“It’s just as remarkable as being left-handed, isn’t it?”: exploring normativity through Australian physiotherapists’ perspectives of working with LGBTQIA+ patients

Figures & data

Table 1. Participant characteristics.

Characteristic	Participants (n = 18)
Age (years), median, range	33, 25–55
Gender Identity, n (%)
Woman	10 (56)
Man All other identities	8 (44)0 (.0) 0 (0.0)
Relationship status, n (%)
Married	9 (50)
Partnered	4 (23)
Single	2 (11)
Engaged	1 (6)
In a relationship	1 (6)
Separated	1 (6)
Pronouns, n (%)
He/him	8 (44)
She/her	6 (33)
She/her, they/them	3 (17)
Mrs	1 (6)
Sexual orientation, n (%)
Heterosexual/straight	9 (50)
Gay man	4 (22)
Gay woman/lesbian	3 (17)
Bisexual	1 (6)
Pansexual	1 (6)
Clinical experience (years), median, range	11, 3–35
Geographical location, n (%)
Large city	12 (67)
Regional	6 (33)
Area/subdiscipline, n (%)
Musculoskeletal	8 (44)
Sports	4 (22)
Pelvic health	4 (22)
Rehabilitation	3 (17)
Orthopaedics	2 (11)
Other	5 (28)
Site of practice^a, n (%)
Private	10 (56)
Hospital	8 (44)
University	2 (11)
Other	4 (22)
Highest obtained level of education, n (%)
Masters/postgraduate	8 (44)
Bachelor ± Honours	6 (33)
PhD	4 (22)

^aParticipants were able to select multiple options.

Table 2. Themes and subthemes produced in the analysis of participating physiotherapists.

Themes Subthemes	Description
Anti-discrimination Language choice Providing a safe physical environment	Encompasses perspectives that anti-discrimination practices are important, and some uncertainty about how to enact them appropriately. Perceived importance of using appropriate and sensitive language with LGBTQIA+ patients to avoid discrimination. Uncertainties physiotherapists’ described about how to approach this.Physiotherapists’ understanding of providing safe environments for LGBTQIA+ clients. Included displaying flags in clinic, having inclusive intake forms and being sensitive to body exposure. Physiotherapists’ uncertainty about whether “advertising” that they are LGBTQA+ friendly is necessary.
Physiotherapists’ understanding of LGBTQIA+ discrimination	Encompasses physiotherapists’ understanding of discrimination that has and continues to exist for LGBTQIA+ communities in general society, as well as healthcare contexts. There were no subthemes.
Taking an equality approach	Physiotherapists’ approach to providing equal treatment for all patients, including those who identify as LGBTQIA+. Uncertainties physiotherapists described about how, and why it is necessary, to provide equitable, rather than equal, care. There were no subthemes.
Knowledge of LGBTQIA+ health	Encompasses a lack of knowledge and understanding of broad LGBTQIA+ needs and those pertaining specifically to people who are transgender and/or gender diverse.
Health needs of LGBTQIA+ communities	Physiotherapists’ levels of understanding about LGBTQIA+ health needs, and the relevance to physiotherapy practice, as well as their perspectives of the intersection between LGBTQIA+ identity and mental health/social stress.
Specific health needs of gender-diverse people	Physiotherapists’ understanding of importance to gain more knowledge relating to transgender and gender diverse health needs.
Managing own reactions	Physiotherapists descriptions of managing their own reactions were related to two key areas; managing their own inherent biases and judgment, and managing their feelings of discomfort.
Managing biases and judgment	Physiotherapists reflected on instances in which they had to manage their own biases and reactions about LGBTQIA+ identities and acknowledged the need for and importantance of being reflexive in clinical practice.
Managing feelings of discomfort	Physiotherapists described situations where they felt uncomfortable during interactions with clients who identify as LGBTQIA+ and the potential impact these feelings may have on therapeutic relationships.

LGBTQIA+ = lesbian, gay, bisexual, transgender, queer, intersex, asexual or related identities.