Gender-affirming care (GAC) plays a critical role in supporting the health and general wellbeing of trans and gender diverse individuals within the area of healthcare.
As Exercise Physiologists, we are uniquely positioned to support transgender and gender-diverse (TGD) individuals by addressing the specific physiological and psychological challenges associated with gender transition such as gender dysphoria and gender incongruence.
What is Gender-Affirming Care?
GAC is HIGHLY INDIVIDUALISED and shouldn’t be approached as a “one-size-fits-all” mentality.
It is a term used for the holistic care of TGD individuals that include social, psychological, physical/behavioural, and medical interventions to support an individual’s gender identity.
It can look like a combination of 1 or more of these 4 key concepts:
1. Social Affirmation
- Using correct Pronouns
- Addressing the Correct Name
- Creating social groups and connections
- Use gender affirming/gender neutral language
2. Medical Affirmation
- Gender-Affirming Hormone Therapy; though oestrogen, progesterone, testosterone, and testosterone blockers
3. Surgical Affirmation
- Gender affirming surgeries such as top/chest reconstruction surgeries and/or bottom surgeries
4. Allied Health Support
- The coordination of Allied Health Services such as Exercise Physiologist, Speech Pathologist, Psychologists and Psychiatrists, Dieticians, and many more health professionals
Why does it Matter?
Gender diverse individuals experience higher rates of adverse health outcomes, including poorer mental health and a greater prevalence of chronic health conditions and comorbidities compared to their cisgender counterparts.
This community also experiences many barriers that can deter the engagement of physical activity and access to healthcare in general. Most of these barriers stem from misunderstandings, stigma and discrimination, lack of trans-affirming services, and lack of awareness that can create negative and uncomfortable experiences for these individuals.
It is important for TGD peoples and anyone in general to engage in healthcare where they feel seen, included, and safe. The role of a healthcare provider is to create a safe and inclusive environment for the participation of physical activity and inclusive access to healthcare.
The Role of the Exercise Physiologist in Gender-Affirming Care
Beyond inclusivity and creating a safe, inclusive, and affirming space, Exercise Physiologists manage the physiological impacts of gender-affirming hormone therapy (GAHT), puberty blockers, and gender-affirming surgeries. For instance, exercise is a primary intervention for maintaining bone mineral density in adolescents on puberty blockers and managing metabolic changes, such as weight gain or altered lipid profiles, in adults on hormone therapy.
Not only, therapeutic exercise serves as a powerful tool for improving mental health outcomes, targeting the high rates of depression and anxiety often reported within this population.
Conclusion
Exercise Physiology is a vital component of a multidisciplinary gender-affirming healthcare team. By combining clinical expertise in metabolic and musculoskeletal health with a commitment to inclusive and safe practice, Exercise Physiologists can significantly improve the physical and psychological well-being of transgender and gender-diverse individuals.
The standard of healthcare should be to promote health, prevent harm, and encourage best practice.