LGBTQIA+ Competency for Healthcare Providers: Interview with Terra Anderson
Listen
Watch
Show notes:
LGBTQIA+ cultural competency helps not only our patients to feel safer, seen, and supported, but it also improves health outcomes. Many providers aren’t sure what that competency looks like, or even where to start. It’s more than the correct pronouns and language – but how much more?
In this week’s episode, we talk with Terra Anderson, who uses they/them pronouns, a somatic therapist, and an LGBTQIA+ educator about how providers can improve their competency when working with LGBTQIA+ patients.
✅ What LGBTQIA+ patients wish their healthcare providers knew
✅ What is affirming care, and why it is important
✅ How to approach sensitive exams
✅ How to frame questions so they feel less awkward for you and your patients
✅ The role of assumptions when working with patients, especially LGBTQIA+ patients
✅ Differentiating biological sex, gender, and sexual orientation – and why we need to
Cultural competency is not about a defined endpoint, but about the journey and the willingness to confront known, unknown, and implicit bias. Let’s talk about starting the journey, and let’s keep working on it for all of our patients.
When you are ready for a deep dive into how to best serve LGBTQIA+ patients, Terra offers a Queer Competency for healthcare providers through their company, Embody Emerge.
-
WEBVTT
1
00:00:08.500 --> 00:00:16.560
Hey there, welcome to the Real World NP podcast. I'm Liz Rohr, family nurse practitioner, educator,
2
00:00:16.800 --> 00:00:22.740
and founder of Real World NP, an educational company for nurse practitioners in primary
3
00:00:22.740 --> 00:00:29.100
care. I'm on a mission to equip and guide new nurse practitioners so that they can
4
00:00:29.100 --> 00:00:34.800
feel confident, capable and take the best care of their patients. If you're looking for clinical
5
00:00:34.800 --> 00:00:40.680
pearls and practice tips without the fluff, you're in the right place. Make sure you subscribe and
6
00:00:40.680 --> 00:00:46.060
leave a review so you won't miss an episode. Plus you'll find links to all the episodes with
7
00:00:46.060 --> 00:00:59.960
extra goodies over at realworldnp.com slash podcast. Oh my goodness, I can't wait to
8
00:00:59.960 --> 00:01:04.400
share this episode with you. So this is a recorded interview that I did with Tara
9
00:01:04.400 --> 00:01:13.780
Anderson. They are a non-binary therapist that somatic therapist that also has a second company,
10
00:01:13.820 --> 00:01:19.860
an educational company specifically for health care providers to help with queer competency.
11
00:01:21.000 --> 00:01:26.660
We just had a really wonderful conversation. It's been a long time coming talking about
12
00:01:26.660 --> 00:01:30.980
health as it relates to our LGBTQIA plus patients.
13
00:01:32.080 --> 00:01:37.980
And this conversation is actually a really foundational place to start. So I got a lot
14
00:01:37.980 --> 00:01:43.280
of questions and when I was asking, I reached out to audience members on the email list. If
15
00:01:43.280 --> 00:01:47.220
you want to get on the email list, you can submit your questions too. And I think what we
16
00:01:47.220 --> 00:01:50.840
realized when we looked at all the questions that people had, we really just had to start
17
00:01:50.840 --> 00:01:57.380
in a really foundational place. And so in this interview, we talk about what queer competency
18
00:01:57.380 --> 00:02:03.840
means, what people think it is versus what it actually is. And some really practical things to
19
00:02:03.840 --> 00:02:14.340
help provide very supportive and holistic care to our LGBTQIA patients. And it's like the
20
00:02:14.340 --> 00:02:20.500
starting place to start with is this episode, this interview, really some core foundational
21
00:02:20.500 --> 00:02:26.180
pieces of information and some resources to learn a little bit more further. So without further
22
00:02:26.180 --> 00:02:30.700
ado, I'm going to share my interview. Actually real quick, if you haven't grabbed the ultimate
23
00:02:30.700 --> 00:02:36.920
resource guide for the new NP, head over to realworldnp.com slash guide. You will get all
24
00:02:36.920 --> 00:02:41.520
of these episodes sent straight to your inbox every week so you don't miss a thing. And
25
00:02:41.520 --> 00:02:46.420
you'll also get patient stories, notes from me and bonuses I truly don't share anywhere else.
26
00:02:46.800 --> 00:02:51.180
Thank you so much for watching. And here is our interview.
27
00:02:51.820 --> 00:02:57.180
Welcome. And thank you so much for being here. Can you introduce yourself?
28
00:02:58.460 --> 00:03:06.460
Yeah, absolutely. So my name is Tara Anderson. I use they, them pronouns. I am a gender equity
29
00:03:06.460 --> 00:03:12.540
educator. I work primarily with healthcare and helping providers who want to better serve the
30
00:03:12.540 --> 00:03:18.400
LGBTQIA community. I'm also a therapist by training, somatic therapist. So I work with
31
00:03:18.400 --> 00:03:23.220
LGBTQIA folks around areas of intimacy and identity.
32
00:03:24.220 --> 00:03:30.240
That's awesome. And how, how did you, how did you get into this path?
33
00:03:30.800 --> 00:03:36.600
It's a great question. Well, I wanted to be a therapist my whole life.
34
00:03:38.820 --> 00:03:45.700
And so I really be lined it for this profession. And once I got there, what I realized
35
00:03:45.700 --> 00:03:55.480
was that this fantasy that I had about helping professions is really, how do I want to say this,
36
00:03:57.040 --> 00:04:04.500
informed by systems of power and oppression. And I kind of had this fantasy shatter a little bit
37
00:04:04.940 --> 00:04:11.000
early on in my career. And I started to work in community mental health. I was just seeing
38
00:04:11.000 --> 00:04:19.680
how many LGBTQIA folks were not being served in a way that made therapy really accessible to them.
39
00:04:20.320 --> 00:04:27.200
In my own experience as a trans person, you know, I'm seeing existing in healthcare spaces
40
00:04:27.200 --> 00:04:34.320
where I either don't feel met or my community members are reporting feeling like they're not
41
00:04:34.320 --> 00:04:40.700
seen by their providers and really getting turned off from accessing help.
42
00:04:42.320 --> 00:04:50.320
So a number of series of events happened and, you know, between feeling like tokenized in the
43
00:04:50.320 --> 00:04:56.640
work that I was doing, witnessing really well-meaning colleagues, just missing the boat,
44
00:04:57.080 --> 00:05:01.040
not because their hearts were in the wrong place, but just because they didn't have the
45
00:05:01.860 --> 00:05:08.080
I decided to go out on my own and start an organization really dedicated to bridging the
46
00:05:08.080 --> 00:05:16.080
gap between the training that healthcare and helping providers get in serving the LGBTQIA
47
00:05:16.080 --> 00:05:20.180
community and what we really need. I love that. And your company is called
48
00:05:20.180 --> 00:05:37.480
Embodimurge. So how does it work? How do you help healthcare providers to
49
00:05:38.740 --> 00:05:47.540
bridge that gap in that separate company? Yeah, so I think I take a different approach than
50
00:05:47.540 --> 00:05:55.260
a lot of LGBTQIA training. I think a lot of training goes into kind of the basics,
51
00:05:55.360 --> 00:06:02.640
the 101, learning about the LGBTQIA community, terms, fluency, pronouns,
52
00:06:03.760 --> 00:06:10.700
language, all of that stuff. And I want to take us a little bit deeper. And so the work
53
00:06:10.700 --> 00:06:16.800
that I do has a couple of different approaches that I think are different than most places.
54
00:06:16.800 --> 00:06:23.660
One, I'm really interested in helping folks do their personal work to see themselves. I think
55
00:06:23.660 --> 00:06:30.720
that if our providers had a better understanding of their own gender experience, of their own
56
00:06:30.720 --> 00:06:37.520
sexual orientations, of how the scripts of society inform those things and are playing out
57
00:06:37.520 --> 00:06:45.920
in our medical professions, that LGBTQIA people would have better experiences. And so I want to
58
00:06:45.920 --> 00:06:52.720
support healthcare providers to do that personal work, to see themselves. And so beyond just the
59
00:06:52.720 --> 00:06:59.200
101 stuff, we go into our own conditioning, right? And starting to break apart and really
60
00:06:59.200 --> 00:07:07.440
see the ways in which we've been fed heteronormativity. And I also center the
61
00:07:07.440 --> 00:07:13.720
body. I'm a somatic practitioner, so I'm really interested in taking us a level deeper
62
00:07:13.720 --> 00:07:20.860
than the general conversation around bias, because it's really hard to see what we can't
63
00:07:20.860 --> 00:07:25.720
really acknowledge, the things that are underneath the level of our consciousness.
64
00:07:26.320 --> 00:07:32.220
But our bodies tell us about those things. And so as a somatic practitioner, we get to
65
00:07:32.220 --> 00:07:43.700
really look at how is your body telling you where your biases live so that you have a
66
00:07:43.700 --> 00:07:49.100
talking about before we started recording, we were talking about what people think. And your course is called
67
00:07:49.820 --> 00:07:54.980
Queer Competency. Okay. I just didn't know if I had other things attached to it, but you and I
68
00:07:54.980 --> 00:08:00.160
were talking about before we started recording Queer Competency. And you've kind of already
69
00:08:00.160 --> 00:08:04.440
touched on it, but I think that there's this discrepancy for a lot of healthcare providers
70
00:08:04.440 --> 00:08:10.260
of what Queer Competency, in terms of my people are healthcare providers,
71
00:08:10.840 --> 00:08:16.560
primary care providers. But there's a discrepancy between what's being taught in school and what
72
00:08:16.560 --> 00:08:22.060
people think Queer Competency is and what it actually is. So can you kind of bottom line
73
00:08:22.060 --> 00:08:26.880
what you see as the difference between what people think Queer Competency is and what it
74
00:08:26.880 --> 00:08:33.580
actually is? I mean, bottom line, that's a lot to pack into one sentence, but if you
75
00:08:33.580 --> 00:08:41.860
simplify it just for conceptual purposes. You know, it's not a really simple concept,
76
00:08:41.880 --> 00:08:46.040
so it'll take a little bit of embellishment to do it. Oh, no, no, that's fine. Take your time
77
00:08:46.040 --> 00:08:51.780
to explain, but I just mean like, yeah, just like boundaries around the grasping. Yeah,
78
00:08:51.780 --> 00:08:56.560
absolutely. And I'll distill it down as much as I can. So I think what a lot of people think
79
00:08:56.560 --> 00:09:03.220
when they think of LGBTQIA competency or Queer Competency is they're really thinking about
80
00:09:04.080 --> 00:09:09.540
pronouns. They're thinking about bathrooms. They're thinking about not saying the wrong thing,
81
00:09:10.420 --> 00:09:16.980
right? And so it's really about our words and our communication of our ideas about gender
82
00:09:16.980 --> 00:09:23.920
and sexual orientation. It's really, for I think a lot of people, folks stop it. I don't
83
00:09:23.920 --> 00:09:29.600
want to put my foot in my mouth. I don't want to do harm, right? And so what can I say? How
84
00:09:29.600 --> 00:09:38.860
do I act? That is going to make LGBTQIA people feel safe around me. And they stop there at
85
00:09:38.860 --> 00:09:45.480
definitions, at terms, at pronouns, at bathrooms, right? And the conversation is actually
86
00:09:45.480 --> 00:09:50.920
much deeper. My favorite saying around Queer Competency is that it's not a destination you
87
00:09:50.920 --> 00:09:59.680
ever reach. It's the journey that you travel. So it's not like, oh yeah, I checked all of these
88
00:09:59.680 --> 00:10:06.080
boxes. I know how to ask for pronouns. I know how to not assume gender identity when I see
89
00:10:06.080 --> 00:10:12.740
somebody. We're not checking boxes. We're actually continuing to audit ourselves,
90
00:10:13.080 --> 00:10:17.600
continuing to interrogate our conditioning and the world around us so that we can create
91
00:10:17.600 --> 00:10:30.750
safer spaces, right, ongoing. Totally. Yeah, and I think just having had my own experiences,
92
00:10:31.270 --> 00:10:40.110
going through dismantling, decolonizing, kind of identifying of different oppressive
93
00:10:40.110 --> 00:10:46.310
structures, like you were kind of talking about in the beginning, of going through that. I think
94
00:10:46.310 --> 00:10:50.990
I can recognize now on the other side that there's what people call performative,
95
00:10:51.110 --> 00:10:56.850
what's performative of what is the thing we're showing versus what's actually truly true
96
00:10:56.850 --> 00:11:02.450
transformation into understanding, learning, and then it comes to be in individuals.
97
00:11:03.310 --> 00:11:09.730
You have to start with yourself first and be included in this whole conversation about gender
98
00:11:09.730 --> 00:11:14.470
and sexuality and all of that stuff. Am I reflecting that correctly? Yeah, absolutely.
99
00:11:16.310 --> 00:11:23.890
I want to just underline that it's not about not doing or saying the wrong thing, right? It's
100
00:11:23.890 --> 00:11:33.270
actually about taking a very active stance in the way in which you show up in your humanity.
101
00:11:34.250 --> 00:11:42.690
It's really deeper relationship things like making your subconscious conditioning more conscious
102
00:11:42.690 --> 00:11:48.630
around gender and sexual orientation. It's really around being engaged in the process
103
00:11:48.630 --> 00:11:57.390
versus going for perfection. It's really around making the work of queer competency about you and
104
00:11:57.390 --> 00:12:04.090
assessing your own biases, right? Totally. Beyond just getting the pronouns right.
105
00:12:04.750 --> 00:12:11.830
Totally, totally. Oh, I love that. Pause for a second. I didn't want to follow my questions.
106
00:12:21.330 --> 00:12:34.680
I'm just trying to decide the next directions. Yeah, let's maybe we'll go into
107
00:12:35.220 --> 00:12:43.060
your favorite part. Does that sound good? My favorite part? Yeah. What do you love
108
00:12:43.060 --> 00:12:46.160
most about your favorite part of what you do? Do you want to do that one? Oh, yeah.
109
00:12:46.160 --> 00:12:55.700
Yeah. Okay. Okay. Next question. Do you love most about your job and your favorite thing
110
00:12:55.700 --> 00:13:07.220
about it or thing to do about it? This might sound a little sadistic. I love melting people's
111
00:13:07.220 --> 00:13:22.060
minds. So the thing about gender is that it is so intricately woven into the fabric of our
112
00:13:22.060 --> 00:13:30.080
society that we think we know from a very early age what it means. And so part of the work
113
00:13:30.080 --> 00:13:36.780
that I do is separating some of those deeply implicit narratives that we've been better
114
00:13:36.780 --> 00:13:42.160
about gender and sexual orientation and making them really explicit and showing people
115
00:13:42.700 --> 00:13:49.740
what the constructs are that are operating under the surface. And when we do that, the number
116
00:13:49.740 --> 00:13:56.580
one, and maybe we'll get into this more in the conversation. If not, I've got loads of
117
00:13:56.580 --> 00:14:01.820
material out there that people can digest on their own time. But really separating the
118
00:14:01.820 --> 00:14:07.800
difference between biological sex, our anatomy, our physiology, gender, our internal sense of
119
00:14:07.800 --> 00:14:12.260
self and sexual orientation, which is about attraction and arousal. And if we're able to
120
00:14:12.260 --> 00:14:19.840
really separate those paradigms, we can see more people for who they are, rather than
121
00:14:19.840 --> 00:14:23.640
conflating, oh, the body parts a person has says something about their gender, how they
122
00:14:23.640 --> 00:14:27.440
express their gender says something about their sexual orientation. All of that is false.
123
00:14:27.440 --> 00:14:35.480
But we're taught that. So when we really break that down in my work, it shifts the way people
124
00:14:35.480 --> 00:14:41.240
see each other and it shifts the way folks see themselves. And that's my favorite part,
125
00:14:42.100 --> 00:14:48.060
is opening folks up to more opportunities to see themselves in one another in deeper ways.
126
00:14:48.500 --> 00:14:57.420
Totally. Oh, I love that so much. I love that so much. I'm going to pause again. I'm
127
00:14:57.420 --> 00:15:03.660
I have a back thing going on. And it's all good. But I'm just like, I normally am able to like
128
00:15:03.660 --> 00:15:09.080
keep up. And I'm just like, I just need some pauses here. Like the holding of two spaces,
129
00:15:09.080 --> 00:15:13.900
because I like want to get into this like conversation with you. And, and I'm like
130
00:15:13.900 --> 00:15:18.100
thinking about the NPS. And I'm like, where are they at right now? And what are they,
131
00:15:18.260 --> 00:15:21.520
you know, like what's going on with that? And it's just hard to hold both right now.
132
00:15:21.520 --> 00:15:28.600
Yeah, well, we can go into more specifics for, for them, if that's helpful. Yeah, I mean,
133
00:15:30.280 --> 00:15:35.100
so it's like, I mean, I just don't want to like, I just don't want to like beat over the head.
134
00:15:35.200 --> 00:15:38.360
It's like, what is your pet peeve about health care providers? And it's like,
135
00:15:38.880 --> 00:15:42.560
I mean, it seems it's like, it's like the same thing. It's like the work, do the work,
136
00:15:42.620 --> 00:15:45.880
right? I mean, if you unless you want to like, go other places with that.
137
00:15:46.530 --> 00:15:52.610
I can, I can say something more specific. Yeah. Or like, what do you wish health care providers knew?
138
00:15:54.120 --> 00:16:04.840
Cool. Okay. Okay. So next question. What do you wish that health care? So the, the people that
139
00:16:04.840 --> 00:16:10.100
I work with, that I serve are primary care providers, nurse practitioners, physician
140
00:16:10.100 --> 00:16:16.960
associates. Those are the, those are the main people or students. And so what, and I think like
141
00:16:16.960 --> 00:16:21.240
you kind of captured this already, there's a lot of people who are very like well intentioned and
142
00:16:21.240 --> 00:16:27.300
want to do a good job. They don't want to mess up. They have desires to help their patients
143
00:16:27.300 --> 00:16:35.260
be really feel welcomed and included. So like they're coming from that context. And we've
144
00:16:35.260 --> 00:16:41.800
talked about how it's like there, it's more than just doing it right, quote unquote, getting it
145
00:16:41.800 --> 00:16:47.920
right on that level. But like, what are, like with that, those contexts in mind, like what
146
00:16:47.920 --> 00:16:57.020
are some things you wish health care providers and students knew or did differently? Or your
147
00:16:57.020 --> 00:17:02.000
pet also like the other way I ask specialists when I do interviews is pet peeves. So like
148
00:17:02.000 --> 00:17:08.760
they tend to wrap in together. Yeah, absolutely. I think if there was one thing
149
00:17:08.760 --> 00:17:16.460
that I could ask folks to do, it would be just don't assume. Don't assume a person's
150
00:17:16.460 --> 00:17:22.300
gender. Don't assume what pronouns they use. Don't assume the sexual orientation.
151
00:17:23.160 --> 00:17:30.780
Don't assume the relationship structures that they exist in. Right. So when a new
152
00:17:30.780 --> 00:17:37.900
patient comes in, you ask those questions. What pronouns do you use? How do you describe
153
00:17:37.900 --> 00:17:47.680
your gender identity? What is your relationship structure? Are you monogamous, polyamorous,
154
00:17:47.680 --> 00:17:51.120
if you need to know that information? Oh, I love that phrasing is what is your,
155
00:17:51.160 --> 00:17:55.680
what did you say? Your relationship structure? I love that. Yeah, structure or relationship
156
00:17:55.680 --> 00:18:02.520
orientation. I love that. Yeah, I think there's a, like, I think there's hesitation.
157
00:18:03.660 --> 00:18:08.080
It just, like, I just speak, thinking of the nurse practitioner mentees I've worked with
158
00:18:08.080 --> 00:18:11.920
and colleagues, like, I feel like there's a lot of hesitation to ask that question because
159
00:18:13.840 --> 00:18:19.440
they just don't want to offend people. Like, and because sometimes people will tell me,
160
00:18:19.460 --> 00:18:22.880
and I've seen this myself too, and patients are like, what do you mean by my pronouns?
161
00:18:22.880 --> 00:18:29.540
Patients who are not accustomed to thinking about that. And I think that's just part of it. Like,
162
00:18:29.580 --> 00:18:33.240
we just have to normalize. Like, we still, we just have to do it. We just have to normalize
163
00:18:33.240 --> 00:18:37.720
these conversations with all of our patients and not just guessing, like, oh, maybe I'll
164
00:18:37.720 --> 00:18:41.860
ask this person what their pronouns are. Right? Like, I think that I hear a bit of that too.
165
00:18:42.360 --> 00:18:46.700
So, yeah, just normalizing those conversations and having those specific language,
166
00:18:46.700 --> 00:18:55.440
languaging pieces, which is part of it, but then also, like, changing the paradigm and
167
00:18:55.440 --> 00:19:00.320
perspective to expect that. We're just gonna, like, the new baseline is, like, we have no
168
00:19:00.320 --> 00:19:06.120
assumptions. We're just gonna ask. Versus, like, oh, most people are, most people are straight
169
00:19:06.120 --> 00:19:11.920
or most people are cisgendered. Like, no, like, we just, we have no idea. Just looking at a
170
00:19:12.500 --> 00:19:19.860
Yeah, absolutely. So the two guidelines I would offer with that. One, only ask the questions
171
00:19:19.860 --> 00:19:26.440
that you need to know. Right? If you don't, if it's not pertinent to a person's health records,
172
00:19:26.500 --> 00:19:32.320
that you know what relationship orientation they have, don't ask. Right? Unless you're just
173
00:19:32.320 --> 00:19:35.980
trying to get to know somebody and you have that rapport already and you're chatting it up,
174
00:19:35.980 --> 00:19:41.980
whatever. Yeah. Yeah. Around the gender piece, the pronouns piece, I do agree with you. I
175
00:19:41.980 --> 00:19:47.040
feel like you should ask everyone. If you're gonna use a pronoun for somebody, ask. If you've
176
00:19:47.040 --> 00:19:52.440
got it down to only use that person's name and you never use a pronoun, then what does it
177
00:19:52.440 --> 00:19:59.120
matter? Yeah. But if you, and most slash all people will use pronouns. It's just habitual
178
00:19:59.120 --> 00:20:07.280
language. And so you must ask. And there are going to be some people who get offended by that.
179
00:20:07.420 --> 00:20:14.220
And so have a pithy statement in your back pocket for why it's important. Just like you
180
00:20:14.220 --> 00:20:21.640
would if you're asking for STI history or, you know, pregnancy history or, you know,
181
00:20:21.820 --> 00:20:27.340
history of hypertension or whatever it is that you're asking about. You know, if someone
182
00:20:27.340 --> 00:20:32.160
asks, what do you mean? You know, like there's something that you're going to come to with
183
00:20:32.160 --> 00:20:38.860
compassion and understanding and why that information. Totally. Totally. Yeah. Totally.
184
00:20:39.520 --> 00:20:44.620
I love that. And yeah, most of the time in terms of relationship structures,
185
00:20:44.620 --> 00:20:49.840
it's in the context of like a physical exam where you're getting to know a person. It's
186
00:20:49.840 --> 00:20:56.080
relevant to potential screenings or support or anything like that. Yeah. But also just,
187
00:20:56.080 --> 00:21:01.700
if they're coming in for, I don't know, respiratory infection, it's probably not
188
00:21:01.700 --> 00:21:07.900
a relevant question. Totally. Also frame the questions that you ask in a way that
189
00:21:07.900 --> 00:21:14.760
doesn't inherently assume. So a lot of times I'll go in for, let's say like pelvic exam or
190
00:21:14.760 --> 00:21:19.880
something like that. And I get asked the question, do you sleep with men or women?
191
00:21:20.600 --> 00:21:26.680
Mm. There's, there's, I mean, I understand the heart in that. They don't want to assume
192
00:21:26.680 --> 00:21:32.400
that I'm heterosexual or that I'm queer, right? But there's also assumptions embedded in that
193
00:21:32.400 --> 00:21:38.720
question. That one, there's a binary. Two, I want to have sex with anybody. You know,
194
00:21:38.940 --> 00:21:49.600
three, that like most of my, my partners are non-binary. So my question, my answer to that
195
00:21:49.600 --> 00:21:56.000
exactly. Exactly. Exactly. What actually do you need to know in asking that question?
196
00:21:56.700 --> 00:22:03.740
My guess is that you need to know what fluids I've been exposed to. Right? You know, like
197
00:22:03.740 --> 00:22:11.260
that's the important thing. So ask about that. Yeah. Right. What fluids have you been exposed
198
00:22:11.260 --> 00:22:19.380
to? In Spanish or Portuguese or Thai? Yeah. Yeah. Obviously putting it in context.
199
00:22:20.820 --> 00:22:31.420
Thank you. Yeah. Totally. So I'm going to pause just to ask you, Tara, do you want to comment
200
00:22:31.420 --> 00:22:39.960
on, let me just look at the questions again. Let's see.
201
00:22:42.140 --> 00:22:47.540
Okay. Do you want to stick to the questions that are in the email or do you want to ask more,
202
00:22:48.740 --> 00:22:56.760
I don't know, like directed questions or like the, the talking about the short,
203
00:22:56.760 --> 00:23:01.460
patients for a short period of time. Like I think, so I guess, and we can include this
204
00:23:01.460 --> 00:23:06.640
in the recording as the question of the scenario, because I'm trying not to, I'm trying not to
205
00:23:06.640 --> 00:23:10.800
like push you into like more answers where it's like, oh, just the superficial stuff,
206
00:23:10.800 --> 00:23:20.120
but I think like, I think a lot of nurse practitioners worry about in the interim. Okay.
207
00:23:20.560 --> 00:23:24.260
So maybe I can put this in the recording. I want to ask your permission first though, but
208
00:23:25.400 --> 00:23:30.900
so most people are in a place as a nurse practitioner, the context is that they are
209
00:23:30.900 --> 00:23:36.400
really overwhelmed by the medical learning. And then they're also trying to make a really big
210
00:23:36.400 --> 00:23:40.780
impact in the world. And they want to take really amazing care of their patients. And also
211
00:23:40.780 --> 00:23:47.540
this saturation point of like, yes, this is a problem. Yes. I need to go into, I need to
212
00:23:47.540 --> 00:23:55.180
get that deep process to get to that on that journey. And also like there's, I don't want to,
213
00:23:55.260 --> 00:24:00.620
I don't want to like hurt somebody right now when I have to talk about pap screenings
214
00:24:01.640 --> 00:24:06.580
for trans masculine patients or things like that, like things that are very sensitive
215
00:24:06.580 --> 00:24:13.660
body-wise. Do you want to get into that at all for specifics or? Okay. Yeah, go with your
216
00:24:13.660 --> 00:24:19.660
intuition and I'll just follow you and I'll answer superficially if it feels right. And
217
00:24:19.660 --> 00:24:26.940
I'll go deeper if I want to. Cool. Cool. Cool. Okay. Okay. Okay. So recorder, we can,
218
00:24:26.940 --> 00:24:33.640
we can, or video editor, we can start again. So I have another question. So yeah, I think
219
00:24:33.640 --> 00:24:39.800
one of the questions that I get a lot from nurse practitioners is they want to be really sensitive.
220
00:24:40.240 --> 00:24:46.880
They are like working on developing their competency. And as they're in that journey,
221
00:24:46.880 --> 00:24:54.140
they're also worried about the specific topic of doing screenings for different patients. So
222
00:24:54.140 --> 00:24:58.600
one that came up a lot when I was talking to nurse practitioners in the audience was
223
00:24:58.600 --> 00:25:04.060
about things like pap screenings for trans masculine patients or other types of sensitive
224
00:25:04.060 --> 00:25:09.420
exams. Do you have any, do you have any things you want to add or comment on or
225
00:25:09.420 --> 00:25:14.880
talk about as it relates to that specific scenario? Yeah, absolutely. I really appreciate
226
00:25:14.880 --> 00:25:22.500
the sensitivity and, and also the very steep learning curve. Yeah. I think the place to
227
00:25:22.500 --> 00:25:28.720
start, if folks were going to like go do a little personal reflection is really like,
228
00:25:28.720 --> 00:25:37.000
what are the assumptions that are made when I am offering a pap? Right. And getting
229
00:25:37.000 --> 00:25:42.480
in front of those and actually asking questions to create more safety with the patient. So
230
00:25:42.480 --> 00:25:49.600
one example is a lot of people assume that because I learned these terms in my medical
231
00:25:49.600 --> 00:25:56.460
school, that those are the terms I should use for a person's body. Really dysphoria inducing.
232
00:25:57.540 --> 00:26:03.940
So you might actually ask your clients or your patients, you know, what terms do you like to
233
00:26:03.940 --> 00:26:09.700
use for your body as I'm describing what I see. Right. Or is there, you know, is there any
234
00:26:09.700 --> 00:26:14.020
place that you do or do not feel comfortable with me touching, you know, those sorts of
235
00:26:14.020 --> 00:26:22.200
that really help folks advocate for themselves when they otherwise will have the opportunity to do so.
236
00:26:22.540 --> 00:26:29.240
Totally. Oh, that's so great. That's so helpful. Absolutely. I love that.
237
00:26:30.620 --> 00:26:34.380
I'm sorry. I'm like, I'm like getting like a wave. I'm not feeling super, super great.
238
00:26:35.220 --> 00:26:41.480
Oh, I'm sorry. Cool. What, where do you, what, where do you think you want to go?
239
00:26:42.040 --> 00:26:46.900
Where do you think you want to go? Do you want to do the risk factors, resilience factors?
240
00:26:48.740 --> 00:26:55.100
Yeah, we could do that. For sure. I also would be happy to just talk more about like
241
00:26:58.220 --> 00:27:06.620
what are things that you, you know, wish nurse practitioners knew or what, yeah, or something
242
00:27:06.620 --> 00:27:11.300
like just going and I can just talk for a while so you don't have to worry about it.
243
00:27:11.300 --> 00:27:15.480
That would be really helpful. I'm really sorry. My brain is actually like, it's like not functioning
244
00:27:15.480 --> 00:27:21.880
super well today. Oh, I feel for you. Yeah. It's okay. Yeah. And then we can totally wrap it up,
245
00:27:21.880 --> 00:27:25.840
you know, if that's okay with you. Yeah. That would be really helpful. Thank you.
246
00:27:28.460 --> 00:27:33.020
Yeah. I've been so looking forward to this, but I'm like, oh God, now I'm like,
247
00:27:34.440 --> 00:27:38.560
okay. Okay. Yeah. And if you want to continue the conference, if you realize afterwards,
248
00:27:38.560 --> 00:27:42.860
like, gosh, there's way more we should have talked about. Yeah. Yeah. Another one.
249
00:27:43.060 --> 00:27:55.360
Totally. Yeah. Thank you. That's super helpful. Okay. Back in. So what, just open-ended
250
00:27:55.360 --> 00:28:02.240
question. What do you kind of wish nurse practitioners knew, new grads, students,
251
00:28:02.940 --> 00:28:09.760
any, I mean, whatever you'd like to share will be amazing. We've talked a lot about assumptions
252
00:28:09.760 --> 00:28:14.430
and yeah, really there is so much assumptions that it's like, there's that's like,
253
00:28:15.120 --> 00:28:21.180
like right there. One takeaway. Don't assume. Yes. Exactly. If there could be one nugget that
254
00:28:21.180 --> 00:28:27.480
everyone wants to go away with. Yeah. So I think I'll reiterate the separation between
255
00:28:28.040 --> 00:28:33.160
sex, our anatomy and our physiology, our gender identities, our gender expressions,
256
00:28:33.300 --> 00:28:39.800
and our sexual orientations. If everyone just got on board with that, those are three
257
00:28:39.800 --> 00:28:44.460
different things. They don't imply anything about each other and we could just treat
258
00:28:44.460 --> 00:28:51.980
bodies as bodies, not assume gender identity, not assume sexual orientation. Everyone would be
259
00:28:51.980 --> 00:29:00.700
for it. Yeah. The other piece that I will really name is that I, I wish that there
260
00:29:00.700 --> 00:29:06.180
was more of an understanding of the interconnectedness of mental health and physical
261
00:29:06.180 --> 00:29:13.740
health. Yeah. Especially for marginalized communities. Yeah. So when you provide
262
00:29:13.740 --> 00:29:20.880
really affirming care, it creates greater positive mental health outcomes and in turn
263
00:29:20.880 --> 00:29:26.080
creates greater positive physical health outcomes. Yeah. Because the way that our
264
00:29:26.080 --> 00:29:32.760
psyches are working directly impacts the neurotransmitters that are available in our
265
00:29:32.760 --> 00:29:37.480
bodies, our hormone levels, all of those other things that impact all of our other
266
00:29:37.480 --> 00:29:43.120
physiological functions and therefore our physical health outcomes. So I wish that
267
00:29:43.120 --> 00:29:52.640
was less siloing between mental health desires and needs and physical health. Yeah. Right. So
268
00:29:52.640 --> 00:30:00.560
that more of our physical health, our medical providers could see themselves as mental health
269
00:30:00.560 --> 00:30:07.800
advocates as well. Yeah. And that would be an underlying non-negotiable around providing
270
00:30:07.800 --> 00:30:15.120
affirming care. One of the greatest, you know, pains I've seen in my own career
271
00:30:15.830 --> 00:30:25.600
and also just statistically is how many LGBTQI people won't seek care. Yeah. It's horrible.
272
00:30:25.920 --> 00:30:33.440
Yeah. It's horrible. And I think that it only takes one affirming provider
273
00:30:34.120 --> 00:30:38.180
to make it more likely that someone seeks care when they need it.
274
00:30:38.180 --> 00:30:43.760
Yeah. For any reason, right? Like any medical care at all, like not necessarily related to
275
00:30:43.760 --> 00:30:49.940
anything. Exactly. Yeah. Yeah. And when you say affirming care, can you clarify for people
276
00:30:49.940 --> 00:30:57.380
what you're referring to? Yeah. What I mean is that when a patient walks in, they have
277
00:30:57.380 --> 00:31:05.380
the experience of feeling seen for who they are and that no aspect of their gender,
278
00:31:05.920 --> 00:31:13.340
their bodies, or their sexual orientation gets pathologized in any sort of way
279
00:31:13.340 --> 00:31:19.040
or othered or marginalized, right? They feel like their full humanity is welcomed there
280
00:31:19.680 --> 00:31:29.260
and fundamentally seen by their provider. Absolutely. Absolutely. Yeah. And in terms of
281
00:31:29.260 --> 00:31:34.940
creating, I guess I want to clarify too with creating safe spaces. You've given a lot of
282
00:31:34.940 --> 00:31:41.060
great examples of like what turned, like in terms of the practicing for people to like,
283
00:31:41.260 --> 00:31:46.400
like language, language can help like also make that transformation of the brain too.
284
00:31:46.400 --> 00:31:50.740
So it's like the, the using the language of like, what terms do you use for your body parts as
285
00:31:50.740 --> 00:31:59.160
we're going through, like what, what would you, what would you say for, I'm so sorry,
286
00:31:59.180 --> 00:32:06.560
I just lost my train of thought. I'm so sorry. I'm trying to keep like multiple things together.
287
00:32:08.700 --> 00:32:15.040
Sorry, let me try that again. I'm actually might have to wrap up. I'm so sorry.
288
00:32:15.120 --> 00:32:19.420
I don't feel super well. Maybe we'll just scratch that last question.
289
00:32:19.420 --> 00:32:25.400
Yeah. I'm really sorry about that. I should have just rescheduled. I just didn't want to lose you.
290
00:32:25.920 --> 00:32:32.140
Sorry about that. Thank you. Okay. So wrap up question and I will get my thoughts together. And
291
00:32:32.140 --> 00:32:36.560
I think when I'm more well-rested, I'll have more, more questions to keep together.
292
00:32:36.960 --> 00:32:43.600
Okay. So, well, thank you so much for being here with us. I'm sure that I will have a lot
293
00:32:43.600 --> 00:32:52.460
more questions. I really wanted us to start this conversation so that I really feel like it's so
294
00:32:52.460 --> 00:33:00.380
many people wrote in when I was asking to survey the audience about very tactical things,
295
00:33:00.440 --> 00:33:06.600
like how do I do hormone replacement therapy or what about chest binding and what about
296
00:33:06.600 --> 00:33:11.660
screening exams and a bunch of very like specific medical things, which I think are all
297
00:33:11.660 --> 00:33:18.540
amazing and things that I really want to help address as well in our episodes and our content
298
00:33:18.540 --> 00:33:24.580
and all that stuff. But I really feel like this is such a foundational conversation to have where
299
00:33:24.580 --> 00:33:30.200
it's easy, especially for newer nurse practitioners who are so stressed about
300
00:33:30.200 --> 00:33:36.600
that role transition and taking excellent care of patients and not making any medical mistakes
301
00:33:36.600 --> 00:33:40.660
that I think that they're apt to want to like jump ahead to that place. But I really
302
00:33:40.660 --> 00:33:48.540
so appreciate us talking about a lot of these foundational aspects because it's so
303
00:33:48.540 --> 00:33:54.880
requisite for all of the other work that we do, because we can learn how to do hormone
304
00:33:54.880 --> 00:34:02.080
therapy or gender-affirming hormone therapy and gender-affirming care. And also I just,
305
00:34:02.300 --> 00:34:06.920
it's just so important to have those other pieces too, like before we even think about
306
00:34:06.920 --> 00:34:14.520
that. Yeah, absolutely. I think the piece I would like to just invite everyone in
307
00:34:14.520 --> 00:34:20.179
too is those questions that you have about binding, those questions that you have about
308
00:34:20.179 --> 00:34:27.760
STI screening, you know, hormone replacement, those are things that are out there on the
309
00:34:27.760 --> 00:34:36.900
internet with really, really good information. There's specific courses that are, you know,
310
00:34:36.900 --> 00:34:42.639
replacement therapy, you know, those sorts of things. Go get that education. I think what's
311
00:34:42.639 --> 00:34:49.340
really important for me and the message that I want to leave folks with is asking those probing
312
00:34:49.340 --> 00:34:54.179
questions to look inside of ourselves a little bit more because the internet's not going to do
313
00:34:54.179 --> 00:35:00.740
that for you. Yeah, totally. Totally. Thank you so much. Where can people learn more about
314
00:35:00.740 --> 00:35:04.200
you and take your queer competency course? Actually, if you can tell us a little bit
315
00:35:04.200 --> 00:35:09.440
about it too. Is it like a self-paced course? Is it a live course? Like tell us about that.
316
00:35:09.740 --> 00:35:19.380
Yeah, absolutely. So it is a self-paced course. There is definitely an option to do it on your
317
00:35:19.380 --> 00:35:23.420
own time. There's also a couple of different tiers. You know, you don't have to go all
318
00:35:23.420 --> 00:35:27.180
in for all the material. There's like an allyship booster pack, which is like,
319
00:35:27.180 --> 00:35:33.300
you know, three short modules or the full queer competency course is eight modules that
320
00:35:33.300 --> 00:35:39.940
takes you through all the way from key paradigm shifts, LGBTQI fluency, allyship,
321
00:35:41.320 --> 00:35:46.160
business, best business practices, all the way into like supporting people through transitions,
322
00:35:47.220 --> 00:35:54.820
being an advocate for, you know, supportive caregivers and family systems, sex, love,
323
00:35:54.820 --> 00:35:59.540
and dating, those sorts of things that are really core competencies for serving the
324
00:35:59.960 --> 00:36:06.040
LGBTQIA community. So all of that can be found on my website. Can be purchased on your own time.
325
00:36:06.600 --> 00:36:13.280
I also run a certification program that happens once a year. Our current cohort is like halfway
326
00:36:13.280 --> 00:36:20.160
through where I send people there. If you're interested in going deeper in like a four
327
00:36:20.160 --> 00:36:26.540
month deep dive experience with me, with, you know, group coaching, one-on-one coaching,
328
00:36:26.540 --> 00:36:32.580
all of that, the next cohort will be spring of 2023. Oh, that's so great. Thank you so
329
00:36:32.580 --> 00:36:36.880
much for sharing with that. Cause I actually thought that you only did the live course.
330
00:36:36.900 --> 00:36:41.060
I didn't realize that there was the self-paced one. Cause I know that a lot of the people that
331
00:36:41.060 --> 00:36:45.620
we serve here are really like, that's a huge priority for them because like,
332
00:36:46.220 --> 00:36:50.160
it's just a really challenging transition to practice. So time management is a little bit
333
00:36:50.160 --> 00:36:54.040
on the challenging side. So I'm so glad to hear that. Absolutely. Cool. And what's your
334
00:36:54.040 --> 00:37:03.100
website? www.embodyemerge.com. Excellent. Oh my goodness. Thank you so much for being here.
335
00:37:03.280 --> 00:37:14.140
I really appreciate it. It's my pleasure. That's our episode for today. Thank you so
336
00:37:14.140 --> 00:37:19.620
much for listening. Make sure you subscribe, leave a review, and tell all your NP friends
337
00:37:19.620 --> 00:37:24.560
so together we can help as many nurse practitioners as possible give the best care
338
00:37:24.560 --> 00:37:29.800
their patients. If you haven't gotten your copy of the ultimate resource guide for the new NP,
339
00:37:30.220 --> 00:37:35.780
head over to realworldnp.com slash guide. You'll get these episodes sent straight to
340
00:37:35.780 --> 00:37:41.100
your inbox every week with notes from me, patient stories, and extra bonuses. I really
341
00:37:41.100 --> 00:37:45.720
just don't share anywhere else. Thank you so much again for listening. Take care and talk
© 2025 Real World NP. For educational and informational purposes only, see realworldnp.com/disclaimer for full details.
