never leave the treatment room but may be documented if it is relevant to the treatment plan and objectives of health care for the client. It takes the same thorough knowledge of ethical standards and guidelines, as well as good judgment and decision making, to work with all clients. Consider a few scenarios to determine the appropriate action (Haines, 2016): A 17-year-old client, known as Dan for the last year, confesses that they always wished to be born female, and asks to be called Cordelia while in private. They also mention that they have not spoken to their mother about the matter yet. Soon after, the Cordelia’s mother calls and asks if Dan has been behaving strangely lately. The client walks out after her session. Another client asks, “Is that a man or a woman? I can’t even tell.” The therapist regularly volunteers at an organization supporting the transgender community, which is how they first came into contact with a client named Lisa who receives services there as well as volunteering herself. The therapist chats briefly about mutual acquaintances and another practitioner asks “Oh, how do you two know each other outside of massage?” The therapist is a recent massage school graduate with a new practice in a small town, and one client is a trans man who recently moved from out of state. Another massage therapist in a public group on Facebook asks whether the therapist has any experience working with transgender clients. A final note on outing When it comes to sexual orientation, the idea of “coming out” is generally seen as a positive thing. It means that someone was hiding their true reality, but is now living it openly. In the T part of the LGBT community, things may be a little more complicated. Someone who has transitioned to life as a woman and is living as such is already publicly living her reality. When it comes to coming out, let people make difficult choices for themselves. The most basic of all ethical standards and guidelines are based on the premise to promote the client’s welfare and do no harm. The practitioner should have a statement of nondiscrimination that goes beyond a legal one and includes a personal statement that reflects a welcoming and accepting tone extended to all clients. These sentiments should be included in advertisements, marketing materials, websites, blogs and any materials that are associated with the practice. In the same way that the practitioner would not want to alienate members of diverse minority, ethnic, or religious groups, and disabled individuals the same can be said for populations that represent diverse gender identities and sexual orientations. These groups represent underserved populations that can extend and grow massage and body work practice that is good for business and promotes acceptance of these populations in the community (Haines, 2016). Sex and gender on forms When making decisions about when and how to inquire about gender or sex on your intake forms, the following information outlines appropriate reasons: ● Massage and bodywork practice is often part of an interdisciplinary medical practice that requires this information. ● As part of a nonprofit organization, this information may be required to track clients to maintain gender-specific grant funding (Haines, 2016). Any concerns about medical conditions should be covered on the medical history form. It is an incorrect to assume that specific populations will have certain medical conditions simply based on gender or sex. Bathrooms Recent federal and state legislation concerning the assignment of gender to bathrooms has made this issue highly controversial
in recent months. It is an issue that must be addresses and the practitioner can decide to declare bathrooms as gender free, allow clients to use whatever gender designated bathroom they choose, allow both types, and provide a family bathroom for fathers or mothers with children. This issue will be more complicated if the practice does not own or have control of the space and therefore unable to alter bathrooms. In these cases the practitioner is challenged to find a way to provide a creative and equitable solution to the problem. Ongoing education and awareness As in all areas of practice, new legislation, scientific and medical advances, cultural and societal changes, and new terminology and language, must be accommodated to maintain an effective practice that keeps pace with population needs and demands. In order to remain current and provide the best practice for client care, it is important for the practitioner to continue their education and training in all areas relevant to the profession. This includes making necessary changes and adaptations to the practice and educating all staff to be sure they share a commitment to ethical and equitable practice that includes all clients. Beyond the professional obligation to treat all clients in accordance with the standards and ethics of the profession, it is up to the practitioner to decide the level of support or advocacy they chose to provide to populations representing diverse gender identities or sexual orientation. Decisions concerning marketing materials, community presence, and support of diverse communities will vary depending upon the philosophy adopted by the practitioner and the way they want to portray their practice to the public. There are no right or wrong answers or blueprints to guide the professional through to these issues as long as the practice is founded on the ethics of the profession. Gael Wood (2016) proposes ten things that the massage and bodywork professional can do to welcome LGBTQ individuals to their practice. She notes that many members of this community worry that they will not feel comfortable and are hesitant to seek services. Wood provides the following information to welcome LGBTQ clients: ● Look over intake form, as they may contain outdated or unnecessary questions about gender, marital status or the relationship to an emergency contact. A quick fix is to have a blank to fill out rather than a box to check. Also determine if any of the health questions could be reworded or are unnecessary. ● Use gender-neutral bathroom signs, if there is a single bathroom. A bathroom is a bathroom, after all. A great bonus of this is less waiting for the right one to be empty. ● Be aware when asking personal questions. A simple “Do you have children?” can be hard on some clients, for various reasons. Stick to asking clients about their needs and activities that will inform ability to provide an effective massage or bodywork session. ● Reach out in person at local events like pride days or LGBT Center events. Just search Google for LGBTQ events in the city. Practitioners may volunteer, give a talk about stress, and how massage can help relieve it, or offer chair massage. ● Get the word out on social media. Use rainbows, because the rainbow flag is commonly used as a symbol of LGBTQ pride and LGBTQ social movements, and let the community know the practice welcomes LGBTQ clients. ● Stay educated about LGBTQ terminology and concerns. Be flexible and willing to change as health care professionals that must stay informed and meet client needs. ● Of course, client confidentiality is a top priority for all clients, and professionals must make sure that all clients understand that their information will never be shared or discussed. This can eliminate any concern about clients might have about their privacy.
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Book Code: MLA1224
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