To investigate clinical preparedness, perceptions, behaviours, and training of physiotherapists in Canada in working with patients from 2S/LGBTQQIA+ communities.
A self-administered electronic cross-sectional survey (Qualtrics) was distributed to physiotherapists in Canada. Participants were recruited via email and social media between May and August 2022. The survey questions addressed demographics, and clinical preparedness, perceptions, behaviours, and training related to working with 2S/LGBTQQIA+ communities. Results are reported as frequencies (percentages) or medians (interquartile range [IQR]), and logistic regression (odds ratios [OR], 95%CI) was used to assess the association between education hours and confidence in assessing/treating 2S/LGBTQQIA+ patients.
A total of 292 physiotherapists completed the survey, with 47 (16%) self-identifying as 2S/LGBTQQIA+. The median age was 37 (IQR=30-47) years. Most participants were assigned female at birth (n=232, 79%), and identified as heterosexual (n=238, 82%), cisgender (n=290, 99%), and white (n=251, 86%). Responses were received from all Canadian provinces and territories, except Nunavut.
Many participants felt confident in assessing or treating (n=245, 84%) and communicating effectively with (n=235, 80%) 2S/LGBTQQIA+ patients. However, few felt their education sufficiently covered 2S/LGBTQQIA+ health and inclusiveness (n=26, 9%), and almost half found it challenging to understand 2S/LGBTQQIA+ terminology (n=135, 46%).
Despite this, most participants were willing to engage in further 2S/LGBTQQIA+-focused training (n=269, 92%) and believed additional education was needed (n=235, 80%) and should be mandatory (n=245, 84%).
Inclusive practices reported by physiotherapists included using gender-neutral language when referring to patients partners (n=252, 86%) and describing body parts (n=214, 73%), asking about preferred names (n=192, 67%), reading sex/gender sections on intake forms (n=162, 55%), and considering their physical position relative to patients (n=142, 50%). Fewer physiotherapists asked about pronouns (n=44, 15%), disclosed their pronouns (n=32, 11%), or ensured their referrals to services were inclusive (n=78, 27%). Over half of respondents felt their clinical practice environment is inclusive of all sexualities and genders (n=213, 73%) and that colleagues use inclusive language (n=175, 60%). However, participants reported 147 acts of 2S/LGBTQQIA+ discrimination, harassment, or abuse in clinical settings.
The median amount of 2S/LGBTQQIA+ health education was 5 hours (IQR=2-12), though almost half received no training (n=135, 47%). An additional five hours of education was associated with higher odds of feeling confident in assessing/treating 2S/LGBTQQIA+ patients (OR=1.69 [95%CI, 1.07-2.66]).
Physiotherapists in Canada lack awareness of 2S/LGBTQQIA+ inclusive behaviours and health knowledge, which may negatively impact patient experiences and contribute to discrimination in physiotherapy.
Increased focus on 2S/LGBTQQIA+ health and inclusion in physiotherapy education and practice is essential to improve physiotherapists’ competencies when working with 2S/LGBTQQIA+ patients.
inclusion
education
