Despite the health benefits of massage therapy (1) it remains by and large inaccessible for bodies that do not fit the status quo. This becomes quite apparent when it comes to transgender / gender variant identities (1). I’ll be using the terms “transgender” and “gender variance” interchangeably, I hope this is okay. Though outside the purview of this post, I’d like to take a moment to acknowledge that massage therapy is also inaccessible for a number of other communities; for instance, when it concerns body presentation, disability, and socioeconomic status. In a culture that strives to control and assimilate gender diversity with a strict gender binary code (that there are and can only be two genders – male & female), it can be challenging to create a massage setting that is welcoming for transgender individuals.
Now, in the spirit of acknowledging small victories, there is a growing awareness among massage therapists to be accepting and non-judgmental. While this is a modicum of progress, the therapeutic atmosphere can only provide so much when a client is being accommodated rather than affirmed. The difference between accommodation and affirmation is quite stark. One is to be a foreign guest, while the other is to be a member of the family. While maybe it feels okay to not be judged, it’s not the same as belonging.
Even if massage therapy were offered in a culture of affirmation, there is another issue to consider. For a good number of people, and especially for transgender persons, the association that one has with touch is often not a pleasant one. Touch is often littered with pained memories and feelings that come with having experienced a lifetime of physical/emotional violation, abuse, and neglect. In the attempt to protect the mind-body, people who have such traumatic experiences can nosedive into a dissociative condition. That is, a state where a person disconnects and numbs out from their body and environment. Though it may serve to provide momentary survival needs, dissociation also shields the person from full recovery. In a manner of speaking, the person can be said to have exiled themselves from their own home that is their very bodily existence.
In the face of these barriers to access, trans communities (among others) have turned to innovative strategies (1, 2, 3) for recovery and sustainability. These strategies have provided opportunities for people to process in a safe and affirming environment with others faced with similar challenges.
I’m now going to visit the clinical significance of massage therapy and later tie it back to its potential for making a difference for the gender variant community.
For some people, counseling works wonders and that is wonderful. For people (like myself) who experience the word primarily through touch, talk therapy alone isn’t enough. Felt sensation and perception are crucial in the recovery process. For instance, people in this category may find deep therapeutic benefits by interacting with furry creatures like the ones below:
Yet, there is still a unique therapeutic dimension with receiving consensual touch from another human being (1). No offense to our cute friends above, but it’s not fluff. Research has shown that massage therapy is an effective intervention for a number of psychological conditions (1, 2, 3, 4, 5). Before anyone starts with the “but it could be just placebo” argument, consider massage therapy’s mechanical and reflexive effects on the body itself (1, 2, 3, 4, 5) and how these biological systems play a role in mental well-being. Bessel Van Der Kolk (MD), author of The Body Keeps the Score, draws on years of clinical experience and research to make a compelling case for integrating a mind and body approach to trauma recovery.
This field has been well developed for some time now, there is even a national association dedicated to this work: United States Association of Body Psychotherapy. Right in our own backyard here in Seattle, Cynthia Price (PhD, LMT) at the University of Washington founded the Center for Mindful Body Awareness. Cynthia and her colleagues have spearheaded a body of research that shows the clinical applications of massage therapy with trauma survivors and those with chemical dependency.
Something that really stood out to me with Cynthia’s work (article link) is showing how developing interoception (inner body awareness) with massage therapy can positively affect treatment for substance use disorder. This interoception increase is facilitated not just by any ol’ massage therapy, but it’s massage therapy that has a mindfulness-based component to it. Often massage clients are passive observers, but this particular method asks that clients remain present and mindfully engaged. It also asks that therapists are mindful with their clients, so that instead of going through the mechanical motions, the therapists is to remain present and connected with the client.
For decades research has made a strong case for mindfulness-based interventions (1, 2). Now I wonder how a mindfulness-based massage intervention could play a role for identity affirmation (mainly body affirmation) and trauma recovery for the trans community. If I were to hazard an educated guess, I’d say that there are reasons to believe that it’s an effective method. I wouldn’t be surprised if there are already private clinical practices that already do this. The social worker in me now wonders about ways that this can be brought from a one-on-one setting to the community level. This is an aspect of our mission at My Praxis . . . that is to link with community organizers from historically oppressed communities. This way we can share something that brings us out of the dissociation and numbing that comes with surviving and fighting oppression. Something that can hopefully bring us all back home to ourselves.