As a massage therapist and health care provider, I am sure that you make every effort to make all of your clients feel comfortable and welcome. Why, then, would we need to take extra care for the lesbian-gay-bisexual-transgender-queer (LGBTQ) community? Because, what we don’t know or realize may cause us to unintentionally discriminate or make a client feel uncomfortable.

When I was in massage school in the early 1990s, one of my fellow classmates was HIV-positive. Unfortunately, some of the other students in the class didn’t understand that this disease was not contagious in a massage setting and wore gloves every time they worked with him. This was my first experience in seeing the kind of discrimination that members of the LGBTQ community experience firsthand.

Four years ago, someone very dear to me came out as transgender and I gained a new awareness of the struggles that transgender people and the LGBTQ community can face. I am writing this article in hopes that I can in some small way make a difference.


Needs & Concerns

If we are not a part of a group, we can’t really understand its unique needs and daily struggles, but we can take steps to educate ourselves and reach a new level of understanding, in order to be of service.

Members of the LGBTQ community have long been discriminated against both in society and when seeking health care. Imagine being afraid of what might unfold by simply using the restroom, or being denied health care because of who you are.

That may sound dramatic, but it happens every day. Studies show that LGBTQ persons are statistically underinsured as well as less likely to seek out health care due to previous experiences or lack of appropriate care being available. Research also indicates that LGBTQ-identified people are more likely to develop anxiety and depression than their straight peers.

Let’s look at what we as massage professionals can do to step up and be leaders in this important societal transition toward treating everyone equally.

As health care professionals, we need to take the time to educate ourselves on terminology, needs and concerns, specific problems and ways that we can make all of our clients feel welcomed, safe and cared for. This will not only benefit our LGBTQ clients, it will benefit our massage practices and our whole profession.



Let’s start by defining some of the different terms that your LGBTQ clients might identify with. There is extensive scientific research into why we are all created so differently from one another. The idea that there are only two sexes a person can be is proven to be incorrect. There are actually six variations that we know of, according to the World Health Organization Gender and Genetics Study, and science is discovering more about what makes us all unique, all the time.

These definitions are from the American Psychological Association:

Sex refers to a person’s biological status and is typically categorized as male, female or intersex. There are a number of indicators of biological sex, including sex chromosomes, gonads, internal reproductive organs and external genitalia.

Gender refers to the attitudes, feelings and behaviors that a given culture associates with a person’s biological sex. Behavior that is compatible with cultural expectations is referred to as gender-normative; behaviors that are viewed as incompatible with these expectations constitute gender non-conformity.

Cis gender is likely how you identify. This means that your gender identity matches the sex assignment you were given at birth.

Trans gender generally means that you do not identify with the sex you were assigned at birth and you may or may not have transitioned physically or to living as the gender you identify with.

Gender queer generally means that you don’t completely identify with male or female and you don’t feel the need to make that distinction.

Gay usually refers to males who have intimate relationships with other males.

Lesbian usually refers to women who are attracted to and have intimate relationships with other women.

Bisexual usually refers to people who are attracted to both males and females.

Even though sexual orientation and gender identity are very different, people who are gay or transgender often face much of the same discrimination, lack of acceptance and challenges.


welcome sign


As massage therapists, we can make sure we don’t unintentionally make anyone uncomfortable, and we can go out of our way to welcome.

First, we should be careful about questions that we ask people. For example, asking a question about someone’s family that might seem like just nice small talk can bring things up for individuals who are estranged from their family for whatever reason. (This actually applies to all clients. We all have talkative clients sometimes; this is not meant to scare you off from having a conversation with your client. Asking, “Is it OK for me to ask a question about your family?” can be a good approach.)

Another step we can take is to label each of our restrooms as restroom. This way we’re not unintentionally putting someone into the awkward situation of having to decide which restroom to use. Of course, in a spa situation letting clients choose the locker room or restroom where they are most comfortable would be appropriate.

Updating our health intake forms to take out male and female references is also helpful. Just include a blank line where each client can fill in what they identify with. We also should be careful about allowing our natural curiosity to put someone in an uncomfortable situation. It’s perfectly natural to be curious about other people’s lives and experiences; however, our clients’ right to privacy trumps our curiosity—and we should not ask questions about their personal lives at all.

We can best serve our clients by sticking to questions that might affect their treatment that day: questions concerning recent surgery and current medications, and concerns that might affect their comfort during the massage session.

Some concerns your LGBTQ clients might have are:

• Will they be welcomed and accepted, or are they entering into a potentially uncomfortable situation?

• Will their privacy be honored? Some of the scar tissue from surgical procedures performed for a female to male transition can be greatly helped by massage therapy, for example; however, people who have or are currently transitioning might have concerns about draping. A transgender person may or may not disclose this information on your health intake forms. There are various reasons for this (one being that it’s generally unnecessary), but we must respect our client’s privacy and understand that sometimes disclosing this information could, if it gets into the wrong hands, lead to job loss and other consequences.

• A gay couple might be concerned about being treated respectfully when coming in for a couple’s massage. Don’t ask about their relationship. In all situations, allow the client to decide what to share.

• It’s a great idea to reassure all of your clients that the information on their health intake forms and anything that is said during the treatment will be kept completely confidential.



Open Arms

There are various ways we can reach out to the LGBTQ community and let them know we are available to provide massage therapy services.

Most areas have GLBTQ Legal Advocates & Defenders (GLAD) and PFLAG (an advocacy group formally known as Parents, Families and Friends of Lesbians and Gays) groups, as well as events like LGBT Pride Day. Attending events and volunteering in your community can help get the word out that you have a welcoming practice. This is also an opportunity for you to spread the word about the benefits of massage therapy.

What else can you do to let people know that you have a welcoming massage practice? You can spread the word! Share that you have an LGBTQ-friendly practice on your marketing materials and on your Facebook page. You could even have something in your lobby or waiting area, or on your window.

Sharing relevant information and articles on social media and through your newsletters will help to spread the word, and educate in your community.


Make a Difference

No matter what someone’s gender or sexual preference is, we all deserve the same quality of health care. I know we can help as a massage therapy community.

Research, as noted by the National Alliance on Mental Health, indicates that members of the LGBTQ community suffer from stress at a rate of two to four times that of heterosexual people. Some of the reasons for this include family issues related to coming out, the stress of not coming out, and the stress and discrimination that comes from being in a minority.

Imagine as a transgender person, always having to censor yourself and word things carefully so that you don’t accidentally give the wrong information to the wrong person.

For example, saying your kids are with their dad versus having to remember to say they are with their other parent, and always having to live with that heightened awareness that you might say or do the “wrong” thing and out yourself. Living this way certainly sounds stressful to me.

We have a real opportunity to make a difference, by helping to alleviate some of that stress and creating an environment where all people will feel comfortable, welcomed and nurtured. After all, that is what we do best.


Gael WoodAbout the Author

Gael Wood has more than 20 years of experience in the massage and spa industry. She now concentrates on training massage and spa therapists in business, spa services and greater success. Visit gaelwood.com for a complimentary Massage & Spa Success Toolkit.