People in the LGBTQIA+ community are facing distinct challenges when seeking comprehensive and affirming healthcare. Six days into Pride Month, the Human Rights Campaign declared a state of emergency for LGBTQ+ Americans. As of June 9, the ACLU is tracking 491 anti-LGBTQ bills in the U.S., 130 of which are healthcare bills. In this legislative climate, it’s become crucial to prioritize and uphold safe spaces for LGBTQIA+ students, staff, and faculty within educational and healthcare institutions.

Christine Pearson, MSOM (’12), LAc, is an adjunct faculty member at NUNM and a Classical Chinese Medicine (CCM) practitioner that specializes in LGBTQIA+ health, gynecology, and pediatrics. In celebration of Portland’s upcoming Pride festivities, Pearson sat down with us to discuss how CCM theories and practices can play a vital role in the healthcare journeys of LGBTQIA+ individuals.

Yin, Yang, and the Gender Spectrum

In Chinese medicine, Pearson noted that the binary does not exist.  When people use Yin and Yang as an example of the binary, they are forgetting basic Yin Yang Theory.  Yin and Yang exist in a state of relative opposition, with aspects or entities being categorized as either Yin or Yang.

However, it is important to note that Yin and Yang are not absolute and independent entities, but rather their nature is defined through relationship with one another. Within Yin, there is Yang, and within Yang, there is Yin.  They cannot be separated.

“If Yin and Yang separated like we think in a binary, you have death. We as human beings, especially non-binary, gender queer, intersex, or trans people,  are not fixed into binary beings. We are dynamic.”

Yin and Yang are interdependent and inseparable; one cannot exist without the other. They are infinitely divisible, allowing for further divisions and subdivisions within each category. The interplay between Yin and Yang is not static but dynamic, constantly in a state of transformation.

As an example, if you have a group of cisgender women, there can be a diverse range of how these women express femininity spanning from more masculine of center to more feminine of center, while still falling under the category of cisgender women.

Therefore, in healthcare and educational settings, we need to regularly check in with individuals to understand how they identify, as identities can evolve and change over time.

Inclusivity in Healthcare

Often in healthcare settings, LGBTQIA+, BIPOC, and women face marginalized experiences resulting in inadequate services. A notable issue in Western medicine is the historical lack of representation and research on women in clinical drug trials, leading to potential risks and side effects of pharmaceutical when administering medications.  Similarly, LGBTQIA+ individuals are typically excluded from research, except in cases concerning specific drugs like those targeting HIV.

Within the LGBTQIA+ community, Pearson has observed a need for tailored care for individuals undergoing hormone therapy during their transition.

“During hormone affirming therapy like testosterone for trans men or estrogen and progesterone for trans women, I see people start at the very highest dose, which leads to side effects. It gives them heart palpitations and anxiety, and they won’t know where it’s coming from.”

If patients are complaining of side effects, Pearson recommends starting at the lowest dose for hormone therapy and then bumping them up slowly until the patient finds their sweet spot.  She recommends working with a Naturopathic Physician who specializes in hormone-affirming care that will customize a treatment plan for the patient.

This personalized approach extends to other areas, such as fertility treatments, where medications like Clomid or Femara may induce emotional side effects. “In Chinese medicine, it  increases the Yang/Qi in the system to make patients ovulate. So, patients will feel nutty, they’ll talk to their doctors about it, and the doctors will say that it’s ‘just a side effect’ and ‘you’ll get used to it’ instead of offering them some sort of treatment because there isn’t any on that side of medicine.”

Chinese medicine can recognize and address these symptoms by focusing on the individual and offering support.

Accountability in Chinese Medicine

However, when it comes to LGBTQIA+ advocacy within the field, there are also important bias considerations that need to be addressed in Chinese medicine. For instance, in the teaching of extraordinary vessel treatments, traditional assumptions often dictate that treatment should start on one side for women and the opposite side for men. This binary framework fails to acknowledge the diverse experiences of intersex, non-binary,  gender-queer, and transgender individuals who may not align with these gendered norms.

“That way of thinking doesn’t translate to every body well. That’s why I have my students first ask how their patient identifies, and then always come back to the body because the body tells the story it wants us to hear. We can make up stories according to theory and things we’ve read about in books, but it doesn’t always translate to a body.”

Assumptions and generalizations can perpetuate harmful stereotypes and exclude those who do not fit within traditional gender roles. Similarly, the concept of the “husband and wife pulse”, where the left pulse is felt more strongly and the right pulse is weaker as a symptom of pathology in the body,  raises concerns about reinforcing gender norms and the idea that women should be weak or subservient. These narratives have roots in patriarchal, cis-gendered, cis-heteronormative ideals that do not align with the lived realities of modern individuals.

“In the treatment room, part of my philosophy is that I am a facilitator. When I see people that come in and they’re frustrated, their symptoms haven’t been listened to or they’re not believed; they’re being taken out of community, right? Nobody believes them. They feel like they’re crazy.  By plugging them back into relationship with others and being a facilitator for that healing, we’re creating community. And that’s one of the things I really love about Chinese medicine.”

By acknowledging and addressing these biases, Chinese medicine can advocate for the LGBTQIA+ community and foster a more equitable and respectful healthcare environment.

“One of the things that I love about Chinese medicine is that we are marginalized in the greater medical community. I think marginalized people will understand the biases more, and we must be aware of how we as practitioners can continue to marginalize within a marginalized medicine. Colonialism is deep in our culture, and we must work within our own community to undo our inherent biases. Especially in the political times we are living in, we must make a commitment of inclusion in the treatment room.  People’s lives depend on it.”

_{by Jessica Salazar, Communications Manager}