Oakland alternative medicine practitioners work to make LGBTQ clients feel welcome

Autumn Ross greets every new acupuncture client the same way: with a barrage of questions. “I ask them about their bowel movements, I ask them about their breathing. I ask them if they have a menstrual cycle. I ask everyone if they have a menstrual cycle,” Ross said, even the men who appear to be cisgender—that means, they identify exclusively with the sex they were assigned at birth. “It’s one way I demonstrate to my clients that I won’t make any assumptions about their health or anatomy from how they present,” she said.

Similarly, Ross, a fertility-focused acupuncturist, is thoughtful about the language she uses when speaking about reproductive care. “When I talk about conceiving the ‘old fashioned way,’ I don’t talk about ‘straight sex,’ because that can still mean a whole bunch of things,” Ross said. Instead, she uses medical terminology like “sperm” and “egg,” focusing more on biology than gender.

A few years ago, “trans competency,” or a fluency in the terminology and health needs of trans patients, wasn’t something practitioners marketed on their websites or taught at alternative medicine schools. But today, Ross is among a growing network of practitioners in Oakland trying to serve the LGBTQ community, [which includes people who identify as lesbian, gay, bisexual, trans or queer.

It’s a specialty within Chinese medicine that grew out of AIDS activism, according to Nishanga Bliss, professor at the Acupuncture Integrative Medicine College (AIMC) in Berkeley. For several years, Bliss worked at a community practice that provided free treatment to patients living with HIV. The work was funded by the Ryan White CARE Act of 1900, which aimed to improve the quality of and access to AIDS-related healthcare. In the early days of the crisis, she said, acupuncture helped HIV patients manage the stress that pharmaceutical treatments took on their digestive and immune systems. “I had patients who were taking 20, 30, 40 pills a day,” Bliss said.

The idea of cultural competency trainings for Chinese medicine practitioners also originated at these community clinics. “It was part of our funding from the feds, that at every staff meeting we’d constantly educate ourselves,” Bliss said. “Could be about race or queerness—it was essential for the population we were working with.”

But when she started teaching at AIMC ten years ago, it was different. “There was a lot of ignorance when it came to LGBTQ health,” Bliss said. She remembered faculty members at the clinic routinely, if unintentionally, acting in a way to make trans clients feel uncomfortable— questioning a person’s preferred pronouns, or not knowing how to handle a trans patient taking pharmaceutical hormones. “That’s what I was seeing a lot,” Bliss said, “clinicians saying ‘I have no problem with you being trans, but I don’t know anything about this, so I can’t treat you.’”

Katrina Hanson noticed this too when she enrolled at AIMC in 2016. “I’d have trans patients who wouldn’t feel comfortable telling us important medical information because they were worried about how practitioners would react,” Hanson said.

Queer herself, Hanson thought this was unacceptable and started immediately advocating for a more inclusive environment. Within the first few months, she pushed the school leadership to install a gender-neutral bathroom and expand the school’s non-discrimination policy.

There were other queer students who came before her and wanted similar changes, but Hanson “knew how to communicate and educate,” Bliss said. Soon Bliss and Hanson teamed up to tackle the school’s curriculum. They changed the mandatory gynecology course to include trans-specific material and renamed it “Reproductive and Sexual Health.”  

“We start off with puberty, and introduce the idea of going through puberty as a trans or intersex person,” Bliss said.

When Hanson graduated and opened Prism Acupuncture in 2016 in Oakland, she became the first acupuncturist in the Bay Area to offer home visits to people recovering from gender-affirming surgeries such as hysterectomies or mastectomies. “Whenever people get home, I’m going there almost every day. Because there can be a lot of swelling and pain, constipation, getting acupuncture right away can really reduce all of that and prevent scar tissue from forming,” Hanson said.

Hanson also uses acupuncture to help trans people who are just beginning to take external estrogen or testosterone and want to regulate their hormones, which are essential for sleep and digestion. Acupuncturists aim to mediate the shift by stimulating the person’s endocrine system, aiding the body’s production of its own hormones.

Around the same time Hanson opened Prism, Sandy Baird opened up Riverstone Chiropractic, the first LGBTQ-focused chiropractic studio in Oakland. Up until two years ago, Baird, who identifies as non-binary and goes by they/them pronouns, focused on treating sports injuries and back pain for the general population.

When Baird graduated from chiropractic school five years ago, they said, nobody saw the need for a queer specialty. “My own marketing person didn’t think I needed to put LGBTQ on my fliers,” Baird said. “I still kick myself because the photo on the front was this white, straight-looking lady with a blond child on her hip.”

But in 2017, Baird decided to host a workshop at the LGBTQ Community Center in Oakland called “Open up Your Chest, For Butches.” It was the first workshop in the city specifically geared towards teaching transmasculine people how to alleviate neck and chest pain caused by binding, a technique that uses fabric to compress a person’s chest, getting rid of the appearance of breasts. The practice is considered gender-affirming, but the compression of the ribs and lungs can be painful and can impair breathing.

At the workshop, Baird demonstrated breathing exercises and foam rolling techniques to show people how to stretch the shoulder and trapezius muscles constricted by binding, and then released YouTube videos and an e-book reviewing these techniques online.

“For so many people, it was the first time they’d heard solutions that made sense,” Baird said. Participants told Baird they’d felt uncomfortable bringing up binding with their doctors. And for the few that had, Baird recalled, doctors had been dismissive, telling them to take their binders off for a few days at a time. But that suggestion doesn’t fully take into account the way in which gender dysphoria, or feeling a disconnect between your gender identity and your biological sex assigned at birth, affects mental health. “You just have to realize why people are wearing binders in the first place. We’re not wearing it for fun,” Baird said. 

After the workshop, Baird began doing everything they could to make their practice explicitly inclusive, like advertising that the clinic uses gender-neutral intake forms and posting binding tips on their blog.

Over the past few months, Baird, Hanson and Bliss have begun a quiet campaign to integrate queer and trans-specific material into the curriculum of local alternative medicine schools. To date, they’ve co-taught a gender competency class to four Bay Area acupuncture schools, one chiropractic school, and one herbalism school. Hanson recently was hired at the Academy of Chinese Culture and Health Sciences in Oakland to teach the sexual and reproductive course she developed with Bliss.

For Hanson, it can feel like a long, slow process. “In order to make a significant shift, with a school clinic, you have to get everyone on board—the front desk staff, the admissions staff, the faculty, and the clinic supervisors, it can be challenging to get that,” Hanson said.

The biggest challenge for Hanson is staying financially afloat while trying to make her services accessible to the queer community. “I want to be able to offer free care to everyone,” Hanson said, “but that’s just not how it is when you have your own practice.”