There is a lot of furor surrounding the new visibility of transgender folk these days. The latest statistics show that approximately 0.3% of the US population identify themselves as transgender, or approximately 1.4 million human beings in this country alone. I believe that as it becomes more socially acceptable to be one’s authentic self, the number will climb somewhat. There are nearly daily stories about people transitioning very late in life because, finally they feel that they are allowed to be themselves. Approximately 1.7% of our population are identified as intersex – and truly that number is much higher as well. The percentage quoted applies only to people born with “ambiguous genitalia,” whereas the vast majority of intersex conditions are not identified without genetic testing.

One of the basic things to understand is that, just as our society has been fearful and resistant to the idea that people of other nationalities, other colors, and other sexualities have validity as human beings, so too with the transgender and intersex communities. Being transgender or intersex is a condition that is born, not chosen; the only choice involved is whether or not a person chooses to act on their knowledge of themselves and be exposed in a world that is very unfriendly to the idea of their very existence. As a group, trans people have the highest levels of anxiety, depression, and suicide rates; the highest levels of unemployment, job discrimination, and homelessness; and the highest targeting of hate crimes, not to mention laws which might govern whether or not they can use a public facility. Trans people of color face the harshest of all conditions, as they are at the intersection of gender and racial discrimination and politics.

A bodywork practice should be a refuge from that, not an extension.

My first-born child came out as transgender in 2015, and therefore I have spent the last couple of years researching and working with trans people and the trans experience. I recognized that there was a whole lot I didn’t know, and I wanted to learn how to make my practice as knowledgeable, inclusive, and friendly as possible. Trans folk are systematically erased at every level of society, and particularly in a healthcare setting, where 70% report that they were refused care or were subject to abuse from professionals (2010 study by Lambda Legal). I feel very strongly that everyone who walks in my door, or who shows up to one of my free clinics, deserves my full attention, presence, and respect for their basic humanity. The better informed I can be about the physical (and social) issues my clients are dealing with, the better therapist I will become.

One of my precepts is that making my practice friendlier for one group makes it friendlier for all. I make certain, when I don’t understand something about an issue that my clients bring up, I learn all I can about it. As a healthcare professional, I cannot expect my clients to inform me how I am supposed to care for them; it is definitely my responsibility to do my own work as far as research and application. On my intake forms, people are given plenty of opportunity to identify themselves and their concerns in a respectful and caring way, without fuss or drama. I update my intake forms periodically to reflect changes in appropriate and respectful language. I try to ask open-ended questions both on the forms as well as in client interviews. This allows the client to know both that I am informed enough not to shriek or chase them out of the treatment room, and that they are welcome in my practice.

Language has real power.

I have heard many otherwise caring and compassionate people act completely unhinged when they speak about trans people and their pronouns, or their identity, or what medical treatments they seek. There is a strong tendency for many cis-gender people to believe that trans folk are “up to” something nefarious, because they think that gender identity is always completely aligned with one’s genitalia. They think that to go against the concept of the black and white binary is morally dangerous and should even be snuffed out. I see the fear, and can be compassionate with the fear, without sacrificing the validity of my trans son, my trans friends, and my trans clients.

I can act from a place of love and not fear, because I got informed. I believe that it is our responsibility as therapists to always work from that place of universal love and factual information. When we connect with each other’s humanity, we will create the therapeutic presence that is so vital to our work.

Ellen Santistevan is a licensed massage therapist who practices craniosacral therapy and polarity therapy, and has additional experience in geriatric work and shamanic practice. She teaches ethics, polarity therapy, and reflexology in Albuquerque, New Mexico. Her practice integrates elements of all these bodies of knowledge, as well as the most current research on wellness. You can find out more about her at

For more information on this subject, see Ellen’s article in the March/April issue of Massage & Bodywork. It was this article that prompted us to create a trans-friendly intake form for bodyworkers to include with our free intake forms package for practitioners. Click here for access to the free forms. ~from your friends at Sohnen-Moe Associates