For most trans/non-binary and gender non-conforming folks, medical care is a horror show. It’s hard to overstate the problem, given the long, ugly history of violence done to trans bodies and psyches under the modern medical system. To this day, trans people in need of health care are often treated like oddities, violated, stigmatized, assaulted, and denied even basic treatment. For those of us who are lucky enough to even have access to health care, it can feel like spinning a roulette wheel: will my essential medications be held hostage by my doctor to coerce me into losing weight or quitting smoking? Will I be steamrolled into non-consensual tests? Will my insurance deny my routine blood work or cancer screening? Will my naked body be put on display for medical students? Will my primary concerns be ignored because my doctor can’t see past my transness? Will I be called by a name or gender other than my own, triggering dysphoria and putting me at risk among staff and other patients?
Trans folks are certainly not the only group mistreated or barred access from conventional medical care. The history of being experimented on, harmed, neglected, and pathologized by medical practitioners is shared by gay and intersex patients, all people of color and indigenous people, independent women, and those deemed mentally ill, fat, poor, or disabled. For those who inhabit multiple of these identities, the impacts are horrifyingly magnified. Many of us, reasonably, distrust and avoid contact with the medical system to whatever degree we can.
This history has left many painful scars. In the wake of this violence and lack of access, the trans community suffers with undertreated chronic conditions, psychological anguish, and tragic death. The toxic impacts of the medical system twine with challenges and violence in many other aspects of life—in relation to family, work and housing situations, and the police and prison system.
Within trans communities, we find ways to take care of one another, as all marginalized communities do. We share information and resources, we create alternative structures and languages to support our needs. For health care, we seek and create and innovate and experiment. We have to. Trans people use herbal medicine and other alternative therapies at much higher rates than cisgender people. Many of us consider ourselves “body hackers,” and plant medicines in particular appeal to us because of the do-it-yourself ethos of herbalism. For queer and trans people who often feel alienated in this painfully straight, cisnormative society, the companionship of plants, which have their own, more expansive reflection of gender, can be deeply healing.
Free and accessible clinics for trans herb-seekers are cropping up around the country (and are badly needed). Though it’s still almost impossible to get decent health care, more and more herbalists are trying to make their practices welcoming to queer and trans clients. This is a wonderful blossoming. Many herbal practitioners offer long consultations and employ client-centered intake techniques, which can create a spaciousness that helps build trust. Having our health experiences heard and validated, without being second-guessed or dismissed, can be deeply healing for those of us who carry medical trauma. The mindset of supporting clients in their own healthcare decisions, and especially helping clients make and steward their own herbal preparations, can be very empowering for those who have been violated or disenfranchised.
Embracing the intention to make your practice more inclusive is a crucial first step in supporting trans clients. But even with the best of intentions, cisgender herbalists can inadvertently recreate the harms trans people experience all too often in conventional medicine—it takes work and humility to create a space that is deeply welcoming, affirming, and safe.
Taking a Personal Inventory
Creating a more inclusive and affirming practice doesn’t only happen when we’re with our clients (or customers or community members, depending on how you practice). It starts with how we think about gender, bodies, the beauty of self-determination, and the complexity of gender and sex.
Whether you are deeply ensconced in trans community or you’ve never met anyone you knew was trans, it’s essential to check what kind of stories you harbor about transness, and how these internalized beliefs can hurt your clients. One of the most widespread and pernicious stories about trans people is that their genders are in some way less real than cisgender people’s—that they’re confused, psychologically damaged, faking it, or that their genders are simply “not as real.” These ideas may appear reflexively, even if we don’t consciously believe them. A trans woman is a woman, and if you notice yourself thinking of her as “really a man,” you are being influenced by a way of thinking that is harmful to trans people! The same is true if you see a non-binary person and think of them as a woman. If you often or repeatedly use the wrong pronouns for trans people, that’s likely an indication that you’ve internalized this way of seeing people. Such thinking can make it very hard to see and understand the experiences of trans people, and creates a likely danger that you will harm your clients. If you notice you are struggling with this, consider referring trans clients to another practitioner who can offer a more gender-expansive practice until you have been able to uproot your internalized transphobia. Even people who have great intentions and want to support the trans community can still have some internalized transphobia; the important thing is to recognize that it’s there and take steps to unlearn and transform it.
If some of these ideas are unfamiliar or if you’re not sure how the pieces of sex and gender fit together, you might start by checking out some of these articles:
Trans 101 by the Sylvia Rivera Law Project
Transgender People and “Biological Sex” Myths by Julia Serano
To make your clinic, practice, or business more welcoming to trans clients, you have to think beyond gender. Trans people are also excluded from care because of poverty, racism, homelessness, incarceration, and disability. We urge our herbal community to work on making clinical offerings radically accessible, so that everyone in our society has access to herbal support. We can’t view accessibility as charity, or something we offer out of generosity or pity. Prioritizing accessibility is a recognition that we are interdependent—that we all have needs in different contexts—and a rejection of the ways our society prioritizes the needs of some while excluding others.
In this post, we’ve introduced some of the reasons why gender-expansive, trans-inclusive herbal care is so deeply needed, and why it benefits not just trans clients but all of us as herbal practitioners. Once you recognize the importance of gender inclusion and feel ready to take some concrete steps to make your practice more accessible and affirming for trans and non-binary clients—what’s next?
In Part Two of this post, we’ll introduce our ideas for some concrete steps you can take to build a more welcoming and gender-expansive herbal practice.