Transfeminine equipment or equipment for those with feminine gender expression among people assigned a male sex at birth, particularly transgender and gender non-conforming individuals may include: prostheses, breast forms, gaff, tape, tucking, padding.
Padding: Padding refers to the use of undergarments to create the appearance of larger breasts, hips or buttocks. Padding may also assist in minimizing dysphoria.
Some padding-specific garments include:
– Padded undergarments: Typically, useful for facilitating appearance of wide hips or full buttocks
– Bras with pockets: Also known as mastectomy bras, they are designed to accommodate breast forms and other associated prostheses
– Padded bras: May be preferable if breast growth is present but not at the desired size.
Prostheses: An artificial body part(s), typically made from plastics, lightweight metals, or composites. May be formed to represent a breasts, penis, scrotum, or other anatomy.
Breast forms: Prostheses that have the appearance of breasts. Typically made of soft silicone gel and adhere to one’s body or are placed in a bra. Can be considered a form of padding.
Tucking: Tucking is the practice of arranging and supporting external genitals between the legs, including the penis, scrotum, and testicles so they are not visible in clothing. There are many ways to tuck, such as pushing the penis and other anatomy between your legs and then pulling on a pair of undergarments, to tucking the testicles inside of you. People tuck for many different reasons. One might tuck in order to feel more at ease in their body (minimize dysphoria), to feel more comfortable in their clothing, or to facilitate affirmation as one’s gender. There is minimal research on the safety of tucking.
Gaff: compression underwear that minimizes the appearance of a penis, scrotum, and testicles.
Tape: tape may be used with or instead of a gaff to “tuck” or minimize the appearance of the penis, scrotum, and testicles.
Important gaff considerations:
o Choosing the right size gaff is like choosing the right size underwear. One can also measure the circumference of their waist, just above the hips for correct sizing.
o Safe tucking/gaff techniques mirror those of binding:
o Minimize frequency of wearing, take breaks throughout the week (although it may not be ideal, it is particularly important for involved anatomical and physiological systems). Reducing the intensity of wearing (daytime donning) can also reduce risk of negative effects, though not as significantly as reducing the frequency.
o Minimize duration of wearing, as in reducing the wear time throughout the years. Bottom surgery is an alternate to tucking, however it is important to note that not every individual that tucks will want bottom surgery, nor will all individuals have access to the procedure (cost, access to healthcare, etc.)
o Unsafe tucking can affect the circulatory system, musculoskeletal anatomy, fertility issues, sex and intimacy, and skin integrity.
Gaff/ tucking garment maintenance: First and foremost, follow the washing/care instructions on the packaging/garment. In general, hand washing is the best. Avoid using bleach and/or a dryer as they accelerate material breakdown/ reduce integrity of the material. Pay special attention to skin folds, folding in the tucking garments (gaffs), bulging skin adjacent to the gaff or selected garment, redness, skin abnormalities, and prolonged indentations. Pay extra attention to the effects of the trans affirming/generally affirming care that you provide.
The risks and contraindications are 𝕒𝕝𝕞𝕠𝕤𝕥 𝕒𝕝𝕨𝕒𝕪𝕤 𝕒 𝕣𝕖𝕤𝕦𝕝𝕥 𝕠𝕗 𝕦𝕟𝕤𝕒𝕗𝕖 𝕥𝕦𝕔𝕜𝕚𝕟𝕘 and 𝕒 𝕣𝕖𝕤𝕦𝕝𝕥 𝕠𝕗 𝕒 𝕙𝕖𝕒𝕝𝕥𝕙 𝕤𝕪𝕤𝕥𝕖𝕞 𝕥𝕙𝕒𝕥 𝕗𝕒𝕚𝕝𝕖𝕕 𝕒𝕥 𝕞𝕖𝕖𝕥𝕚𝕟𝕘 𝕒𝕟 𝕚𝕟𝕕𝕚𝕧𝕚𝕕𝕦𝕒𝕝𝕤 𝕟𝕖𝕖𝕕𝕤. We need to have the knowledge based to educate our clients on safe tucking practices as healthcare provides and 𝕖𝕤𝕡𝕖𝕔𝕚𝕒𝕝𝕝𝕪 as occupational therapists. HELLO!! ADLS!! DRESSING!! Anotha time for the people in the back: we alllll know that our professors/we talk about dressing all of the time throughout our programs and throughout providing care 𝕒𝕔𝕣𝕠𝕤𝕤 𝕥𝕙𝕖 𝕝𝕚𝕗𝕖𝕤𝕡𝕒𝕟. That’s right peds friends, I’m calling you in on this too. You may have a child, adolescent, or young adult that is going to need 𝕪𝕠𝕦 to educate them on safe tucking practices.
Transmasculine equipment or equipment for those with masculine gender expression among people assigned a female sex at birth, particularly transgender and gender non-conforming individuals may include: binders, packers, prostheses, and bandaging.
Prostheses: An artificial body part(s), typically made from plastics, lightweight metals, or composites. May be formed to represent a penis, scrotum, testicles, or other anatomy.
Packers: A prosthesis with the form a penis
Binders: commercially produced binders designed for binding. Other options (usually less safe options) are sports bra, neoprene/athletic compression garments, plastic wrap, duct tape, and more. The benefits of binding far outweigh the risks, however 𝕥𝕙𝕖 𝕣𝕚𝕤𝕜𝕤 𝕒𝕣𝕖 𝕥𝕠 𝕓𝕖 𝕥𝕒𝕜𝕖𝕟 𝕧𝕖𝕣𝕪 𝕤𝕖𝕣𝕚𝕠𝕦𝕤𝕝𝕪.
Binding: Binding involves wearing tight clothing, bandages, or compression garments to flatten out one’s chest and/or other anatomical features.
Safe binding practices include:
Donning neoprene/athletic compression garments or commercial binders. The limited research supports using neoprene/athletic binders over commercial binders.
Minimize frequency of wearing, take breaks throughout the week (although it may not be ideal, it is particularly important for involved anatomical and physiological systems). Reducing the intensity of wearing (daytime donning) can also reduce risk of negative effects, though not as significantly as reducing the frequency.
Minimize duration of wearing, as in reducing the wear time throughout the years. Top surgery is an alternate to binding, however it is important to note that not every individual that binds will want top surgery, nor will all individuals have access to the procedure (cost, access to healthcare, etc.)
Binding maintenance: First and foremost, follow the washing/care instructions on the packaging/garment. In general, hand washing is the best. Avoid using bleach and/or a dryer as they accelerate material breakdown/ reduce integrity of the material. A binder should never be too tight. Pay special attention to skin folds, folding in binding material, bulging skin adjacent to the binder, redness, and prolonged indentations. Pay extra special attention to the effects of the trans affirming/ generally affirming care that you provide.
According to research, some benefits of binding include:
– Increased self-esteem, confidence, ability to go out safely in public, positive mood
– Decreased suicidality, anxiety, and dysphoria
The research also notes the following risks and contraindications:
– Pain related to the musculoskeletal system and at times internal systems
– Musculoskeletal system changes including bad posturing, shoulder joint ‘popping’, fractures, and muscle atrophy
– Neurological system changes like numbness, dizziness, and more.
– GI system changes, decreased motility, and more
– Respiratory changes like SOB, coughing, and more
– Skin and tissue change like skin breakdown, wounds, and infection
𝕃𝕖𝕥’𝕤 𝕓𝕖 𝕤𝕦𝕡𝕖𝕣 𝕔𝕝𝕖𝕒𝕣
The risks and contraindications are 𝕒𝕝𝕞𝕠𝕤𝕥 𝕒𝕝𝕨𝕒𝕪𝕤 𝕒 𝕣𝕖𝕤𝕦𝕝𝕥 𝕠𝕗 𝕦𝕟𝕤𝕒𝕗𝕖 𝕓𝕚𝕟𝕕𝕚𝕟𝕘 and 𝕒 𝕣𝕖𝕤𝕦𝕝𝕥 𝕠𝕗 𝕒 𝕙𝕖𝕒𝕝𝕥𝕙 𝕤𝕪𝕤𝕥𝕖𝕞 𝕥𝕙𝕒𝕥 𝕗𝕒𝕚𝕝𝕖𝕕 𝕒𝕥 𝕞𝕖𝕖𝕥𝕚𝕟𝕘 𝕒𝕟 𝕚𝕟𝕕𝕚𝕧𝕚𝕕𝕦𝕒𝕝𝕤 𝕟𝕖𝕖𝕕𝕤. We need to have the knowledge based to educate our clients on safe binding practices as healthcare provides and 𝕖𝕤𝕡𝕖𝕔𝕚𝕒𝕝𝕝𝕪 as occupational therapists. HELLO!! ADLS!! DRESSING!! I don’t want to hear any of that “we don’t have room in our curriculum for LGBTQIA+ topics” anymore. Sis, honey, darling, we alllll know that our professors/we talk about dressing all of the time throughout our programs and throughout providing care 𝕒𝕔𝕣𝕠𝕤𝕤 𝕥𝕙𝕖 𝕝𝕚𝕗𝕖𝕤𝕡𝕒𝕟. That’s right peds friends, I’m calling you in on this too. You may have a child, adolescent, or young adult that is going to need 𝕪𝕠𝕦 to educate them on safe binding practices.
Peitzmeier, S., Gardner, I., Weinand, J., Corbet, A., & Acevedo, K. (2017). Health impact of chest binding among transgender adults: a community-engaged, cross-sectional study. Culture, Health & Sexuality, 19, 64-75. doi:10.1080/13691058.2016.1191675
Background: While completing my undergraduate degree, I became passionate about the field of sexual wellness while working with various non-profit organizations that provided HIV-related services and raised scholarships for LGBTQ students. Those experiences emphasized the importance of education around sexuality, and after beginning graduate school I was delighted to discover that sexual activity is included in the domain of occupational therapy. I was able to bring OT and sexuality education together and collaborate with @sexintimacyOT for my doctoral capstone project to create a continuing education course on LGBTQ0-inclusive practice.
Profession: Occupational Therapy
Area(s) of Practice or Interest: Sexual activity and education, pediatrics, hand/orthopedics
What does being ‘Out in Healthcare’ mean to you?: I believe that generally people have many misconceptions about what it means to be LGBTQ until they know that they know LGBTQ people. In my day-to-day life, I live by the mantra of “advocacy through visibility”, and I try to do the same in a professional setting by being authentic about my own sexual identity. I think this normalizes conversations about sexuality, models to colleagues how to respond, and indicates a safe-space to clients.
What is one thing everyone should know about your identity?: Overall I think that LGBTQ visibility is a good thing, but I’ve noticed that a lot of the mainstream media highlighting LGBTQ people are pretty narrow in their scope. I just want people to check themselves for implicit biases that are easy to subscribe to and know that being gay does not mean being into interior design, subscribing to a particular style of drag, or being into drag at all for that matter. Part of allyship is celebrating LGBTQ people for their identities, so just recognize that there are countless ways for identities to differ and each is as valid as the next.
How do you feel when your identity is included?: We [LGBTQ people] have gone so long without seeing proper representation or inclusion that I definitely notice when we are included in policies and media, even with little things.
What does “taking up space” mean to you?: To me this goes back to the idea of advocacy through visibility. It’s not like I always talk about being gay, queer culture, or anything like that, but I do think it is important to share my sexual identity with the people around me. I think its personal relationships that create allies. It’s so obvious to LGBTQ people how cisnormative/heteronormative everything is by default, and that creates a lot of marginalization that the majority never considers. I think that we can use that lens for the better to recognize how other minority groups could be excluded and erased, then aim for more inclusive, mindful practice.
What is one piece of advice that you would give to healthcare workers who aren’t sure how to honor the identities of their patients?: I know for OT in particular, there are not very many resources, which is why I created the LGBTQ-inclusive course for my capstone project. For healthcare professionals in general, I think the National LGBT Health Education Center is the best resource for practice guidelines. Time in the clinic is precious and the experience is often stressful for clients; it would be very unusual that that time would be best spent with the client educating the clinician about their sexuality. Being educated about sexuality before interacting with clients is best practice. If somebody finds themselves in a situation where they still are unsure, I think the most import thing they could do is approach the situation with humility.
Has your identity influenced healthcare that you’ve received?: There are two instances that come to mind in which providers made assumptions about me after I disclosed that I am gay, and both instances were regarding sexual health interestingly enough. The first time I was just completing a routine check-up and getting some vaccinations to start graduate school, and the physician suggested that I complete a battery of STD tests. Even after I explained that I have worked in sexual health, am very aware of my relative risks, and was current on all my tests, the physician suggested that I at least get an HIV test. The second time, the nurse told me that they were going to ask me some questions about my sexual health, but once I said that I was gay, they moved on to ask me about other areas of health. Afterwards, without knowing any of my risk factors or sexual habits, they proceeded to try to administer a test that was completely inappropriate and did not apply to me at all. At this point, I said I would not be doing that test, explained that I previously worked in sexual health, and commented that I was surprised that they did not ask more questions to assess which tests were appropriate. The nurse brushed off my response and quickly said that there were more questions on the template but they were optional to ask and this was standard procedure.
Background: I am 23 year old cisgender female born and raised in Mumbai, India. From being an 8-year-old child interested in gynecology and pursuing Occupational Therapy at the age of 17, a lot has changed unlike my passion for understanding sexuality. When I joined OT all I knew was it enables independence, holistic in approach and has scope for creativity and research. I haven’t been disappointed with that idea ever since I graduated from Asia’s first Occupational Therapy school in 2019. I came out to my family and friends 2 years back. While my parents still believe “bisexuals” don’t exist; my brother, colleagues and friends have been extremely supportive of my choices. However, this relationship with my own sexuality is ever evolving and I’ve so much to learn about my own body & desires. Currently, I am working as a school-based OT and on the mission of educating and equipping therapists with tools and resources to create and build upon safer, inclusive, and judgement-free spaces for sexual expression.
Profession: Occupational Therapist
Area(s) of Practice: Sexuality and Mental Health, Wellness and Rehabilitation
What does being ‘Out in Healthcare’ mean to you?: It means to represent and own my authentic self as a person and professional. It allows me to be open, honest with my clients and get a better perspective towards intimacy and relationships. Moreover, it has become a means of creating safer spaces for awareness and sensitizing people on gender and sexuality. This further sets an example of courage for others to be themselves and represent what they believe in.
What is one thing everyone should know about your identity?: Bisexuals are not indecisive, confused, experimenting, or only engaging in polyamory. Sexuality is fluid and sexual expression is a personal choice. Bisexuality for me is having a slightly wider spectrum of choice- an attraction to the person of same or opposite gender. This may also look like attraction to two or more genders for someone else. So, even though it’s one identity, the way we all express it can be vastly different.
How do you feel when your identity is included?: The “B” in LGBTQ is often invisible to most people. Bisexuals aren’t straight enough for the heteronormative society and not gay enough to be included in the LGBTQ+ community. It’s a constant struggle for belongingness but as long as people who matter to me are a part of my life and let me be part of theirs, nothing else matters!
What does “taking up space” mean to you?: Taking up space is an act of resistance. To own and establish your unique brand of self in this beautiful mess of a world. This space has a certain vibe, healthy boundaries, and provides a sense of belongingness. I don’t have to wait to belong anywhere as I belong everywhere. My thought & idea matters. My voice matters. I matter.
What is one piece of advice that you would give to healthcare workers who aren’t sure how to honor the identities of their patients?: Look and create that space of communication about sexuality. It won’t naturally arise because most healthcare workers aren’t addressing this area making patients clueless about the services we could offer. It will be awkward but it’s a skill set we learn and get better at- just like sex! And if it’s too much for you, be open to learn from your patient and let them guide you through this.
Has your identity influenced healthcare that you’ve received?: There is often no acknowledgement or plain ignorance to how I identify. It’s always assumed that I’m a heterosexual because I identify as a cisgender woman. I’ve not been denied any healthcare facilities but most providers fail to understand what I need from them. They lack providing optimal quality care expected from them which makes it harder for me to trust them at times.
Where people can find you: Website:sexloveandot.in Instagram/Facebook: @sex.love.andot Email: email@example.com
Background: I was born and raised in Buffalo, NY. I graduated with my Masters from D’Youville College. I have been practicing for 3 years (currently as a travel OT) and I have worked primarily with traumatized youth in specialized behavior schools. This is where my passion lies and I plan to become a certified specialist in trauma interventions for youth. I am lucky to have grown up in a city like Buffalo, where the LGBTQIA+ community is celebrated. I attend local LGBT events, hang out at LGBT bars and cafes, and support local arts and music. I have also modeled for a gender neutral shoot at my hair salon. When I am not being social I enjoy being as active as possible, whether with yoga, lifting, cycling, or hiking. Needless to say, I keep myself busy!
Profession: Occupational Therapist
Area of Practice: Youth-Young adult, School-based
What does being out in healthcare mean to you?: Since I primarily work with youth, coming out as a healthcare worker gives me the opportunity to be an LGBT role model for kids, who are experiencing their own journeys in a world that prioritizes being cisgender and straight. There is a common misguided idea that children are “too young” to be exposed to the concept of being queer, when everything they are exposed to in our current social climate emphasizes heterosexual, patriarchal relationships. Kids who feel they might be trans, gay, etc. have very little representation to identify with, and can be left confused, ashamed, and targeted by their peers. I value that my platform in healthcare allows me to be someone kids can be their authentic selves around, while showing them that being queer is both normal and something they can (and should) celebrate in themselves and others. Destigmatizing queerness in school will help kids feel safer and more empowered to come to school, perform their occupations, and achieve to their full potential.
What is one thing everyone should know about your identity?: Non-binary lesbians are valid! My gender identity is non-binary, which means I do not identify within the culturally imposed male-female binary. Gender is socially constructed, and I don’t feel compelled to participate in concepts of masculinity and femininity. I’m just Sara! My sexuality is lesbian, which means I am attracted to women and non-binary folk (this frequently misunderstood and sometimes argued, but non-binary people have historically always been included in lesbianism!)
How do you feel when your identity is included?: Even within the LGBT community, non-binary lesbians are often looked at with a sideways head. Even people within the community need to be further educated on inclusivity. When my identity is acknowledged and respected, it feels affirming and great. At work, I have been hesitant to even come out as a lesbian at certain jobs, mostly when it seemed like there weren’t any other queer people around. Once I started encountering openly gay colleagues, I was much more confident to come out. I enjoy feeling empowered to come out on my own terms rather than let people make assumptions and judgments. Fortunately, I’ve never been in a workplace where I felt ostracized after coming out, which has made it easier and more comfortable to be myself while doing my best work.
What does “taking up space” mean to you?: Taking up space means that I feel empowered and safe to be openly and proudly queer. I should be able to live my truth as fully as my cis and straight peers do, without any shame or disrespect. Unfortunately, LGBT people do still face stigma and discrimination, but the more we take up space and come out, the more we demand that we be considered as equals in healthcare and society as a whole.
What is one piece of advice that I would give to healthcare workers who aren’t sure how to honor the identities of their patients?: The most important thing is learning the needs of each individual patient, rather than relying on generalizations or assumptions. Ask the patient directly what their name and pronouns are so you can always address them and speak about them without invalidating their identity (and never refer to them with labels they have not used themselves). If you are unsure of something related to gender/sexual identity and need to know to help you can work with your patient, ask the patient directly, with open-ended, non-invasive questions (i.e “Are you sexually active? With which genders?”) Never assume that someone performs certain tasks or behaviors because of their identity.
Has your identity influenced healthcare that you have received?: I don’t feel I’ve been discriminated against due to my identity, but I do feel the system needs work in its approach to sexual health in general. All my doctors know that I am a lesbian, and I have been asked if I am with a partner and if I am sexually active. This is usually where the questions end, and I feel patients would benefit from more in depth questioning. I was once asked about sex toy usage and cleaning, which may have been asked since I am a lesbian, but I would hope practitioners would ask all individuals this question.
Background: I was born and raised in Buffalo, NY. I decided to enter nursing school because I was always inspired by the compassionate care that nurses provided me throughout my life.
Area(s) of practice: Mental/Behavioral Health
What does being out in healthcare mean to you?: Being out in healthcare means accepting that you are a role model to those around you. Living my truth is not always easy, but even if it eventually inspires one person to do the same, or feel represented in some way, I’m happy.
What is one thing you think everyone should know about your specific identity or the LGBTQIA+ community as a whole?: It’s important to never make assumptions about an individual based on your stereotypes of the collective group. Each person is unique in their own way and should be treated so.
How do you feel when your identity is acknowledged and included, in the workplace/ in media OR how do you feel when your identity is not included or acknowledged?: It is amazing to see in my lifetime, the drastic changes that have already occurred in regards to LGBTQIA+ representation in the media and in workplaces. I’m hoping that the ball keeps rolling and that this can be the case for every member of the community.
What does “taking up space” mean to you?: It means living my truth and helping those around me understand better. It means showing clients who come through the clinic doors that this is a safe space, and while we may not get everything right the first time for them, they can count on the fact that we are always evolving for the better
What is one piece of advice that you would give to a healthcare professional that is unsure of how to/inexperienced with honoring and including the identity on someone within the LGBTQIA+ community while receiving healthcare services?: Accepting that you don’t have all of the answers is the first step to a therapeutic relationship with a client in the LGBTQIA+ community. Even for me, my experiences as a gay man may be completely different than those of another gay man. Understanding that a client shouldn’t have to constantly explain their existence and identity to healthcare professionals is also important.
Has your identity influenced healthcare that you’ve received in the past? Absolutely, I remember being asked on a physical if I was “safe when I was privately with girls,” or, “a guy like you must have no problem finding a nice girl.” It’s hard for some people to understand that their assumptions can be really harmful to the mental health of people in the LGBTQIA+ community, and even in some cases deter them from receiving treatment.
Background: I was born and raised in Rochester NY where my whole family is from. Growing up I always wanted to be in medicine because I’m passionate about human connection and the human body. As soon as I researched the PA profession I knew it was a perfect fit; it is versatile, allows me a wonderful work/life balance, and provides abundant opportunities to learn and grow every day. I went to PA school at D’Youville College in Buffalo, NY and now I work at a community hospital back home in Rochester. Outside of work I love to draw, hike, sing, and spend as much time as possible with my friends and family.
Profession: Physician Assistant
Area of practice: Hospital medicine
What does being out in healthcare means to you?: I am a person who is proud to display rainbows on my ID badge and my identity in the queer community isn’t something I shy away from, especially at work. I truly believe that love is love, and this openness is something I talk about often and freely. I don’t hold myself back from ignorant people, instead leaning into my queer identity as a tool to educate. I am living proof that kindness and compassion can exist within any body. I have had coworkers thank me for breaking down their own stereotypes about queer folx. I have had patients thank me for creating a safe space to relax and be themselves in an otherwise scary and unfamiliar environment. I am fortunate to be a feminine, straight passing cis woman and I recognize the ease at which I can walk through the world. It is my hope that by gently challenging people’s preconceived notions someday everyone in the queer community will be met with love and acceptance, no matter their identity or outward presentation.
What is one thing everyone should know about your identity?: We ace (asexual) folx don’t get a lot of attention! This is a new area of my identity that I’ve recently been exploring and coming to terms with. Even writing this gives me some anxiety but the more asexuality is talked about, the more normal it becomes, the more people will understand it and maybe even recognize it within themselves. One important thing to know is that asexuality really is a spectrum and people experience it very differently. For me, being asexual and panromantic means I experience romantic attraction to people of all genders, and I very rarely experience sexual attraction (this is where the spectrum comes in). Sex is the least interesting and stimulating part of a relationship; I just don’t get much out of it. I still enjoy physical intimacy, but mostly because it facilitates emotional intimacy. I’m still capable of loving, fulfilling romantic relationships built on solid communication and clear expectations. For a long time I saw my asexuality as something that needed to be fixed or worked through, and it caused a lot of inner turmoil. But I’m finally learning that it is a beautiful part of my identity and something to embrace, not hide from!
How do you feel when your identity is included?: Historically, the media overwhelmingly acknowledges gay, straight, and bisexual. Lately, it seems like more shows/movies mention pansexuality (Schitts Creek) which is gratifying because it makes me feel really seen and it also makes “pan” a more commonly recognized concept (no, I’m not attracted to skillets or bread). Asexuality however doesn’t get much recognition so my expectations are usually really low when I’m consuming media, and whenever it’s included it’s a lovely little treat. I recently watched a show on Netflix called Sex Education (WATCH IT) and when they had a subplot about an asexual girl I legitimately cried. Generally, I do think we have a lot of work to do in recognizing sexual and romantic attraction are very separate for some people.
What does “taking up space” mean to you?: Simple. This means I can freely be myself in any room I walk into. When I picture myself taking up space I am not minimizing myself. I am proud to be queer regardless of who is in that room with me. Even in situations where people might not understand me, I stay true to myself. I wear that rainbow on my badge and show it off rather that hide.
What is one piece of advice that I would give to healthcare workers who aren’t sure how to honor the identities of their patients?: Most of my coworkers understand and acknowledge my identity because it revolves around who I date. However, some of them still really struggle with understanding trans/non-binary/non-conforming folx and honoring pronouns or addressing sexuality is uncomfortable for them. My advice is this: when it comes to gender identity, a patient’s pronouns aren’t up to you, they are up to the patient. Your job as a healthcare worker is to create safe spaces for patients where they feel comfortable and taken care of, not further isolated by ignorance. Using correct pronouns is an extremely simple way to facilitate a sense of safety and trust. In regards to sexuality, if you aren’t comfortable addressing this topic, then don’t bring it up, just be a kind human and let someone else be a queer ally. If you absolutely have to bring it up because it’s relevant to your job, then do it in a neutral, non-judgmental way please.
Has your identity influenced healthcare that you have received?: Fortunately, no!
L represents Lesbian. The term or identity Lesbian, describes an individual that identifies as a woman (yes, both cis and/or trans) and is primarily emotionally, physically, sexually, and/or spiritually attracted to women.
G represents Gay! The term or identity gay, describes an individual that identifies as a man (yes, both cis and/or trans) and is primarily emotionally, physically, sexually, and/or spiritually attracted to men. The term Gay is also used generally to describe individuals who are primarily emotionally, physically, sexually, and/or spiritually attracted to those of the same sex and/or gender.
B represents Bisexual (Bi)! The term or identity Bisexual, describes individuals who are emotionally, physically, sexually, and/or spiritually attracted to more than one gender. Those who identify as bisexual aren’t “greedy” or “confused”, their identity is valid.
T represents Transgender (Trans)! The term or identity Transgender, describes individuals whose gender identity is different from the gender assumed at birth. Fun fact, those who identify as a trans female are equally as female as those who identify as a cis female. Transgender refers to gender identity, not sexual orientation or preference.
Q represents Queer OR Questioning! The term or identity Queer, is an umbrella term for people who don’t identify as heterosexual and/or cisgender. Queer is also used interchangeably with the acronyms LGBT, LGBTQIA, LGBTQIA+, etc., to represent the community as a whole 🏳️🌈. However, Queer is not always a preferred term or identity for those within the LGBTQIA+ community, due to is historical use as a derogatory term.
Q is also used to represent the term or identity, Questioning. Questioning represents an individual that is unsure about and/or is exploring their own sexual orientation and/or gender identity.
I represents Intersex! Intersex is a term for a combination of chromosomes, hormones, sex organs, or genitals that differs from the male/female binary. For example, a person might be born appearing to be female on the outside, but having mostly male-typical anatomy on the inside. A person may be born with mosaic genetics, so that some of her cells have XX chromosomes and some of them have XY. Interesting fact: Intersex is often thought of as an inborn condition, though intersex anatomy doesn’t always show up at birth. Sometimes a person isn’t found to have intersex anatomy until they reach the age of puberty, or finds themself as an infertile adult. Some people live and die with intersex anatomy without anyone (including themselves) ever knowing. Reference: https://isna.org/faq/what_is_intersex/
A represents Asexual! The term or identity Asexual, describes individuals who experienced little or no sexual attraction to others and/or lack of interest in sexual relationships and/or behaviors. Asexual is also used as an umbrella term, for additional identities within the spectrum of sexual orientation. Myth buster: People who consider themselves asexual may have relationships, but they would not have the interest in adding a sexual component to the relationship. Individuals that identify as asexual can and do have romantic relationships with others.
➕ represents the inclusion of all identities within the LGBTQIA+ community! The ➕ represents identities, genders, and orientations that fall under umbrella terms used within and outside of the LGBTQIA+ acronym. Some (but not all) of the identities represented by the ➕ include: Pansexual, Fluidity, and Demisexual. Pansexual (Pan) refers someone who is emotionally, physically, spiritually, and sexually attracted to all gender indentured. As @instadanjlevy wrote in @schittscreek episode 10 of season 1 for his character David that identifies as Pansexual, “I like the wine and not the label.” (see next picture from Andrea Van Sickle on fb) Fluidity (or Gender Fluid) refers to a gender identity that may shift or change over time. Demisexual is a term or identity that represents an individual that has little or no sexual attraction to another individual, unless there is romantic connection/involvement. This term or identity is mostly considered to be under the umbrella of Asexuality, though some view it separately.
GQ represents Gender Queer! The term or identity Gender Queer, is an umbrella term for those who identify as Gender Non Conforming (GNC) or Non-Binary. It is a gender identity label that is used by those who may identify outside of the societal gender binary (male/female). Gender nonconformity, is an identity or gender expression by an individual that does not match expected/societal masculine or feminine gender norms. It is important to note that the term Queer is not accepted by all within the community, due to the derogatory use of the term throughout history. A L W A Y S ask an individual, “How would you like to be identified.”
Hello it’s me! Your NB OT! NB represents Non Binary! The term or identity Non Binary describes an individual who does not identify with the assumed gender binary, male or female. It includes a spectrum of gender identities that are not exclusively masculine or feminine. For all of my OT and healthcare friends, think of gender as a spectrum, just as we view some neuro diversities (ASD) as a spectrum. Real talk, what does this identity mean to me? Non Binary means freedom. Freedom from societal pressure to be X or Y. I can wear makeup, have a beard, wear heels, and engage in whatever occupation I want because all of it is ME. I don’t identify as male or female, I am non binary. I do not engage in occupations because they are ‘inherently’ masculine or feminine, I engage in them because they are meaningful to me and hold no relevance to gender or societal expectations. I am comfortable with he/him pronouns but they/them pronouns best represent ME, to the core of my being. I’m still exploring and adding new pieces to my identity puzzle and I have never felt more true to myself in my whole life. It’s okay to still not know who you are, but know I am a safe space for you and am here to protect, love, support, and include you. Your identity matters. Please note that gender identities and sexual orientations can be dynamic and change or evolve over time, even from day to day. Remember to A L W A Y S ask an individual, “How would you like to be identified.” Don’t argue with their identity, honor it.
C represents Cisgender (cis)! The term or identity Cisgender is a gender description for when someone’s sex assigned at birth and gender identity/ personal identity correspond in the “expected” way. Remember, gender identity does not include sexual orientation or identity. An individual could identify as cisgender and heterosexual, or within any identity of the LGBTQIA+ community.
I always found the idea of ‘coming out’ as strange or forced, but like many other LGBTQIA+ individuals I went through the same process on my journey to self-discovery and establishing my identity. I came out “officially” at the age of 17, or as I would prefer to say it, I started to let people in to who I am at 17. That is the same age that I decided to pursue an education in occupational therapy.
I applied to 9 schools originally and decided to attend D’Youville College in Buffalo, NY for my combined BS and MS of human occupation and occupational therapy. OT school was challenging, energizing, and fulfilling. I was fortunate to have incredible faculty, family, and friends who supported and challenged me with my crazy ideas like starting a community wellness clinic on campus or creating the official D’Youville OT instagram page – which is where the idea of @therainbowot grew from.
It was during professional development lecture in my final year of OT school where I found enough passion and frustration to start my lifelong mission for enhancing education, inclusion, representation, and advocacy for those within the LGBTQIA+ community, inside and outside of healthcare settings. I was so excited in class when we finally had a lecture where part of the class discussion was designated to address LGBT topics in OT. There was an objective to cover vast cultures including Korean and Latinx culture in a two hour span, leaving little time to cover all of the material, including LGBT+ topics. Without saying any names, it was clear to me that the professor was unprepared to answer questions about LGBT+ topics, especially those surrounding trans individuals – so the spotlight was turned to me (the token gay person). This wasn’t a new situation to me or the first time that I was placed with the responsibility to discuss LGBT+ topics in a class. I remember feeling powerful, frustrated, and concerned. There is a great amount of pressure when discussing topics and identities of the LGBT+ community, especially when my identity of being a white, gay, male (sex) does not come close to representing the entire community. It’s important to note that at the time of this class, I hadn’t really started acknowledging my non-binary identity, so I identified as a male. My concern came from the fact that I was one student, unable to represent or educate on all LGBT+ topics in only one section of the class. What did the other sections talk about? Did they discuss what it means to be trans? Did anyone validate the trans identity or provide definitions for the letters of the acronym? From there, the fire was lit to go on my own path of providing education and resources to anyone regarding these topics and more.
Where are we now? Well, The Rainbow OT has been running for just about a year. I launched my first LGBTQIA+ 101 series, a pronoun promise campaign, and have been a guest on two podcasts discussing LGBT+ related topics and occupational therapy’s role. With the support and safe space provided for friends that I owe the world to, I was able to let others in to who I am, a proud non-binary individual. I’m still in the beginning of my journey to self-discovery, but I am so happy with where I am when I look back at where I was. Where are we going next? You’ll just have to tag along and see.
Black Trans TV: A digital media platform used to promote unity and dismantle the idea that Black queer/trans folx exist separately from the black community.
Zuna Institute: A National Advocacy Organization for Black Lesbians that was created to address the needs of black lesbians in the areas of Health, Public Policy, Economic Development, and Education. http://www.zunainstitute.org/
The National Black Gay Men’s Advocacy Coalition (NBGMAC): The NBGMAC is committed to improving the health and well-being of Black gay men through advocacy that is focused on research, policy, education and training. https://www.nbgmac.org/
The National Center for Black Equity: connects members of the Black LGBTQ+ community with information and resources to empower their fight for equity and access. https://centerforblackequity.org/
Black Transmen: A a nonprofit organization focused on social advocacy and empowering trans men with resources to aid in a healthy transition. https://blacktransmen.org/
Incite!: A national activist organization of trans and gender nonconforming people of color working to end violence against individuals and communities through direct action, dialogue, and grassroots organizing. https://incite-national.org/
Know Your Rights Camp: Works to advance the liberation and well-being of black and brown communities through education, self-empowerment, mass-mobilization, and the creation of new systems that elevate the next generation of change leaders.
The BQI Collective: Black Queer & Intersectional Collective is a grass-roots community organization that works towards the liberation of Black queer, trans, and intersex people through direct action, community organizing, education, and creating spaces to uplift our voices.
The Okra Project: Collective that seeks to address the global crisis faced by Black Trans people by bringing home-cooked meals and resources to the community. http://www.theokraproject.org
HBTW Fund: The Homeless Black Trans Woman Funs is a fund for the community of Black Trans women that live in Atlanta and are sex workers and/or homeless. gf.me/u/x3h8h
South Asian Sexual & Mental Health Alliance (SASMHA): SASMHA’s goal is to fight cultural stigmas, educate, and empower the South Asian American community by providing resources on issues most important to us, from sex and sexuality to mental health. They also have a podcast. http://www.sasmha.org
Queer the Land: A collaborative project that works towards the liberation of Black queer, trans, and intersex people through direct action, community organizing, education, and creating spaces to uplift our voices. Queertheland.org
Princess Janae Place: PJP provides referrals to housing for chronically homeless LGBTQ adults in the New York Tri-state area, with direct emphasis on Trans/GNC people of color.
Emergency Release Fund: Ensures that no trans person at risk in NYC jails remains in detention before trial. If cash bail is set for a trans person in NYC and no bars to release are in place, bail will be paid by the Emergency Release Fund. Emergencyreleasefund.com
House of GG: Creating safe and transformative spaces for community to heal, and nurturing them into tomorrow’s leaders, focusing on trans women of color in the south. http://www.houseofgg.org
The Starfruit Project: The Starfruit Project supports radical healing and brilliant growth through creative writing and performance programs that center queer and trans people of color. Offerings are for practicing artists, budding artists, and anyone seeking support on their journey toward healing and growth. https://www.thestarfruitproject.com/workshops
The Black Trans Advocacy Coalition: A National organization led by Black trans people to collectively address the inequities faced in the black transgender human experience.
The Marsha P. Johnson Institute: Defends the rights of Black transgender people.
National Queer & Trans Therapists of Color Network: A network committed to transforming mental health for queer and trans people of color.
Brave Space Alliance: A Black-led, Trans-led LGBTQ Center working on the South Side of Chicago. @bracespacealliance
SNAPCO: Builds power of Black Trans and queer people to force systemic divestment from the prison industrial complex and invest in community support. http://www.snap4freedom.org
The Brown Boi Project: a community of masculine center womxn, men, two-spirit people, transmen, and our allies committed to transforming our privilege of masculinity, gender, and race into tools for achieving racial and gender justice. Located in Oakland, CA. http://www.brownboiproject.org/
The National Black Justice Coalition (NBJC): A civil rights organization dedicated to empowering Black lesbian, gay, bisexual and transgender (LGBT) people. NBJC’s mission is to end racism and homophobia. http://nbjc.org/
Black Trans Travel Fund: Works on providing resources to Black trans women to be able to access safe transportation and travel alternatives.
TGI Justice Project: A group of transgender, gender variant, and intersex people – inside and outside of prisons, jails, and detention center – fighting against human rights abuses, imprisonment, police violence, racism, poverty, and societal pressures.
The National Queer and Trans Therapists of Color Network (NQTTCN): The NQTTCN is a healing justice organization that actively works to transform mental health for queer and trans people of color in North America. Together we build the capacity of QTPoC (queer and trans people of color) mental health practitioners, increase access to healing justice resources, provide technical assistance to social justice movement organizations to integrate healing justice into their work. Our overall goal is to increase access to healing justice resources for QTPoC. https://www.nqttcn.com/
Black Trans Femmes in the Arts: A collective of Black trans women and non-binary femmes who are dedicated to creating space for Black trans femmes in the arts. @btfacollective
By Us For Us: A collective of queer, femme, and non-binary Black and POC artists and organizers. @Bufu_byusforus
The Trevor Project: The Trevor Project’s Trainings for Professionals include in-person Ally and CARE trainings designed for adults who work with youth. These trainings help counselors, educators, administrators, school nurses, and social workers discuss LGBTQ-competent suicide prevention. https://www.thetrevorproject.org/education/
Sex and Intimacy OT: Our mission is to dismantle restrictive norms related to sexuality and intimacy which limit clients and limit ourselves. We strive to promote understanding, respect, and empowerment for individuals as sexual beings. https://www.sexintimacyot.com/
Sex Love and OT: a sexuality, mental health, and OT advocate, writer, and practitioner. Dr. Tickoo works as a school-based OT in Mumbai, however her work is not limited to kids. Dr. Tickoo’s work explores the integration of sexuality in OT practices for people of all ages. http://www.sexloveandot.in
The Transgender District: The transgender district aims to stabilize and economically empower the transgender community through ownership of homes, businesses, historic and cultural sites, and safe community spaces. http://www.transgenderdistrictsf.com
CHANGE: Promoting gender equality by advancing the sexual and reproductive health and rights of women and girls worldwide. http://www.srhrforall.org/
National Center for Transgender Equality: advocates to change policies and society to increase understanding and acceptance of transgender people. In the nation’s capital and throughout the country, NCTE works to replace disrespect, discrimination, and violence with empathy, opportunity, and justice. https://transequality.org/
Youth Breakout: Works to end the criminalization of the LGBTQ+ youth in New Orleans to build a safer and more just community. http://www.youthbreakout.org
Trans Cultural District: The world’s first-ever legally recognized Trans district, which aims to stabilize and economically empower the Trans community. http://www.transgenderdistrictsf.com
LGBTQ+ Freedom Fund: Posts bail LGBTQ people held in jail or immigrant detention and raises awareness of the epidemic LGBTA overincarceration. http://www.lgbtqfund.org
GLMA: Health Professionals Advancing LGBTQ Equality (previously known as the Gay & Lesbian Medical Association). http://www.glma.org/
NALGAP: The Association of Lesbian, Gay, Bisexual, Transgender Addiction Professionals and Their Allies is a membership organization founded in 1979 and dedicated to the prevention and treatment of alcoholism, substance abuse, and other addictions in lesbian, gay, bisexual, transgender, queer communities. http://www.nalgap.org/
Coalition of Occupational Therapy Advocates for Diversity (COTAD): The Coalition of Occupational Therapy Advocates for Diversity (COTAD) formed in 2014 through a collaboration that occurred between members of the AOTA Emerging Leaders Development Program. COTAD has grown tremendously since its early days and has added individuals to its Executive Board and general membership. Now established as a non-profit organization, COTAD operates as group of individuals from across the United States all working towards a common goal of promoting diversity and inclusion within the occupational therapy workforce and increase the ability to occupational therapy practitioners to serve an increasingly diverse population. COTAD’s new Ignite Series: https://www.cotad.org/ignite-series