those who bind . Chest binding is used by transgender, gender-non-conforming and non-binary people to minimize the appearance and feel of undesired chest tissue. Commercial binders come in different sizes and styles (e.g., half-length crop tops, full-length tank tops). Ask permission to discuss binding with a client. If they consent, first ask about locations of muscular tension from binding. Typical areas include the shoulders, neck, chest and the back (including ribcage and diaphragm). Some clients report facial and jaw discomfort. Some clients will want to remove the binder, and others will not. This decision is very personal, and it is best not to suggest its removal, just as you would with other client garments.

• Learn about gender reassignment procedures . If the client is taking feminizing or masculinizing hormone therapy, ask about routes of administration and side effects. If the client is having or has had gender reassignment surgeries, the usual contraindications apply. Be aware that some surgical scars are previous sites of gender dysphoria. Show compassion • Seek out additional education as necessary . Train staff and provide continuing education on cultural competence in general and the care of LGBTQIA+ clients specifically. Invite members of the LGBTQIA+ community to participate in staff meetings and in-services. There are studies that document LGBTQIA+ youth growing up and facing discrimination as a form of childhood trauma. 43 This discrimination impacts mental health and may lead to posttraumatic stress disorder in this population. Being queer is not a disorder, nor does it cause mental illness. The trauma is actually a Gender dysphoria is psychological distress from an incongruence between a person’s sex assigned at birth and their gender identity. Though gender dysphoria often begins in childhood, some people may not experience it until after puberty or much later. 44 Someone may have male genitals and facial hair but not identify as a male or feel masculine. Someone may have female genitals and breasts, but not identify as a female or feel feminine. Some people do not define themselves as having a “binary” identity, and gender is not important to their identity. They may use different terms, such as gender diverse, gender non-conforming or non-binary. Many people with gender dysphoria have a strong desire to live a life that matches or expresses how they feel about themselves in regard to their gender, which is often achieved by changing the way they look and behave. Some response to lack of societal acceptance. What Is Gender Dysphoria? and consideration when working in these areas, and always obtain active consent.

Many people with gender dysphoria have a strong desire to live a life that matches or expresses how they feel about themselves in regard to their gender, which is often achieved by changing the way they look and behave. Some people with gender dysphoria use hormones and other gender-affirming care like surgery.

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