Queer Theory and Acupuncture
As a non-Queer practitioner trying to improve the care I provide to those who do identify as LGBTQ+, and while sheltering in place I’ve been doing a lot of reading. One recent book that really resonated with me is Queer: A Graphic History by Meg-John Barker and Julia Scheele. It gives a fairly comprehensive overview of the development of queer theory, a sort of philosophic/gender studies area of thought, with lively illustrations. The authors identified their objective in writing the book “is to be useful to people in their everyday lives, as well as introducing the academic world of queer theory.”
Perhaps the main point I took away from queer theory is the limiting nature of binaries, of all sorts including gender. Binary concepts are often opposites, such as “near/far” and can be extremely useful. Imagine trying to describe locations without being able to use those terms. One significant difficulty comes, however, when we stop viewing them as relative concepts and make them rigid categories. Consider “up/down.” Upstairs in my house is higher than downstairs but relative to the cedar tree tops outside, upstairs is actually lower in height and therefore down. Imagine if I were to suggest that the upstairs of my home is an absolute, fixed “up.” The same can be said about humans. As an example, some humans are male and some humans are more male than female. There isn’t an absolute category of “male” (or “female”) but rather relative degrees.
It may be because I am an acupuncturist and one of the primary diagnostic paradigms is the “Eight Principles,” which are four sets of opposites, but I spent a fair bit of time pondering binaries. In acupuncture we use hot/cold, interior/exterior, yin/yang, and deficiency/excess for diagnosis. They may look like binary concepts but, in practice, they are treated as dualities: different but related and coexisting. Just because someone has “hot” symptoms does not mean that they cannot have any “cold” symptoms simultaneously. Yin could not exist without Yang; Yang could not exist without Yin. But not in the same way that Simone de Beauvoir explains that male is the standard and female is the “other,” rather they are dependent parts of a coexisting whole. You have undoubtedly seen the Yin/Yang symbol. It is a filled circle and can only be a whole with both the Yin portion and the Yang portion. Again, this applies to humans: there is no absolute “female” (or “male”) but rather they both co-exist in a single person, at varying degrees, simultaneously.
This brings us to another point in queer theory: process rather than static. Queer theory encourages us to look at HOW something is being DONE not WHAT something IS. In Chinese medicine an “excess” in one area of the body can, and often does, lead to a “deficiency” elsewhere in the system. Having an interior deficiency might make a person more susceptible to an exterior excess (a commonly experienced example of this is catching cold when you get run down). Just because this situation currently exists doesn’t mean that it can’t or won’t change over time. To use our analogy, probably you have had a cold at one time but not always had a cold. So as practitioners we treat the person in front of us at the time; treatments might be similar from one visit to the next but usually they are not identical. In the case of gender expression, queer theory recognizes it can be a fluid process rather than a static fact determined based upon your sexual phenotype at birth.
The final piece of queer theory that I took away from the book was to question “normal.” This term often gets used to mean “majority,” but I can tell you I consider myself “normal” and I haven’t always taken a majority viewpoint or voted for the candidate with the most votes. Just because most people you know do something doesn’t mean it makes any more sense than not doing it or doing it differently. Which is more “normal”: wearing no eyelash modification, using mascara, or getting eyelash extensions? Maybe they are all “normal” options. This concept was brilliantly illustrated by my favorite of the many insightful depictions in the book: the Stereotypical North American Female asks of the Drag Queen “Why do you dress like a woman?” The Drag Queen responds, “Why do YOU dress like a woman?”
Binding and Breath–chest binders in the time of corona
Breathing. It’s something we often take for granted and don’t think much about. Besides keeping you alive, breathing can help you slow down, manage anxiety, focus your attention, and even reduce pain. It’s kind of our body’s built-in wonder drug!. Breathing is the foundation of things like meditation and biofeedback. Yet, for those of us living with certain forms of gender and body dysphoria, easy breathing can be a challenge….and well, not so easy after all. I’m talking about binding.
Chest binding is a way to flatten one’s given chest to give a more masculine appearance and to reduce the appearance of given chest/breast tissue. For many transmen and masc-of-center nonbinary folx, a binder is a self-required item to have on before leaving the house. Binders help us feel better in our bodies, help prevent misgendering, and give confidence to appear in our identified gender.
They also can restrict breathing. In our current COVID-19 pandemic, that is problematic.
The CDC is recommending the use of cloth face coverings to help prevent the spread of coronavirus. This is an important tool particularly in public spaces like grocery stores and pharmacies where social distancing measures are difficult to maintain. However, these face coverings can mimic symptoms that binder users report including shortness of breath and overheating. Binder users also commonly report back and chest pain as negative outcomes from use. These outcomes can be reduced with changing how and which binders we use, according to this study.
The article(published in 2017 in the Culture, Health & Sexuality journal) was one of the first population-based studies on binder usage. Researchers surveyed 1,800 AFAB transgender and intersex binder users over the age of 18 from 38 countries and analyzed the data. They found that the average days per week spent binding correlated the most to the self reported negative outcomes. It’s suggested that taking days off from binding may reduce the risk of these health impacts.
The use of commercial binders is another factor most consistently found to correlate with negative health outcomes. This is likely due to the significant compression these binders provide. It is surprising that the binders most of us have come to think of as the safest are actually causing the most harm. Of course, elastic bandages, plastic wrap and duct tape were also commonly associated with negative outcomes, as we’d expect.
So what does all this mean in the context of our “new normal”? Ultimately, we must weigh the risks and benefits of the items we use to protect ourselves and others from disease with the items we use to decrease our dysphoria. As a genderqueer physician, I highly support wearing cloth face coverings or masks anytime you leave your home or with any interaction with others who do not live with you. Infection control in these times is key.
As for binding, if you are home and can tolerate it, skip the commercial binder and take a deep breath. If you do need to leave your home, consider short term use of sports bras, layering sports bras or other athletic compression wear instead of the commercial binder. These alternative items usually allow for easier breathing. We all work within the context of our own mental and physical health and we need to do what we feel is safest for our bodies. While you consider your options and is right for you, I ask that you also consider the social responsibility we each carry to protect ourselves and others during these times. And remember, breathe. For help with that, here a link for 6 deep breathing apps.
During this time of social distancing, the providers at Rainbow Health Center want you to know we are still here for you. For many of us the ways we are here look different. Check below to see the providers who are scheduling new appointments and if we can fit your needs.
** Healthy and strong together **
Dr Jill Corey, ND: Dr. Corey is still available for appointments via telehealth and phone. Dr. Corey is able to offer a wide range of health support and hormone therapy support virtually. Dr. Corey accepts Regence, Premera, Lifewise and Firstchoice insurance plans. They also offer sliding scale cash pay rates to those that qualify. Call or text 206.971.6708 for more information.
Dr Chelesa Unruh, MD: Dr Unruh is available for telehealth visits for established patients and in person visits for new patients. Dr Unruh manages hormone therapy for all ages (including children/teens and puberty blockers), can write letters for state and federal gender marker change requests, and refer for surgery. Dr Unruh accepts United, Premera, FirstChoice, Cigna, Regence, Amerigroup, and has a discounted cash rate.
Sharonne O’Shea, L.Ac.: Under the Governor’s “Stay Home – Stay Healthy” proclamation (20-25), “alternative medicine” providers, such as acupuncturists, may continue to see/treat patients. Some acupuncturists with immunocompromised family members have closed their practices temporarily. I remain open to see patients at RHC on Fridays and in Lacey on Tuesdays.
As acupuncture breaks the skin surface, I have always been compliant with best practices to limit infection such as changing linens between each patient, cleaning my hands before and after treatment, and – as required by federal law – using one-time use, sterile needles. In addition, I now screen everyone for fever and/or symptoms of upper respiratory infection and reschedule folks who have one or both. I am also wiping down surfaces that I normally would not, such as door knobs and shared pens, and wearing a mask while treating patients as I cannot perform acupuncture from 6 feet away – I may have long arms but not THAT long and no one wants me to play darts with them as the target.
Perhaps more importantly, I am diligently working at not succumbing to pan(ic)demic mindset; I leave a roll of TP on the shelf for the next person, I get outside daily, I keep a regular schedule, and – since my schedule has freed up considerably with no kid activities, meetings, etc. – I am getting lots of rest. It is possible to take the situation seriously and lightly simultaneously. For instance, my kids share with you this message of empowerment during these times of uncertainty: “Wash-your-hands-ington” residents like to “give high fivers not high fevers.” https://www.youtube.com/watch?v=5jhwyAsZAvo. Stay well, not just virus-free.
Sarah Peace, MA, LMHC
Work cell: (360) 451-4903
Fee: $130 or ask about sliding fee availability, paid by debit, credit, or HSA card. Out of Network insurance receipts can be provided.
Sessions: Individual adults and teens, couples, relationships, and families. Online video or audio, or phone call. For people located anywhere in Washington State or abroad. 55 or 110 minutes session length available.
Availability: Wednesdays, Thursdays, and Saturdays, daytime and evening.
* I am offering more sliding fee and pro-bono sessions right now as there is need, and I do so with the clear recognition of the people and oppressive systems that led to this need: that I am intending and currently able to be flexible in providing more counseling with sliding and no fee is in direct response to the corrupt, neglectful, and oppressive actions and laws of the wealthy people, corporations, and US government that profit without care for the rest of us.
Fennec Oak, MA, LMHCA, MHP
I offer telehealth video sessions that can be accessed through computer or cell phone for adults and youth ages 12 and up in Washington state. I continue to offer a sliding fee scale and have added more capacity to work with people with limited financial abilities. I specialize in working with transegnder, gender expansive, and sexualy expansive people, as well as those who have experienced trauma.
Please visit my website for more information, or contact me directly.
Teresa Guajardo, MA, LMHC
I am offering telehealth video counseling sessions via my practice management app, Simple Practice. We can also do telephone sessions if video technology isn’t working for you. Hormone and surgery letters are available via the telehealth video medium.
Who: individual counseling for adults and adolescents as young as 13 years old.
What: LGB and gender affirming counseling, anxiety, depression, and adapted EMDR therapy for performance enhancement, trauma processing, substance use urge reduction.
Rates: Regular rate is $120/clinical hour. Sliding scale and some grants may be available. Kaiser Permanente for gender affirming counseling. Apple/Medicaid with Amerigroup. Otherwise out of network for other insurances. Check with your insurance company about coverage. I will give you a statement to submit for reimbursement.
Availability: Mondays, Wednesdays, and Fridays.
Contact: email@example.com, 360-789-7025
Erin Daly, MA, LMFTA, ATR-P
I am currently offering telehealth sessions via phone and HIPPA compliant video sessions. I am currently available for telehealth sessions for anyone in Washington State.
I offer therapeutic services for individuals for ages 12 and up, as well as relationship focused therapy for families and romantic partnerships. I provide psychotherapy (i.e. talk therapy), as well as Art Therapy, Mindfulness, and Somatic Based Therapies.
Fees: My regular fee is $110/clinical hour. As always, I believe in supporting access for all to the best of my ability. To do this, I am continuing to offer flexible sliding scale rates. I work with people on what makes therapy more accessible to them.
Insurance: I am an out of network provider, and am not able to bill insurance companies directly at this time. If your insurance company offers reimbursement for out of network providers, I can provide you with the necessary paperwork to receive reimbursement.