Making Physiotherapy an inclusive experience for queer patients

Author: Tyler Tytgat

Reading Time: 6 minutes

We recently had the opportunity to create an educational video for our staff on how to make Physiotherapy a more inclusive space for LGBTQ+ patients. The video is led by Tyler Tytgat who recently completed his Kinesiology practicum at our High Performance Center. He spent weeks learning with us beyond the classroom; but as it turns out, we have a lot to learn from him as well. Tyler is a cisgendered gay man working as a new kinesiologist and is driven make his industry more welcoming to fellow LGBTQ+ community members.

In this blog, we’ll share some of Tyler’s valuable insights and strategies that Physiotherapy clinics, practitioners, and clinical teams can reflect on and adapt to their day-to-practice.

In a clinical setting, Tyler has recommended directing focus in the following areas:

For clinical staff:

Use queer friendly language.

  • Pronouns and gender affirmation
  • Gender neutral language

For clinics:

Adapt operational practices to express a LGBTQ+ friendly clinic.

  • Clinic imagery
  • Inclusive paperwork
  • Acknowledge Pride Month

USING QUEER FRIENDLY LANGUAGE

Language matters! Evidence in research suggests that the words we use affect the care decisions we make for people. Stigmatizing language can cause people to feel unsafe in our care and limit their access to healthcare resources.

Using queer friendly language in a physiotherapy setting can help reduce the delay of treatment and help avoid microagressions

Fear of discrimination is a forefront barrier to treatment for transgender and gender non-conforming (TGNC) patients, so much so that 28% of subjects who responded to a survey admitted to delaying treatment due to fear of discrimination.

Furthermore, by knowing your patient’s pronouns and using inclusive language, you can avoid unintentional offensive statements or microaggressions that may deter them from returning for follow-up-care.

Here are some ways to use gender neutral language with patients:

  • Pronoun ice breakers: sharing your own pronouns can be use a useful tool for comforting queer patients and showing that you respect the complexity of gender identity. This can help you be conscious of your overt and subtle cues that may affect the comfort and safety of TGNC patients.
  • Develop a standard practice of asking pronouns from all your patients. If your patients are not used to being asked for their pronouns in their healthcare journey, let them know that asking everyone is an effort to help to break down barriers for other people.
  • If a patient hasn’t provided their pronouns, ask them in a private professional manner. Take them aside in a closed room or with the curtains drawn and ask them, “I’d like to respect you, what pronouns do you use” or “Are you comfortable sharing your pronouns with me?
  • If you make a mistake using the wrong pronouns with a patient, it’s ok! Identify your mistake, correct it, and apologize. This will show that you’re actively trying to respect your patient and affirm their identity.
  • Patients may think you’re pushing an agenda. Let them know that everyone is asked for their pronoun, state it matter-of-factly, and don’t be afraid to use professional judgment. If you feel like this question is going to upset them or come in the way of their care, don’t ask it – that’s ok.

Here are some general guidelines for using gender neutral inclusive language with patients:

  • The biggest general rule is reflect the language your patients use.
    • Example 1:  If they refer to their partner as a partner, say partner instead of girlfriend/wife or boyfriend/husband.
    • Example 2: If your patient’s pronouns are she/them, has romantic relationships with females, and identifies as queer; use she/them equally and interchangeably but don’t refer to them as lesbian because that’s not the language that she’s used.
  • Be mindful of terms related to family. This acknowledges the diverse configurations of families. Inclusive language relating to family involves using terms like parent, caregiver, or guardian instead of mom or dad.
  • Patient history. Ask for genetic history instead of family history. Some queer patients may not be accepted in their families after coming out. This can be a hard topic to discuss.

Adapt operational practices that help create a LGBTQ+ friendly clinic

Representation matters! It raises visibility and promotes acceptance.

CLINIC IMAGERY

Sensitive care practice begins even before a patient walks through the doors. A clinic can include visibility and presence of allyships through social media and websites. 

Here are some ways to express a gender neutral/inclusive clinic through clinic imagery:

  • On social media, use images that display same sex couples or symbols that reflect queer identities
  • Publish blog posts that focus on LGBTQ+ related issues 
  • Display pronouns on practitioner’s website biographies 
  • Consider posting a non-discrimination policy on your website that outlines specific queer-related topics
  • Signage for bathrooms or change rooms should identify that they are all gender or universal 

CLINIC PAPERWORK

Using inclusive language on paperwork can help queer-identifying patients feel welcomed and recognized in their physio journey. * Remember – Intake paperwork applies to employees as well!

Here are some ways a clinic can develop gender neutral/inclusive paperwork:

  • Policies on sexual and gender identity anti-discrimination should be included in the hiring process.
  • A “Not applicable” option should be available for “male only” or “female only” questions.
  • Charting/intake forms that use body images to reflect location of concerns should be gender neutral.
  • Gender affirmation should be addressed right away by asking for gender and sex separately as well as pronouns.
  • Ensure front desk are also aware of inclusive language. For example, saying  “Hello there, how can I help you?” vs “Hello ma’am/sir, how can I help you?”
  • Avoid gender-specific language like mother/father or boyfriend/girlfriend. Instead ask for parents, partners, relationships, or blood relatives.

CELEBRATE PRIDE MONTH

Celebrating pride month acknowledges its significance and also respects the existence of the community. By showing your clinic is engaged in pride month, you can attract patients who may otherwise avoid treatment – espeically if they cannot find queer friendly clinics. 

Here are some ways a clinic can celebrate pride month:

  • Display a pride flag in the clinic/waiting room.
  • Use photos on social media with team members wearing pride pins. 
  • Wear pride pins while at work.
  • Share posts, videos, images that advocate queer progression and queer inclusion.
  • Look for local queer-operated events that donate back to organizations who work towards LGBTQ+ advancement.

Worried about stirring the pot?

Pride month is a time for celebration and promotion of inclusion! It’s unlikely that you will receive backlash for promoting pride month. 91.87% of Canadians reported positive feelings towards people who are gay, and 87.6% were comfortable with people who are transgender (Akin, 2020). 

IN SUMMARY:

  1. Implement gender neutral practices. This includes front desk staff, Kins, practitioners, and office staff.
  2. Mistakes are going to happen. Acknowledge your mistakes, apologize for them, learn, and move on. Don’t avoid the conversation – it’s ok to learn from mistakes.
  3. Pronoun terminology is reflective language that helps affirm identify, they are not labels.
  4. Personal and professional imagery should reflect the diversity of the patients you treat – this includes gender, race, and sexual orientation.
  5. Affirming care starts from the moment your patient enters the clinic. This means intake paperwork, primary encounters, and our front desk staff should be the start of affirming care.
  6. Celebrate pride month! Help queer patients feel welcomed.

Written by:
Tyler Tytgat, Kinesiologist

In collaboration with:
Cathy Ocol-Duque, Director of Marketing and Corporate Communications

Additional Resources:

References:

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