For Trans and Queer People, Massage Therapy Can Be a World of Pain
"When I eventually took my clothes off, she asked me if I wanted to see a psychologist."
Photo by Alex Crate for Stocksy
Massage devotees say the ancient art decreases pain and nausea, improves their mood, and lowers their stress levels.
They are probably onto something: A study recently revealed that massage actually turns off genes associated with inflammation, and turns on the genes that help muscles heal. Another suggests massage reduces cortisol, the chemical released by your body when you're stressed.
Massage is also increasingly accessible: as easy as visiting your local massage clinic or finding a practitioner online.
Unless you are not cisgender, able-bodied, or thin, in which case the odds of finding a massage therapist who won't actually cause further discomfort—both physical and emotional—can feel very slim.
I don't feel comfortable taking my clothes off.
Riley, 26, is a student and a trans man with persistent lower back pain. In the past, he felt regular physiotherapists didn't understand his trans status or the fact some of his transitioning drugs would contraindicate the drugs they prescribed for his pain.
"I often get misgendered and it sucks," he says. "I have no desire to undergo sex reassignment surgery, so I still get read as a woman. I don't feel comfortable taking my clothes off in that kind of environment either. I had one practitioner who was actually making it worse, because I was so stressed out every time I went to see her. She didn't understand why I didn't want to take my clothes off.
"When I eventually did—basically coming out to her, because I bind—she asked me if I wanted to see a psychologist."
Natasha, 28, an academic, is a trans woman who lives with chronic pain. "Being visibly queer means that every interaction is dicey, and this [feels] especially so, since I haven't yet changed my name legally," she says.
Natasha feels like she has to hide her trans identity when she sees her physiotherapist, whom she suspects sees her as a man—and holds the implicit assumption that she needs to "man up" when she gets upset. "She's treating me like I'm just being a crybaby."
Then there are those who give up altogether. Bartender Martin, 32, says as a gay man he finds it hard to simply find a practitioner that makes him feel safe from judgement. "I've tried countless times," he says, "and every time, I feel like the practitioner is judging me. Which makes me tense up even more. I don't have the money or energy to keep looking."
It can be difficult to ascertain if a massage or physiotherapy service is body-positive, queer-friendly, or (rarer still) specifically queer-centric. Currently only a few clinics in the world advertise themselves as the latter, and they are often run by practitioners who also identify as queer.
In Australia and New Zealand, the All Bodies Directory zeroes in on fat-positive and queer-friendly therapists, acting as a useful peer-submitted resource. Founded by Frances Lockie, a public servant, the directory was initially set up in 2011 with the intention of making going to the doctor a less stressful experience for fat people. On top of massage therapists, the resource also features listings for psychologists, gynaecologists, and general practitioners.
Will they be judged? What will they have to lie about?
"Many patients are told to lose weight as the first course of treatment regardless of their symptoms," says Lockie. "Sometimes, patients are told this even if their symptoms indicate an eating disorder. A bad experience with an anti-fat doctor can result in people not seeking preventative healthcare.There are definitely good healthcare professionals out there, but it's hard to know where to look.
"So I set up All Bodies to collate healthcare providers who treat all bodies carefully and respectfully."
Sydney-based clinic Every Body Massage is also seeking to bridge the chasm. "For a lot of people who are already marginalised to begin with, so much energy goes into considerations regarding safety and comfort," says founder Kira Magee, a queer-identifying medical science graduate who specialises in remedial massage.
Kira aims to reduce as many barriers to pain relief as possible, by eliminating the questions that go along with the search and treatment: "Will they be judged? Will they have to deal with uncomfortable questions? What will they have to lie about? Will they be misgendered? Can they afford it?
"When you're exhausted by the world a lot of the time," she says, "it's hard to put extra energy into navigating these issues."
As a cancer survivor, Kira feels that conventional medicine—while still playing an important role—tends to view people as sick bodies instead of full, visible beings. "I want to fill the spaces I find lacking in conventional medicine, while working in tandem with it," she explains. "You have to see your role as that of a partner in someone's health journey. I aim to find a meeting point for the two."
When she set up her practice, Kira looked at the elements necessary to make her clients comfortable: towels that were both big and small to accommodate different body sizes; how much weight the massage table could hold; what kind of pronouns her intake forms offered. The clinic, like most other inclusive clinics, also offers a sliding scale fee, which prioritises a patient's ability to pay an amount based on their financial situation, over a standard fixed rate.
The fear for some is that when doctors and therapists are unfamiliar with their body type, they still won't ask the client for guidance because they still think they know best.
Anastasia, 30, a queer-identified youth support worker, says she finds this aspect of treatment difficult. "I find it intimidating to tell massage therapists that something they're doing is too painful," she says. "But when I do, often they won't change their pressure or movement. I usually end up feeling like I'm being tortured instead of relaxed.
"As a larger-bodied person, the massage therapist needs to make me feel comfortable, especially when I'm already lying naked in front of a stranger who will then touch my body in a very intimate way. I need to have my boundaries respected and not have anyone try and push my pain threshold. Communication is of the utmost importance."
Massage by Mercedez, a clinic based between London and Chicago, offers various modalities of massage—from Swedish massage and trigger point therapy to prenatal massage—to queer and trans clients in their own home. The practice focuses on creating a safe space for massage that is accessible, prioritizing marginalized communities and offering a sliding scale payment option. The clinic is run by Mercedez Gonzalez, a licensed massage therapist who identifies as queer and believes positive touch can heal painful bodily disconnection, particularly with queer folk.
Our own bodies can be such a huge source of trauma.
"Bodywork can be very clinical, and as many of us know, even skilled medical professionals lack the training to work with bodies that don't fit social norms," says Mercedez. "Often, queer and trans folk don't think we deserve to care for ourselves and heal, mainly because there hasn't always been spaces for us to do that.
"Structural oppression makes us ill both mentally and physically, and many of us go ages without care for our bodies, and end up doing more damage. Our own bodies can be such a huge source of trauma so it's nice to have people who are committed to being intentionally welcoming and inclusive."
With the emergence of massage therapies such as oncology, connective tissue and myotherapy, the traditional vision of massage is broadening, allowing for a multitude of identities and conditions to enhance their general well-being. Increasingly, researchers and practitioners are discovering the benefits of massage for cancer patients, anxiety, depression and as a tool for overcoming trauma.
Creating safe spaces will mean people like Riley can access treatment without added anxiety. "I've generally avoided medical institutions after a few bad experiences due of lack of awareness," he says. "I know that I slouch to seem less visible. Along with binding, it has caused serious tension in my neck, shoulders and lower back."
"I think we have a powerful capacity to heal each other with manual therapies," says Every Body founder, Kira. "But the healing also comes from being held in a space by someone outside of our lives—and, for an hour, having some energy focused solely on us."