Diverse People; Diverse Practice Gender Expansive Care at the Heart of Herbalism By Lyz Moore-Frey, BSN, RN, Clinical Herbalist

I recently spoke at the 2022 American Herbalists Guild Symposium in Bethesda, Maryland regarding the demystifying of gender expansion in our current herbalism framework. This concept of heath care being a human right, and herbalism being health care, and that moving to an inclusive framework ensures the human rights of others was met with some pushback.

Fast forward to January of 2023, and we are now met with an unprecedented number of new legislation across the United States limiting, restricting, and sometimes banning gender expansive and transgender people from accessing vital health care. While herbalism is never a replacement for contemporary western medicine, herbalists sit at the precipice of providing life saving care for our gender expansive community.

When the 2SLGBTQIA+ community does not have access to care that affirms their identities, it often results in their death. When equitable access is denied to people, they die. This is unacceptable, no matter what. Data shows across North America that the 2SLGBTQIA+ community experiences outright denial of care, discrimination in care, as well as significant barriers when accessing care. The highest rates of this discrimination happens to transgender and gender expansive persons - 20 to 30 percent actually reporting, and even more silent in their suffering. We, as herbalists and human beings, cannot be complacent in this struggle nor can we continue to hold beliefs that the herbalism community does not operate with this same discrimination.

In 2016, Zena Sharman wrote The Remedy: Queer and Trans Voices on Health and Health Care an anthology of real-life stories from queer and transgender folks discussing their experiences when accessing health care, including the barriers. The book challenges the reader to consider how we can reimagine healthy and resilient systems of care for the 2SLGBTQIA+ community. In this anthology we find the first-hand accounts of over 30 people, experiencing barriers and trauma in regards to accessing health care. Within, Sharman also highlights innovative programs across North America providing care in these communities. Lambda Literary calls The Remedy "A much-needed anthology that shares stories from patients and providers across the healthcare field ... The Remedy is part of a growing effort within queer and trans communities to lead the long-lasting and healthy lives that we deserve."

This book is an amazing starting point for herbalists to consider health access equity within our own subspecialty of care and how our frameworks are built. As herbalists, we must explore systems of oppression and supremacy that exist in our own structures, and how we can tear down these barriers and decolonize our own practices.

Understanding health disparities requires acknowledging that a greater burden of suffering exists for certain populations. Long-standing ethical and humanitarian foundations of medicine compel physicians and other health care providers to alleviate suffering in individuals and to advocate for social justice as a means to eliminate the structural sources of those disparities.
Dr. Kristen L. Eckstrand, Ph. D.

The Association of American Medical Colleges put out an executive summary in 2014 called Implementing Curricular and Institutional Climate Changes to Improve Health Care for Individuals Who are LGBT, Gender Nonconforming, or Born with DSD: A Resource for Medical Educators, which Sharman cites, but we have yet to see the creation of similar guides and resources within the herbalism community. Our herbal education systems often lack voices of queer and trans people, their needs, clinical practice considerations, and gender-affirming care by herbalists. 2SLGBTQIA+ people studying or practicing as herbalists face stigma and discrimination as well, only adding to the exacerbation of other intersectional issues like racism, violence, and ableism, which continue to be documented but ignored in the herbalism world. We have failed to create safe spaces for 2SLGBTQIA+ herbalists to share their stories, perspectives, and help us all create a more equitable herbal health framework. Our spaces as they are now have led to queer and trans herbalists encountering violence, and instilling of fear. There are not enough adaptogens in the world to fix the trauma and stress caused by these situations.

What if all health care providers and healers genuinely honoured and valued queer and trans people, worked collaboratively with us, and trusted in our expert knowledge of our own bodies? What if health and healing we widely understood not as individual responsibilities but as processes that happen collectively in communities? What if all health care and healing was built on a foundation of antiracism and disability justice? What if the care we received was rooted in a commitment to our liberation and the liberation of all people?
Zena Sharman, The Care We Dream Of

Zena Sharman has followed up with her newest book The Care We Dream Of: Liberatory And Transformative Approaches To LGBTQ+ Health. "The Care We Dream Of offers possibilities—grounded in historical examples, present-day experiments, and dreams of the future—for more liberatory and transformative approaches to LGBTQ+ health and healing. It challenges readers to think differently about LGBTQ+ health and asks what it would look like if our health care were rooted in a commitment to the flourishing and liberation of all LGBTQ+ people. This book is a calling out, a out, a calling in, and a call to action. It is a spell of healing and transformation, rooted in love," Sharman states. “The truth is, this whole book might feel triggering, which is a reflection of what we’re up against and why systemic transformation is both necessary and possible,” Sharman continues.

The Care We Dream Of lays out clear, practical, and immediately implementable steps that often benefit all people, not just our queer and trans clients. The main theme throughout the book is building community, compassion, and collaboration.

I am dreaming of a world where LGBTQ+ people love going to the doctor, nurse, counsellor, midwife, massage therapist, traditional healer, or any other practitioner we see.
Zena Sharman - The Care We Dream Of

Sharman goes on to discuss the importance of leaving "no body behind". And that means all bodies, including queer and trans bodies. "To leave no one behind is not just a moral and ethical imperative," she explains. Sharman makes it clear that it is an "invitation to dream" beyond what we thought was possible, and exceed what "we have been conditioned to accept". Through her intersectional approach, Sharman highlights that queer and trans health and healing is also intersectional justice and harm reduction. We as herbal healers and practitioners are part of that intersectionality, and our own ancestors were often rooted deeply in anti-oppression work. Somehow, along the way, many people in the herbal community have lost sight of our ancestral birthright to tear down systems of oppression and injustice. It is sacred work, hard work, but rewarding work to tear down those walls.