Improving Representation and Fostering Inclusion in Wellness for the LGBTQIA+ Community

As a member of the LGBTQIA+ – lesbian, gay, bisexual, transgender, queer, intersex, asexual, plus (used to symbolize and explain a number of gender identities and sexual orientations not already present in the acronym) – community, I have not always felt represented in the way health and wellness are depicted by mainstream and social media. When I consider how healthy people have been portrayed to me over the years, I think of an attractive heterosexual couple smiling while chopping an array of colorful vegetables in their large, modern kitchen or a thin white woman doing yoga in expensive athletic wear.

While there is nothing inherently wrong with these images, it becomes an issue when they dominate the space, creating a standard for health that excludes a substantial percentage of the population. The message created by the repetition of such images over time is that wellness can only look one way and is only accessible to a specific kind of person.

As Health Coaches, business owners, and health and wellness practitioners, many of us share the mission of wanting to increase health and happiness across the globe. It’s important we recognize the barriers that prevent some individuals from accessing healthcare and seek opportunities to be more inclusive of all identities. The Oxford English Dictionary defines inclusivity as the “practice or policy of providing equal access to opportunities and resources for people who might otherwise be excluded or marginalized.”

For purposes of this post, and as a nod to National Pride Month, I will focus on inclusivity as it relates to the LGBTQIA+ community in health and wellness. However, it should be noted that every person’s experience is unique, and the LGBTQIA+ community encompasses a wide range of individuals of different races, ethnicities, ages, socioeconomic statuses, and identities.

Addressing LGBTQIA+ stigma and discrimination

In addition to a lack of representation in the health and wellness space, it is common for LGBTQIA+ people to face stigma, discrimination, and mistreatment in doctors’ offices and hospitals and when working with mental health professionals. In some cases, they are refused treatment. In other cases, they are misgendered or a healthcare provider uses inappropriate language when treating them. Clinics like the Callen-Lorde Community Health Center in New York City strive to provide judgment-free healthcare that caters to the LGBTQIA+ community, but they are rare.

Discrimination isn’t always overt. It isn’t discriminating enough to speak up against, but it’s inappropriate enough to leave a mark. For example, I once had a therapist tell me she didn’t feel equipped to work with “lesbian issues” and wanted to refer me to another therapist. I know what she meant – she didn’t have the training nor experience to work with me on the same-sex relationship concerns or complicated gender dysphoria I was experiencing at the time. But her comment made me feel ostracized and “othered.” I would have preferred her not using the words lesbian or issues. She could have instead said something like, “I can see you’re really struggling to understand your gender and navigate some relationship concerns that are coming up in relation to that. How do you think you might feel about speaking with a therapist who has more specialized experience in this area?”

Networks like Manhattan Alternative include service providers who are sex-positive, affirmative, and have expertise related to struggles faced by the LGBTQIA+ community. But perhaps LGBTQIA+ competency training should be required for all health and wellness practitioners, including mental health professionals. The cost of not attuning to the needs of the LGBTQIA+ community to Health Coaches, healthcare workers, and health and wellness practitioners is that the potential for discrimination and lack of safety can deter LGBTQIA+ people from seeking care in the first place.

So, how can we make the health and wellness space feel more inclusive to members of the LGBTQIA+ community?

1. Educate yourself.

The antidote to ignorance is education. If you have access to the Internet, you have access to a plethora of tools, resources, and trainings to help you gain more competency in working with LGBTQIA+-identifying individuals. Some popular resources include The Trevor Project, Human Rights Campaign, Main Line Health, and the Gay and Lesbian Medical Association.

Become familiar with common terms that relate to the LGBTQIA+ community, such as nonbinary, cisgender, and pansexual. If they’re open to it, have conversations with LGBTQIA+ individuals in your family or your network and ask them respectful, honest questions about their experiences.

Watch YouTube videos created by LGBTQIA+ influencers. Listen to people’s stories. You can also grab a copy of The ABCs of LGBT+ by Ashley Mardell if you’re seeking a basic understanding of LGBTQIA+ terms and concepts or check out A Clinician’s Guide to Gkender-Affirming Care by Sand C. Chang, PhD, for more specialized knowledge in working with transgender and gender-nonconforming clients.

Being part of the LGBTQIA+ community yourself doesn’t automatically make you competent to work with other members of the community without specialized competency training. A lot of discrimination toward LGBTQIA+ people occurs within the LGBTQIA+ community.

2. Don’t just hang a flag.

There is a difference between accepting or tolerating a certain demographic and actually empowering them, celebrating them, and attuning to them. In other words, it’s one thing to hang a rainbow flag in front of your fitness studio to make it known that all genders and sexual orientations are accepted. It’s another thing to make this group feel represented by hiring LGBTQIA+ staff or asking people’s pronouns when they sign up for a class or package.

Unfortunately, it has become quite common for businesses to simply hang a flag or update their social media to incorporate a rainbow banner during Pride Month. And it’s obvious, at least to me, when businesses do this to follow a trend or because they want to gain the patronage of LGBTQIA+ customers. If you are a business owner, health and wellness practitioner, or Health Coach, I encourage you to consider ways you can adjust your business to be more inclusive of the LGBTQIA+ community before you make the claim that “all are welcome.”

3. Consider ways to be more inclusive in your advertising and beyond.

Many don’t consider it a huge step toward inclusivity to simply choose new stock photos that include members of the LGBTQIA+ community for the home page of your website. However, I advocate for adjusting your branding to attract a more diverse group of people as long as you are also doing the work to educate yourself and adjust your business or program offerings to accommodate the broader demographic you are working to appeal to. Otherwise, resist claiming to be “gay-friendly” or “queer-friendly.”

4. When in doubt, ask.

One of the main reasons people resist educating themselves or opening themselves up to being more inclusive of LGBTQIA+ individuals is because they are afraid of what is unfamiliar. It can feel overwhelming to attempt to attune to a community that is so vast, especially when there are new identities, acronyms, and terminologies being created every day to help people describe the way they experience their gender and sexuality. But it’s still important that we make the effort.

When you aren’t sure what pronouns someone prefers or how to best respect an LGBTQIA+-identifying individual, simply ask them. For example, often LGBTQIA+ folks will feel more respected if you ask than if you avoid using a pronoun altogether. We are not a separate species, after all! We are all human and in this together, so it’s always better to ask than to avoid or make assumptions.

Whether or not you identify as part of the LGBTQIA+ community, we can all benefit from having more honest and open conversations about how we experience our identities, desires, and ourselves. Our health, and the community’s health, depends on it.