Evolved Living Podcast

Engaging with an OS Lens to Support Intersectional Allyship with Gender Expansive and Queer Communities (Calls to Action for AOTA 2024 Florida Conference)

June 16, 2023 Dr. Josie Jarvis, PP-OTD, MA-OTR/L, BA, BS Season 1 Episode 8
Engaging with an OS Lens to Support Intersectional Allyship with Gender Expansive and Queer Communities (Calls to Action for AOTA 2024 Florida Conference)
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Evolved Living Podcast
Engaging with an OS Lens to Support Intersectional Allyship with Gender Expansive and Queer Communities (Calls to Action for AOTA 2024 Florida Conference)
Jun 16, 2023 Season 1 Episode 8
Dr. Josie Jarvis, PP-OTD, MA-OTR/L, BA, BS

This episode of the Engaging Occupational Science Podcast explores the AOTA 2025 Vision and the complexities that emerge in attempting to realize this vision in the United States context during a time of escalating national tensions and the spread of trans-exclusionary laws that are seeking to target and oppress members of the gender expansive and queer communities throughout the United States.

Please sign COTAD’s 2024 AOTA Conference petition here: 


Panel Guests:

Andi Brown, MS-OTR/L and Writer 

Andi Brown is a trans writer, artist, and occupational therapist. He is passionate about disability rights and the transformative power of story. He is a writer and intersectional OT researcher who conducted autoethnographic research on identity disruption and occupational identity disruption following traumatic brain injury. He is a fantastic example of an OTP who engages with and helps develop our knowledge of occupational science through practice and lived experience expertise. Andi currently works in Boston with LGBT+ youth in the foster care system. Previously, he completed a fellowship at CSU working with college students with mental health challenges, founded a pain management clinic in Oregon State Hospital, and coordinated OT services in an acute psychiatric unit in Oklahoma. 

Susan L. Yebra, OTD, OTR/L, CLT 

Susan L. Yebra a pelvic floor occupational therapist who is focused on improving the inclusion of gender in occupation, specifically gender-affirming surgical techniques + impact on function, to include context, sequencing, and roles associated with gender affirmation.  She is a current member of the AOTA and Holistic Occupational Therapy Association. She has presented at numerous state and national conferences, has been featured on podcasts is currently working on her first submission to the open journal of occupational therapy. 

Website: https://susanyebraotd.wixsite.com/susan-yebra

Capstone Course for OTPs: Lower-Body Gender-Affirming Surgery:

The Occupational Therapy Roadmap

Knowledge Dissemination and Collaboration Facebook Group:

S3xuality & Gender Capstones & Dissemination for the OTP/OTs


Evolved Living Network Instragram @EvolvedLivingNetwork
Free Occupational Science 101 Guidebook
OS Empowered OT Facebook Group
Link to Full Podcast Disclaimer

Show Notes Transcript

This episode of the Engaging Occupational Science Podcast explores the AOTA 2025 Vision and the complexities that emerge in attempting to realize this vision in the United States context during a time of escalating national tensions and the spread of trans-exclusionary laws that are seeking to target and oppress members of the gender expansive and queer communities throughout the United States.

Please sign COTAD’s 2024 AOTA Conference petition here: 


Panel Guests:

Andi Brown, MS-OTR/L and Writer 

Andi Brown is a trans writer, artist, and occupational therapist. He is passionate about disability rights and the transformative power of story. He is a writer and intersectional OT researcher who conducted autoethnographic research on identity disruption and occupational identity disruption following traumatic brain injury. He is a fantastic example of an OTP who engages with and helps develop our knowledge of occupational science through practice and lived experience expertise. Andi currently works in Boston with LGBT+ youth in the foster care system. Previously, he completed a fellowship at CSU working with college students with mental health challenges, founded a pain management clinic in Oregon State Hospital, and coordinated OT services in an acute psychiatric unit in Oklahoma. 

Susan L. Yebra, OTD, OTR/L, CLT 

Susan L. Yebra a pelvic floor occupational therapist who is focused on improving the inclusion of gender in occupation, specifically gender-affirming surgical techniques + impact on function, to include context, sequencing, and roles associated with gender affirmation.  She is a current member of the AOTA and Holistic Occupational Therapy Association. She has presented at numerous state and national conferences, has been featured on podcasts is currently working on her first submission to the open journal of occupational therapy. 

Website: https://susanyebraotd.wixsite.com/susan-yebra

Capstone Course for OTPs: Lower-Body Gender-Affirming Surgery:

The Occupational Therapy Roadmap

Knowledge Dissemination and Collaboration Facebook Group:

S3xuality & Gender Capstones & Dissemination for the OTP/OTs


Evolved Living Network Instragram @EvolvedLivingNetwork
Free Occupational Science 101 Guidebook
OS Empowered OT Facebook Group
Link to Full Podcast Disclaimer

Engaging with an OS Lens to Support Intersectional Allyship with Gender Expansive and Queer Communities

[00:00:00] Josie: hello everyone. Welcome to the Engaging Occupational Science Podcast. I can't tell you how excited, maybe a little bit nervous I am to host this first panel discussion with two OTPs that I really admire here in the United States.

[00:00:17] Josie: So excited to introduce you. As you guys may or may not know, last month was OT Month here in the United States. It was April, every year we have our annual conference. It's always in a different state, different location. I appreciate that, by the way, with AOTA, they tend to try to. Have the conference hosted in different regions.

[00:00:40] Josie: Like I, that's somewhat of an effort to make things a little bit more equitable in terms of trans transport. I'm always gonna be an advocate. I think there's more we can do with conferences, right? That's, I'm all about that. So I, and we might even have some conversations about that during the session today, but there were several events at AOTA [00:01:00] that kind of made a stir, got out and trickled out beyond the conference, which is what we want.

[00:01:04] Josie: We want, when there is dialogue that comes up annually, we have a o t months so that we can gather, reflect as a profession, have some conversation about where we're going as a field. And the goal of this podcast is to broaden that table and bring some of those conversations outside of these more exclusive spaces.

[00:01:24] Josie: Cuz, I'm sorry, AOTA, I dunno if you know this, but sometimes AOTA conference can be quite cost prohibitory to many important, I've heard that word that the word stakeholders isn't the best term. So I need to figure out a different word than that. But we have many allied groups and community members that have an interest in what we decide as a profession and how we organize, how we work together.

[00:01:53] Josie: And I really want to work towards expanding the size of this table. And sometimes that starts with [00:02:00] conversations and facing some uncomfortable challenges in our systems. And I'm a strong believer that we can use some of the tools that have been innovated in the spaces around occupational science to help us understand the complexities of these challenges and give us some resources and some areas that we can engage with for collaborative problem solving that can be more inclusive to diverse identities.

[00:02:26] Josie: And OT is really about expanding inclusion, present participation, engagement and wellbeing. And that's the goal of this podcast, is to host dialogue where we can role model engaging with these p concepts to really face some of the challenges so we can experience constructive growth.

[00:02:43] Josie: And I think in really in many ways, and I imagine Andi and Susan, when we share, I have this value of being in integrity, in alignment with my values and principles as an otp. And I want to help create spaces and build relationship and community with [00:03:00] others that really want in our work as OTPs to be one where we are practicing what we preach.

[00:03:05] Josie: If we're gonna be ambassadors of inclusion and diversity and accommodating, inclusive spaces, I think it helps us to practice doing that work in our own spaces. And that's what this is all about. So one of the things I wanna bring you in the loop on those that are listening to this podcast, at least in the United States context, we have through AOTA Vision 2025.

[00:03:27] Josie: This is meant to be a mission. Statement, sort of something that upholds our values as a professional organization. And it got updated after a centennial conference in 2017, and it got expanded after the, revival of the Civil Rights Movement post-Ferguson and the unfortunate death of George Floyd on the hands of systemic racism.

[00:03:53] Josie: I wanna read for everybody out loud that this is gonna help guide how this conversation's gonna unfold.[00:04:00] AOTA has vision 2025, which we only have, gosh, two more years or less to do this. So as an inclusive profession, occupational therapy maximizes health, wellbeing and quality of life for all people, populations and communities through effective solutions that facilitate participation in everyday living.

[00:04:28] Josie: And we do this by using five different pillars. So the first pillar is effective occupational therapy is evidence-based, client-centered, and cost effective. I wanna add that at least the OTPF offers evidence informed rather than evidence-based. So at least in the OTPF , there's some flexibility in.

[00:04:49] Josie: Other things cuz occupa evidence-based often has a formal CL term that's not as inclusive to some of the social sciences. So I'm just gonna add that as a caveat. Just because this says evidence-based doesn't mean we can't use [00:05:00] evidence informed strategies as well. The next one is Leaders Occupational Therapy is influential in changing policies, environments, and complex systems.

[00:05:11] Josie: The next one is Collaborative Occupational therapy excels in working with clients and within systems to produce effective outcomes. Accessible occupational therapy provides culturally responsive and customized services. The last one, this was a added after the events of 2020 in which George Floyd was unfortunately subject to systemic racism and police brutality and violence, which catalyzed much awareness and dialogue.

[00:05:44] Josie: AOTA responded to grassroots activism and added to our pillars, equity, inclusion and diversity. We are internationally inclusive and equitable and embraced diversity in all its forms. [00:06:00] All right, so I invited two of my OT colleagues, Susan Yba. Is that how you say your last name? It's Yara.

[00:06:11] Josie: Beautiful last name. Andi. I'm so glad that yours is easier for me and Andi Brown. And these are two of colleagues that I've been collaborating with over, the past years. And, I'm here to be an ambassador for grassroots organizing. I think it's so needed to actually respond to this vision.

[00:06:31] Josie: And we wanted to talk about some of the pa the challenges that we faced in the field, trying to ground some of these intentions because as we all know, our aspirations and our vision. Is often different than what's going on the floor. And it's challenging, we have to make compromises.

[00:06:47] Josie: It's messy when we go from aspirations to practical realities, but for many of us as OTPs, that's why we signed up for this. We wanted to see really grounded change in the systems that we work in. And I think it's good to be honest [00:07:00] about the challenges that those face and to think about how we can support each other and build community around these challenges so that we can sustain in this work.

[00:07:09] Josie: It's challenging work. And we need to build community. We need to build awareness and I think we need some literacy too, around these terms because there's, trust me, there's actually a lot of tools academia has to offer us to understand these challenges and you deserve to know what they are. So this is a conversation that we're gonna help bring up some of those tools that we've learned because we've, I think everybody here's had a good amount of academic privilege.

[00:07:33] Josie: Is that okay to say? We're gonna go through, actually this next is each one of us is gonna introduce our positionality and our intersectionality in relation to this division 2025 challenges OTPs. And as we explain that, I hope that it will ground for you what those really highfalutin academic words mean.

[00:07:53] Josie: I think they're like intersectionality, positionality, that's easy to go over on just about anyone's head, right?[00:08:00] Sorry Andi and Susan, I'm obviously like very long intro to contextualize the conversation. And I'll add, by the way, as we're expressing here, and I need to add this on the podcast in the beginning, that all of the opinions that I say they just represent myself and where I'm at in this moment.

[00:08:17] Josie: And I'm not gonna say that they're perfect. I'm likely gonna say things here that are missteps that are harmful and I welcome getting access to that information that helps me grow as a person. But no one here is representing AOTA WOTA anything. We're just respect. We're just representing our own perspective and we're seeing what we have to learn from each other.

[00:08:38] Josie: And I would say that Susan and Andi would probably also have that intention of a welcoming and inviting you to this conversation. Just because we're having this conversation doesn't mean that our voices are the end all, be all. This is just starting a conversation that we all need to have. Cuz truly if we want Vision 2025, that's gonna take all of us.

[00:08:57] Josie: We all have skin in the game. So does anybody 

[00:08:59] Andi: I [00:09:00] actually represent all trans people. 

[00:09:02] Josie: No. Yeah, 

[00:09:03] Andi: I know. I told you I don't interrupt and then I 

[00:09:05] Josie: did, but yeah and that's a good thing to say too. And culturally I'm realizing that I've internalized some East coast conditioning, even though I didn't grow up in the East coast.

[00:09:14] Josie: I am. Some of my neuro divergence as well. I am a little bit of a blur in an interrupter, and that's a little bit sometimes of socialization from my gender too, is that there's often not space and time for women to speak. And so I've had to be pushy and abruptive just to get things known.

[00:09:30] Josie: But you men, you mentioned Andi having some affiliation with the trans community. Would you mind going first and contextualizing your positionality and intersectionality as anOTP? We'd love to get to know you a little bit and what you think and feel about Vision 2025. Yeah, of 

[00:09:46] Andi: course.

[00:09:46] Andi: My name's Andi Brown. My pronouns are he, him. I grew up in the south and I live in New England now. My current practice is I work with queer youth in the foster care system. But in addition to being [00:10:00] trans, I'm also disabled. I sustained a brain injury, and so I'm one of the working disabled folks.

[00:10:06] Andi: And I think what I wanted to say that I'm most appreciative about in terms of, you're talking about positionality and where we feel about this conversation. I appreciate you bringing up the murder of Floyd by the police and as what has been a catalyst for that. And then to also add man, we're so late into this conversation.

[00:10:25] Andi: It is, it's tragic that's what took. For some of this to happen, but this conversation should have been happening from the beginning. Social workers happened way ahead of us, but 

[00:10:34] Josie: Oh wow. Yeah, definitely. And better late than never at the same time. Like just that we're catching up.

[00:10:41] Josie: And part of why I also wanted Andi and Susan here is part of this conversation is in my perception, I think we're at a really, there's a lot of danger in the United States context around folks that have intersectional identities around fullness, queerness, and [00:11:00] gender expansion, expansiveness. And it's really putting the quality of life, like when I think about the vision 2025, especially where we're an inclusive profession that maximizes health, wellbeing, and quality of life for all people, populations, and community, through effective solutions that facilitate participation in everyday living.

[00:11:19] Josie: Some of the conversation is gonna look at pelvic health and it's gonna look at, we had. We've added sex as an ADL and we've added gender identity and gender expression to the OTPF four with the 2020 edition. So we have an opportunity to be a little bit more on time in responding to occupational injustices that are currently manifesting in the US context related.

[00:11:43] Josie: To our trans brothers and sisters, the occupational beings that are wanting to live occupationally with a gender expression that aligns with how they feel internally and occupationally. Like I'm signing up to be an ally to this community and [00:12:00] I want them to be safe, fully expressed and to have longevity where they can, everybody can feel like they can age in place in the United States.

[00:12:08] Josie: And from that we have to take a look at the policies and the laws and the systems and how we respond to different forms of gender expression. So that's part of why I was hoping and just feel so lucky to have you hear Andi is somebody with lived experience around gender expansiveness. And then I also wanted to invite Susan to be here because we both as kind of cis women have, in our OT identities, been wanting to develop work in allyship with trans communities here in the United States and navigate some of those complexities in grounding the OT P F 4 20 25 vision.

[00:12:46] Josie: Susan, do you man mind introducing yourself a bit and some of your interest in, grounding this vision 2025? Hi. 

[00:12:54] Susan: Yeah. Thank you so much for having me, Josie. My name is Susan. My pronouns are she, her. [00:13:00] I live and work in Burlington, Vermont. And I specialize in pelvic health. I see every age every diagnosis.

[00:13:09] Susan: But I do see a lot of individuals who identify as queer or as trans. And so one of the things that I realized in doing my post-professional o t d was that there was just this gap. And I thought it was me at first and I realized it's everybody. There's nowhere to get this information.

[00:13:27] Susan: Should I have a patient that comes in and I didn't wanna look like a fool and not know how to use the right pronoun, or how to address them, or how to like, even, call what to call their genitalia. I just knew that there were some considerations that I just had never learned and I didn't learn them in OT school.

[00:13:44] Susan: And in my kind of work in trying to better understand myself, I've somehow I guess in the pelvic health kind of realm in the public health circles I've had a lot of pelvic health practitioners that have [00:14:00] reached out to me or I've had people message me that work in pelvic health specifically.

[00:14:04] Susan: But, hey, I had a client who had a vaginal classy and were having some pain with dilation. What is, what does the literature say? What are the recommendations? And I don't mind, sharing that information, but there are many times when I certainly don't feel as though I am the person to go to. I am sure that there are other people much more skilled and knowledgeable than myself.

[00:14:25] Susan: I do identify as cisgender heterosexual. And so for me not having that lived experience of being, trans or queer has made me kind of question, it's been, what do I do? What is my role in this? And it's been a kind of a constant evolving thing over the past, gosh, like year and a half for me.

[00:14:47] Susan: I personally besides that, as far as intersectionality, I was born and raised in New England and then I moved away for many years and I much like Andi. I lived in a lot of different places. I lived in [00:15:00] El Paso, Texas for almost 10 years. And that was the first time in my life that I had really been outside of New England.

[00:15:08] Susan: Everything was different. The language, the climate, the what everything looked like outside, right? The culture, it was a complete culture shock for me, and I had to do a lot of adjusting and a lot of peeling away at everything that I had known my whole life. And that really humbled me, and it was a great learning experience.

[00:15:30] Susan: I met my husband there. I have two kids, so my kids are biracial. They're his Hispanic. And yeah, I've really acclimated to that. And so I've learned a lot about the culture and I've really immersed myself in that. But it wasn't easy. So I can understand like on these topics that we're maybe gonna talk about today, right?

[00:15:47] Susan: It's, it is very uncomfortable to like, put yourself out there. Whether that's with, any population that is different from your own, right. But yeah, so I'm really happy to be here. I'm hoping that I [00:16:00] can share, more about that kind as we go, but. 

[00:16:05] Josie: I love Susan in your introduction to me models.

[00:16:08] Josie: For me that's that's, I think this is a common experience as OTPs is we're constantly interfacing with clients communities and populations that might have developmental trajectories and contextual experiences that are so different than our own. And when I think about that, I'm noticing part of when the pillars of the 2025 vision is this idea of being culturally responsive with customized services.

[00:16:37] Josie: And like what I like about your reflection there is that models for me where I've seen this conversation evolve in academia where we're moving away from a prior model in terms of culturally mindful care from one of like cultural competence. Like competence is actually a dirty word to one of cultural It's a humility.

[00:16:59] Josie: [00:17:00] Yeah, exactly. To one of like cultural humility and mindfulness and like reflection and like reflective practices where we're constantly self reflecting on ourself in the relation of the context of a broader community and collective context. And What I'm excited too, Susan, in case you didn't get, as in, in the loop on occupational science as much as I have, I'm hoping to share this with other OTs out there because there's so many tools that have helped me go through this humbling process.

[00:17:33] Josie: Because like I also grew up. In the Bible belt. I was born in Wyoming. I lived there for six years and I then moved to different parts of Kansas. I wor lived in urban Kansas. I lived in small podunk town, rural Kansas. And then I moved out to the Pacific Northwest when I was age 11 to where I'm now ping ponging around.

[00:17:57] Josie: I like exploring things and trying to learn. I [00:18:00] think because I changed so many cultural contexts when I was little. Like the way that you socially fit in rural Kansas isn't the way you socially fit in a suburb of Microsoft in Seattle. Yes. Trying not to get socially ostracized constantly has been this like tap dance that, I went to 13 schools by the time I graduated high school and I have since learned that my parents, I think even subconsciously cause this is what privilege does when you grow up in a privileged bubble, it blinds you to the context that surrounds you.

[00:18:35] Josie: And there's actually a lot of genuinely conniving interest that want to prevent, especially. Christianized, Midwestern, white women like myself from having an accurate picture of global history and of United States. And I, to me, that's actually an occupational injustice issue because I've never had that desire to be willfully [00:19:00] ignorant.

[00:19:00] Josie: I've been very hungry to get accurate information and it's routinely so frustrating to me how we've systemically made that information inaccessible. I think that's part of my passion for knowledge translation and transparency and broadening access to this information because I hate that someone can weaponize my ignorance without my consent.

[00:19:24] Josie: Yes. And that's what I'm wanting to bring this conversation out there, because I'm a fellow, often structurally ignorant white woman, and I have been deprived of humanizing the experience of so many different ways of relating to the United States culture, ways that the United States culture has. Engaged in the dark side of occupation.

[00:19:48] Josie: I highly recommend folks check out Dr. Klia Johnson and Dr. Ryan Lava's, partnership with the OT Potential podcast, where they really break down the importance of [00:20:00] know, acknowledging the United States contextual history of systemic racism and how that has executed occupationally and how that relates to accountable practice in the United States today, which I love, Andi, that you brought up too.

[00:20:14] Josie: That race is actually present in this conversation, even though we're likely gonna talk a lot about gender expansiveness and sexual orientation just with pelvic health, which if either of you also want to in this conversation also highlight the importance of understanding that gender identity is a distinct and separate intersectionality, then sexual orientation.

[00:20:35] Josie: I think that's really important. They often get conflated in my mind, in part because systemic policy pushback and violence often bundles these communities together and they do have cause to come together and get allied support to push back against these occupational injustice in laws that violate human rights.

[00:20:56] Josie: I understand how they get conflated. And obviously when it [00:21:00] comes to bottom surgery, top surgery, there are implications for how people engage sexually in that id a dl. And there's nuances when you're somebody trans and you wanna engage in physical intimacy with your partner. There are nuances that we need to know about as OTPs Susan and I like how you bring up that yeah, I'm not trans myself, but if you think as an OTP you haven't worked with trans clients, 

[00:21:26] Susan: I'm sorry.

[00:21:28] Susan: I'm 

[00:21:28] Josie: sorry. Didn't know. Yeah. Especially if you work with autistic and neuro divergent folks, that vinn diagram's pretty huge. It might behoove you to get some gender literacy, Andi. 

[00:21:41] Andi: And I just wanna say I know we're shifting away from talking about race to, or to not exclusively talking about that, but I think it's important to acknowledge how like I was taught, growing up in Tennessee and Mississippi oh, the Civil War wasn't about slavery, it was about land rights, which isn't a lie, but [00:22:00] I was explicitly taught that by teachers and I didn't challenge it until maybe I was in college.

[00:22:06] Andi: And so there are ways in which like, yes, I was lied to, but I think I, didn't investigate. Because it benefits me to not investigate, like it benefits me to not look into like systemic, racism. And to say that part of this is we take active roles in being complicit or benefiting from white supremacy, 

[00:22:30] Josie: which I love that you role modeling, Andi, that even though you're somebody that is embedded and has you, you have lived experience expertise as somebody who has developed with life as a trans identity, right?

[00:22:44] Josie: In that situation, that in that intersection, that's a place where you have subject matter expertise. However, maybe when it comes to conversations around lived experiences of systemic racism and how that intersects and that, this, the complexity of this [00:23:00] compounds, right? Because then you have folks that maybe have trans and gender expansive experiences that are living with the legacy of systemic racism on a day-today basis that impacts their occupational engagement, right?

[00:23:13] Josie: So Say you have somebody where it would really support their mental health and their occupational wellbeing to pursue a top or bottom surgery. But if they are, of a marginalized community that hasn't had systemically the opportunity to amass cultural wealth, cultural capital, access to healthcare services, or they happen to live in a state, these boundaries and these barriers in the occupational justices, they compound.

[00:23:39] Josie: The more marginalized identities that you have are monetarized because there, there is these calculated for forces. I think it, of it like the scar complex, right? I love the Lion King metaphor as a vehicle of getting some literacy and occupational science concepts. Right now we're in the part of the Lion King where scar took over.

[00:23:58] Josie: He rigged this social [00:24:00] system in his favor. He's partnered with these violent hyenas to create a system that prioritizes his needs over the occupational wellbeing and balance of the e uhhuh. And this is why I think gender rules are actually really important, even for us cis folk to get comfortable with.

[00:24:18] Josie: Because, I. I'm sorry, I'm just gonna go off on a millennial thing of the Lion Kings, cause I love the Lion Kings anyway, Steppa, right? He was engaging with his gender identity in a lot of ways. He had gender roles that were modeled him by his family system. And they got challenged by outside laws and structures and how he was allowed to express.

[00:24:41] Josie: And he actually got excluded, scapegoated and marginalized because Scar wanted to build a system of exclusive power that benefited him. And Scar was threatened by Simba and his fully expressed self and kind of masculine identity. And in my mind, I think Timone and PBA were these [00:25:00] prototypical occupational therapists that helped him try out Different roles and experience uhhuh, like maybe try eating this food and maybe try relaxing a bit, maybe get some occupational balance in your life.

[00:25:13] Josie: And honestly Nala challenged him a little bit. She was like, I dunno, you're stuck in this slump and I believe you have more potential. I think you can adapt to these challenges. Let's try to build some bravery and take on these injustices in the system. And I truly feel that if we all do that and we all find and engage in different roles and break out of these boxes that this system has put us in, that we can actually bring balance back to our ecosystem and we can restore the circle of life.

[00:25:44] Josie: I love it. You laugh. I made the Susan laugh with my Os Barbie comment. 

[00:25:50] Andi: Love it. I used to work with adults with developmental disabilities and those clients. Loved the Lion King and Aladdin. So I have seen both of those on. So I just keep laughing. I'm like, oh yeah. [00:26:00] And I still cry every time.

[00:26:01] Andi: Every time 

[00:26:02] Josie: the dad die. Oh, totally. That's one of the things that we can use narrative reasoning and we can actually humanize each other through some of these diverse human stories and experiences and get some of the wisdom from them. That's one of the things I love about occupational science and the power of narrative and all of our narratives.

[00:26:19] Josie: Yes. And I think that's actually part of, Andi, do you mind if I ask you too, in some of your perspective from trans experience and like you have an unusual amount of OS literacy? As anOTP? From my perspective, I think we were the only two primary clinicians at last year's conference. I might be aware, not aware of some others that were there, but I felt like we were some of the main clinicians that And the folks you presented with?

[00:26:43] Andi: Yeah, Devin Barhan, Amanda, Greg were, yeah, were there too. Yeah. 

[00:26:47] Josie: And their practitioners. Do you think that os and like the OTPF four, like I'm curious as somebody with experience developing a with lived experience as a trans person, like part of what I [00:27:00] feel might be important about OTPs gaining gender literacy and awareness of occupational sciences, because I feel like these tools might actually be super helpful for a lot of folks with trans experience and like how has that been of used to have this lens with the clients that you're working with right now, or even on your like own request for occupational wellbeing.

[00:27:18] Josie: Do you end up understanding your experience occupationally in some way? 

[00:27:23] Susan: That's really interesting. 

[00:27:24] Andi: Because I, before I came out myself as trans, I worked with trans college students and a lot of it was like I like figuring out systems. So it was like here's how you do makeup.

[00:27:36] Andi: Here's how you make friends with staying gender people. Here's how you come out to your manager. And with the caveat of none of these things mean you are or aren't a woman, but, or aren't a man or non-binary. But a lot of people, especially young people, wanna learn what they didn't learn from their family or their mom and then decide what to keep or not.

[00:27:54] Andi: So I kinda had seen gender through that lens already. And [00:28:00] then I was talking with my friend Susanna at at AOTA conference of all things, and I was telling her about the students and I was like, oh man, if I was just younger, I would come out, and I was in my like mid thirties then, and she was like, it's not too late for you, but yeah, I do think, like when I see gender they talk about gender as a performance, there's an internal reality and then there's a performative performance is probably a performance element of it in gender studies. And I think that's a really nice place where gender studies and occupational science overlap to see there are ways that we operationalize gender Day-to-day.

[00:28:35] Josie: And it can be ways that help us and ways that can harm us too. And that's something that I've learned from engaging with I'm sorry. Now maybe this is out of place with the podcast interview, but before we got on, we talked a little bit about one of the things that OT PS can be careful about is not wanting to address our own ignorance in a way that can harm the community in some way.

[00:28:58] Josie: So you would wanna [00:29:00] be careful just going up to anybody, like with trans experiences or experiences of racism and just like asking them to share all of the core, most traumatic parts of their life. Or like just bringing up things about what was harmful about their experiences with health professionals or educational professionals.

[00:29:17] Josie: And I think that was a really, and Andi, I'd invite you to add more context to that example too. If you'd like. But I will say one of the strategies that I used when I was first trying to gain some gender literacy myself as an master's of OT student is I watched a lot of YouTube videos.

[00:29:33] Josie: I would try to find a lot of YouTube videos of people ranting about I felt like I was less likely to step on some toes and like backlash if I could just do some passive field research of, cause like by the way too, The literature on transgender stuff isn't great because a lot of trans folks don't make it into academia.

[00:29:56] Josie: And the truth is that a lot of trans folks don't make it through [00:30:00] adolescence and adulthood because the habitat, particularly United States is so hostile to gender variance and gender expansiveness, that it tries to repress it quite violently. And that means that you don't get to develop your science base, right?

[00:30:18] Josie: Yeah. We kinda have to use field work techniques, and that's what I like about occupational science, where we don't presume to know our clients in advance. It's helping us have a mindset of being receptive in the field to the lived experiences of our clients. Sorry, I guess this, I'm a non-linear processor, so I have some intentions of things and it comes up, but maybe, is this something I'm curious, Susan, too?

[00:30:43] Josie: Maybe you can explain some of the strategies you've learned used to try to gain some gender literacy too. And then Andi, you can add some of your recommendations and context on why it's challenging to get this information. 

[00:30:56] Susan: Yeah. I did something similar to, I actually [00:31:00] decided, so when I decided that I was going to look at gender affirming surgery for my capstone project.

[00:31:06] Susan: I made a TikTok account, which I'm a millennial and I should not be on TikTok, but I was like, I'm gonna track this journey, right? And maybe it's just for me, I don't know what I was doing. But there are a lot of people who wanna share their story of their transition, right? Everyone knows who Dylan is, right?

[00:31:25] Susan: So like there are some wonderful people out there who are willing to share their story. And so for me it was sim similar, Jersey to watching YouTube, right? I was just okay, wow, this person is like willing to bear all of this, right? And share it for their own reasons.

[00:31:40] Susan: And for me I was able to learn a lot in that way. And then we briefly touched on this before, but, so I reached out to for, so my undergraduate degree I did in sociology cuz I was like, I don't know what I wanna do with my life. And actually I'm so grateful that was my undergrad.

[00:31:56] Susan: Like it was perfect for ot. Yeah. Yeah. People, talk badly about it, [00:32:00] but I'm I'm so happy I did that. So I reached out to, I was a my senior year of college, I was like a research assistant for one of my professors and at the time, this was like 2009, 2010. And so she was a lesbian and she had me doing research on At the time it was gay marriage in the US state by state.

[00:32:20] Susan: And that was like her research at the time. And so when I decided to go on this journey, she was one of the first people I reached out to because I have kept in contact with her this whole time. She's been a mentor, helped me figure out school, 

[00:32:33] Josie: whatever. 

[00:32:33] Susan: And I was like, Hey, this is my idea.

[00:32:35] Susan: What do you think? And so I met with, she set me up with other faculty, and then I had a colleague who, or a former professor who now is a colleague and she said, Hey, we've got a speech therapist here who does voice affirming therapy. She's awesome. Let me set you up with her.

[00:32:50] Susan: She set me up with a statistician who does L G B T Q research. She just does all of that part of it. And then someone else who does this something called photo voice [00:33:00] projects with trans women US Mexico border. And so I just kinda kept branching, like spreading my branches, and whoever would give me some of their time, whether they identified as trans or whether they worked with that population.

[00:33:13] Susan: So that's how I I guess I, I initially gained traction. But yeah, that was what I did. And really it was just a ma it was, whoever would give me some of their time. I was really grateful for it. 

[00:33:22] Andi: Mercury, stardust, have you watched her videos? No trans hAndi, ma'am.

[00:33:26] Andi: She's the best. The trans hAndi, ma'am. Mercury starter. Cool. There's amazing, there's so many great people online though that are sharing their expertise and especially as trans stories and narratives are excluded. From so many spaces that you really have to go straight to the source 

[00:33:43] Josie: and it's, we have to put in some effort.

[00:33:45] Josie: I think that's one of the things I, I get from following some of this dialogue and some of the social justice movements that have emerged. There's been several in my lifetime. Sometimes I think we think of the civil rights movement and the disability rights movement as like things that were [00:34:00] decades in the past before we were born. And like they're not these things and it's no, these things never end the, these are generations long continuum things. We're not gonna do all the work we need to do in our lifetime. But yeah, the baton has been passed to our generation. If we have privilege and we have a agency in these spaces, if we wanna make something like Vision 2025 a lived reality, not just for us but our children, one of my like sayings that I used to pump myself up and to center myself is I wanna be the OT that I wanna receive someday.

[00:34:35] Josie: I'm working in post-acute care, so I do work with a lot of elders and I wanna be an OT that I'm proud of, that I would feel would help me at some point. And it's important not to just think of me too. That is part of the problem here is sometimes when we don't have good self-awareness and we don't understand the context we're in, we end up like doing this very human thing of projecting our desires and our wants and our [00:35:00] culture on everyone that we're in.

[00:35:02] Josie: Cuz by the way, one of the elephants in the room in this dialogue is that ot, which is also not alone in HU Health and human service professions, by the way, has a problem where we have a bit of a demographic imbalance, right? In our little scarred dystopia, OT has been carved out as a profession that could support much of the conventional socializing for particularly white women of a certain station in Western Europe, colonized Canada and the US.

[00:35:40] Josie: It's been designed to support the demographic desires, wishes, and socialization of often Christianized inherited, privileged status cuz that's often what's needed to access. Things like undergraduate education, master's level education, graduate education, [00:36:00] all of these systems have biases and filters that end up creating, a higher concentration.

[00:36:06] Josie: It's systemic, it's not personal. You're not wrong because you wanted to be anOTP and you happen to be a white woman. It's just we have to acknowledge that those systems were designed to prefer us and our traits and our gender performance in some ways and our things. So there's just a higher percentages.

[00:36:25] Josie: There's over 80% women of systemic privilege and white identities and settler descent in the US context. And so there are parts of our lived experience that we can't assume are the ways that our clients want to occupationally exist. And we could actually do harm if we impose, say, the way I manage my menstrual cycle on somebody from a more indigenous cultural context that has different practices to manage their menstrual cycle.

[00:36:59] Josie: If [00:37:00] I tried to force them to do it the way I was taught to do it in. Pacific Northwest thing with corporate, Cotex pads. But they need to use something that's more culturally mindful for them. They don't need to adapt to my standards according to the OTPF four, our code of ethics in Vision 2025, and with the advances of occupational science, I'm in keeping with best practices if I adapt my treatment approach to their culture and their wishes.

[00:37:32] Josie: That's what it means to be client-centered. So these are tools and lenses that even if you are somebody who's trans and has a lot of experience like, or some other, like we all as OTPs have to exercise these muscles of learning how to understand each other and people coming from different cultural contexts than we grew up in.

[00:37:54] Josie: That's part of the skill we have to develop. And that's not easy at all. Yeah. And [00:38:00] Andi, I, I did, I interjected after Susan shared, and I wanted to make space for you to also share some comments on the previous discussion. 

[00:38:07] Andi: Okay. But you'll have to remind me what that 

[00:38:10] Josie: we you know what? We did bring up a little bit about how sometimes in our effort to address our ignorance, we can.

[00:38:19] Josie: Ask communities in disrespectful ways to educate us or possibly put them at risk of harm. There was an example where you shared where we won't name names or anything like that, but there was somebody that as anOTP wanted to maybe work with the community that you were working with, but in a way that could have been harmful to the community.

[00:38:39] Josie: And I actually felt like you actually did a really great job of also compassionately directing alternative ways that person that went on to do research. Which I think is helpful for the OS researchers in the audience too, because we have to look at our research methodologies and make sure that as we're designing our research, whether it's participatory action research [00:39:00] or it is more, structured and scientific, part of what OS is challenging us to do is to value how our methodologies and how our publication patterns can put people at risk.

[00:39:12] Josie: I'm wondering, can you maybe even speak in general about some of those patterns with the trans community and how providers and researchers can be mindful of how what we do could actually be harmful in some way? 

[00:39:25] Andi: It's funny because I'm also a writer and so I've been in writing circles where someone is oh, I wanna put a trans character in.

[00:39:31] Andi: Can I interview you? You seem like one of the normal ones. Such. 

[00:39:36] Josie: Oh, that's the gap. The part was the normal ones, right? The messed up part was the normal ones. I was like, 

[00:39:41] Andi: oh, great. I'm a palatable queer. That is not my ambition. I've, and very similar type things. I think what I experience in my life, and I'll speak to it that way, is I have had once I, I told a doctor that I was trans and he was like, were you molested?

[00:39:58] Andi: You don't seem like a normal lesbian. [00:40:00] And so that's like the far end of, we all know that's a really hateful way to, he thought he was not being hateful, but that's, a really hateful and demeaning way to talk to someone. And then on the op, there's all kinds of levels in between, but on the opposite end really struggling with this issue of the joy deficit.

[00:40:18] Andi: Like when you look in research about trans people, for example, there's a real joy deficit in terms of what do people focus on? A lot of like little violins playing while these poor, sad trans people are over there. And it's really joyful to be trans. Like it's really a fun group of people that have decided to live life in a way that feels most authentic.

[00:40:40] Andi: And once you've done that kind of work, there's so much that opens to you and feels very free. And so it's not to say that There's not a great deal of suffering that trans people experience and that I haven't had been harassed at work and in public and all those different things.

[00:40:53] Andi: But some of the ways when you're talking about occupational science and we do research, I really want more research on joy [00:41:00] and I want more research on activism. And I don't think another study about life being hard for trans people needs to be done because that's well established and it costs something emotionally to answer those kinda questions.

[00:41:12] Josie: Do you think that there, you're, you almost run that risk of almost being a little bit like victim blaming and like putting the burden of re like, cuz some of that pain is gonna come from systemic oppression and violence, which is actively taking place across the country right now. Even in my state, performatively, progressive Washington Pacific Northwest, I have some sorted relationship to political diet developments here in Washington.

[00:41:41] Josie: But I will say as a largely progressive, if not leftist woman, CI woman, it does feel like a safe space for me to be in. By and large. I don't think that would be the case if I was still living in Wyoming or Kansas. I actually feel like the ways in the context I, Elton, I would've had very limited [00:42:00] gender role options.

[00:42:01] Josie: And just in my own occupational history, I experienced backlash, if not on a daily or weekly basis for being an educated woman, right? Like I have that cardinal sin of choosing academia over children. I might just upend the whole, Why did he have to buy that bite? That apple of knowledge. Don't do that.

[00:42:23] Josie: Don't do that. He mess everything up. And I'm somebody that does that. So I get backlash constantly in my communities, even in these prescri progressive spaces. But in some of my own activism work in my community, that's, often centers disability. When I was working on, we had a successful behavioral health pill to make occupational serv occupational therapy services available in community-based behavioral health agencies where OTs can work with clients with behavioral health diagnosis, which is relevant to this conversation because as Andi alluded to, when you're trans, there's nothing [00:43:00] wrong with being trans as an occupational being, but it often comes with trauma because our systems are not designed to accommodate gender variants.

[00:43:10] Josie: And often people with gender variants have all other like it's con like autistics just tend to be more gender variant. So you get a lot more trauma for being neuro atypical on top of this. And when we act like the emotional burden of engaging in things like, and I'll speak with my own lived experience with systemic sexism.

[00:43:35] Josie: I'm one of those people that got diagnosed with bipolar when I was grieving the loss of my cousin because I had emotions as a female and. Yeah. Or while I was getting harassed at my college and I bore the burden of their bad actions, right? And you're only studying the negative results of systemic trauma.

[00:43:56] Josie: We're inadvertently putting the burden of [00:44:00] recovery on the victim rather than having some accountability on the systems that are creating that harm in the first place. Yeah. That's what occupational science has helped me see is that sometimes that's one of the ways that therapy, profe progressions can be complicit in victim blaming.

[00:44:16] Josie: Is that we're not fully seeing the full context on where the injustices are actually taking place. And sometimes the more efficient way to address a public mental health crisis is to look at the loss that are causing this instability. Like right now. We are at the brace of having a mass.

[00:44:35] Josie: Suicidality crisis amongst trans youth because of how rigid and stern these anti-trans bill, anti-bot surgery bills that are happening in all 50 states. And I'm bringing this up because right after I abdicated for the behavioral health bill, there was a bill on female genital mu mutilation being heard in the, in Washington, a very progressive state [00:45:00] that would've made bottom surgery like the subject of your work, Susan, like illegal here in Washington.

[00:45:05] Josie: So like maybe this is an appropriate time to talk about the current climate and context and things that we want AOTA to have in mind when they're organizing to have, our next AOTA, around this time next year in April, is it gonna be safe for us to have these conversations in Florida?

[00:45:24] Josie: What are the things like if we're truly wanting to be in alignment with being an inclusive profession that maximizes health, wellbeing, and quality of life for all people, not just some genders over other genders or some races over other races, all people, populations and communities. We have to be really mindful to the context around us and where it's safe and where it isn't safe to bring visibility to these issues.

[00:45:48] Josie: And often when we bring visibility to them, It does inspire a lot of pushback, a lot of defensiveness, a lot of trauma. Like gender in particular is one of the first things you learn about, like from the day [00:46:00] you're born, you're often taught that gender is this or this, and it's like a rigid binary, and that can cause a lot of cognitive dissonance in all of our socializing.

[00:46:09] Josie: I think that's part of why the backlash tends to be so strong. But part of we, we wanted to have this conversation to also think about how do we resource ourselves to have these conversations because they're important conversations. Be aware of the danger of the defensiveness and come up with some problem solving about how we're gonna keep this conversation going.

[00:46:30] Josie: If we really have to 2025, we need to think about this, 

[00:46:33] Andi: Andi? So I think one thing that we could finesse, like in our conversation right now is it is very easy to attribute a benign intentions to like whatever the system is, or, but it's not by accident that our society is not built to, to include disabled people or trans.

[00:46:53] Andi: There, there's a, there has been very intentional decisions of exclusion and bigotry that are made[00:47:00] by politicians, by daily people. So it's good to frame these things as. Something that's actively happening and not something that just passively happened. But what I wanna say in terms of the laws is because you're right a lot of trans people are dying by suicide right now.

[00:47:17] Andi: I had three people in one month and it was just too much. But what I can understand, like from the beginning cuz of all the people that are into like knowing how important going to the bathroom is, it should be occupational therapists 

[00:47:32] Susan: and we've been that for forever. I have, 

[00:47:34] Andi: I don't understand why AOTA, and OTs in general haven't been more like leading the cause of bathroom toileting is important.

[00:47:43] Andi: Can you do the bathroom in a safe place? That's really that's so much of what we do. It feels like OT could take a lot of leadership in some of these discussions, but we've been, 

[00:47:54] Josie: why are we avoiding them? I think that's one of the things is like, why are we avoiding them? [00:48:00] And I think there's a lot of fear.

[00:48:01] Josie: Like I've had a lot of fear just even having this conversation. I was really grateful. I like some of the things I do to help me. Process from my own, like constant trauma just from being an OT in the field. But that's, Andi and I, before this conversation, got to bond over. We have hard jobs, we have tough jobs, we work in tough systems.

[00:48:22] Josie: And the more that you have a lens of once you get primed to look out for injustices and opportunities, you'll start to see them everywhere. And that's one of the things I like about occupational science is we all we focus on structures and policies that are harmful, but we also look at agency and what actions we can start taking in communities.

[00:48:41] Josie: We can start building to bring more health and constructive change into the system. And I find that my depressive symptoms get really bad if I just focus on structures and barriers and limitations. Yeah. And I'll be a fan, Andi, and I'll be a supporter of potentially your joy research or whoever who does it, because I think cis people could also benefit from that.

[00:48:59] Josie: I think a [00:49:00] lot of us have been deprived of the joy that can come from fully expressed gender identity. Yeah. Even if happened to align with where you were socialized in. But at the same time, what did I wanna see? I lost it. Susan, do you have something on the tip tongue and I'll think 

[00:49:16] Susan: about it. Yeah.

[00:49:17] Susan: No, I was just gonna piggyback off of that because I know we talked about briefly about the OTPF right? And how it's like behind this paywall. And I think that the original. If you don't know, we're referring to a post that was online and someone was looking for, I guess they were in the state of New York and they're in OT and they were being challenged from what I understand, by a physical therapist.

[00:49:37] Susan: Maybe I'm missing out on some of the details. No, it 

[00:49:39] Josie: That's what he said. Yeah. Oh, they, that's what they said. Yeah. Okay. 

[00:49:42] Susan: They were, the original poster was being challenged by a PT in the state of New York a pelvic floor pt. How can OT treat pelvic health or what's your proof, 

[00:49:50] Josie: right?

[00:49:50] Josie: What's it said? It said only o the claim was a asserted by a physical therapist, and if you're anOTP in the op in the experience, I wouldn't be surprised if you've had this experience where [00:50:00] the physical therapist said, only a PT can receive reimbursement for pelvic floor therapy. I hate how we get conflated with physical therapy all the time as if we're not separate services.

[00:50:11] Josie: Like Yeah, you never hear of say one of my hospitals has an entire cardiology floor. Like every single profession there is doing something related to the heart. And there's no never any question about whether they could bill their codes. What is it about, like this area of the body and like how negligent of health professionals are we when we assume that one profession can contain all the complexity of one intact area of the body.

[00:50:37] Josie: It's ridiculous. This, that's one of the areas where it's almost like harassment when you're abusing policies and procedures to try to exclude someone. That was, I think, an effort to try to exclude OTs from being able to offer an occupational approach to intervening on pelvic floor. Challenges.

[00:50:57] Josie: And I, sorry, I'm just gonna add in too that [00:51:00] Andi, part of what you brought up in talking about toileting is also a social facility. Some of our clients can't go to the bathroom because they have a physical impairment that we need to look at. Adaptive equipment, environmental cation, which in some ways is a social model of disability, but that's still like a quote unquote pathology internal to that one client that's causing that barrier.

[00:51:23] Josie: And that we would intervene both within the environment and within the physical body of the individual. But we had many individuals in the US that can't toilet because they're legally not allowed to go into a freaking bathroom. Yeah. 

[00:51:36] Andi: And that is, that's what I worry about much of an occupational problem.

[00:51:40] Andi: That's what I worry about in Florida. I'm like where am I gonna go to the bathroom if I'm not at the conference, if I go to a restaurant? I, it's not comfortable to go to the bathroom, especially when you don't pass, I don't pass as male. 

[00:51:50] Josie: I would hope that people, so I'm a little bit salty about OTs not addressing toileting in the schools because I feel like everybody [00:52:00] toilets in the school, usually they should have the opportunity to toilet in the school.

[00:52:03] Josie: And I don't understand why OTs don't use our unique expertise to help that school role function, performance, and accessibility issue. I think that should be more of a role reemerge. At least in my state, it's not used very often. But I think about the OTPs, the OTAs, and the OTRs that could be working in schools in Florida that have trans students that they're supporting in toileting or education about menstrual cycles and sex ed.

[00:52:30] Josie: That's a huge, emerging area of curriculum development And. I actually don't have much context on what the laws are in Florida, but it sounds like you can lose your job in the school system for just alluding to queer identities. Or there's this idea that you could almost get, claimed that you're a quote unquote the trigger warning being a groomer for just talking about these topics.

[00:52:55] Josie: And that's a huge problem because I, from the way that a OTA is code of ethics and [00:53:00] our, this vision, right? We're supposed to be having these conversations in all 50 states. So how are we protecting not just OTPs, but our clients that have these needs and these states where these laws are happening we have to start having these conversations 

[00:53:16] Susan: and actions.

[00:53:18] Andi: Do you think it's because cuz we have to have these bipartisan bills to protect OTs and to, reimbursement rate, blah, blah blah. Do you think that's why AOTA is not getting politically involved is cause they don't wanna alienate like conservative politicians or conservative lobbyists?

[00:53:37] Andi: Because nurses and doctors like those and social workers, like their professional organizations are quite vocal. But maybe it's because we have the scarcity view about our standing in the medical community that we're more hesitant to stand to speak up. 

[00:53:51] Josie: I'll say my hypothesis is that we just have a very disengaged like speaking of my state, and I've heard of this of [00:54:00] many other states, like some o OTA associations have like single digit turnouts at elections and the amount of positions that run UNPOSED every year.

[00:54:11] Josie: That's 90% of OTA elections. We do not have an active and involved membership base. AOTA I think in my lifetime has never been representing more than 13% of OTs. So anytime I think as OTs we need to be more honest about the actual work it takes to have a representative organization.

[00:54:32] Josie: I feel what you're alluding to, Andi, to me is a lack of grassroots organizing and allied partnerships with other communities. Nurses and social workers are so much more ahead of us in terms of actually building active relationships with the communities we work in, listening and being responsive to the policy and injustice issues.

[00:54:51] Josie: And I trained as a student activist for, honestly, decades before I became anOTP. That's part of my occupational [00:55:00] history and my identity. I'm so much more comfortable with these conversations because I showed up to do some of this messy work. And we need to start to realize that this is part of our work as anOTP.

[00:55:11] Josie: It's not a separate identity, it's now part of the OTPF and if we're not, part of it is we have a deficit of active involvement in our associations or building outside organizations outside of O T A to challenge not being as political, 

[00:55:29] Andi: which is wild because we started as social workers and nurses.

[00:55:33] Andi: They're the ones that started our 

[00:55:34] Josie: profession. And we can reconnect with that now. I wanna create, some role modeling where I'm partner, one of my major partners is somebody also with lived experience with disability and neurodivergence, that's a fellow doctorate clinician, but he's a doctorate in social work.

[00:55:50] Josie: Yeah. And we're collaborating to build this knowledge dissemination program. So there's nothing right now that's blocking us from getting this going and getting it started. And I [00:56:00] think, Susan, I wonder, can you share some of cuz you're connected to the pelvic floor OT community who I think has done some of the most impressive grassroots organizing with AOTA to increase our ability to address things like to toileting.

[00:56:15] Susan: Yeah, no I guess I would say just watching I don't know how helpful this is, like to the conversation or not, but I've been following I mean I found pelvic health, right? I knew toileting right forever, but I found pelvic health probably in the midst of the pandemic.

[00:56:29] Susan: And so I feel even in just the last three years that it has grown. And in terms of even more specifically those of us that are more interested in gender and understand understanding gender diversity, I feel like even that has grown a little bit. But yeah, we had, I think it was over at this AOTA conference.

[00:56:51] Susan: It was maybe like 10 considering like presentations and posters we had I think over 10. And I think in previous years, it [00:57:00] was way less than that. And now we also have this big push for students, right? Like students are getting involved at conference level. Students want to do public health field work placements, which is in and of itself it's its own thing.

[00:57:13] Susan: I have mixed feelings on that. But at the end of the day, if we wanna move OT forward, that's kinda how I look at everything, right? Is this, no matter what I'm doing, is this gonna, is this gonna progress OT forward or is this going not right? Talking about. AOTA and just, I don't always think that those individuals who I guess are the at the top of AOTA that represent AOTA itself.

[00:57:37] Susan: I don't feel like those individuals always represent us as practitioners. And we did at this AOTA conference. I know you mentioned Lindsay a little bit ago Lindsay Vest, who she's one of, she is the one, I guess the original, I don't know how you wanna say it, but she's the person that I found, so she does all this grassroots stuff, right?

[00:57:57] Susan: She spends her time doing [00:58:00] podcasts and interviews and creating courses and putting a lot of free content out into the world. And yes, she applied for AOTA to present and was denied at first and then I guess resubmitted. And that was accepted. And so then actually at the conference, at the presidential address, she was, she said, I have to sit up front and I think they're gonna announce me.

[00:58:22] Susan: And so she had actually been interviewed by the president of AOTA, they met at state conference. And so they met there and now they have this collaboration where the president of AOTA Alison STS is more she's in the know, I guess more about pelvic health specifically and what that is.

[00:58:37] Susan: She attended our first meeting of the community of health. There's a new pelvic health specific community of practice that was finally approved. Again, that was the first time around that was denied. And we were all told that what we needed to do was jump on board with the Women's Health Community of practice.

[00:58:55] Susan: So I remember last year we all jumped in and started going to 

[00:58:58] Josie: those. This kinda would be a [00:59:00] problem for trans identities, right? Yes. 

[00:59:02] Susan: I had my own I went to the meeting to just. To show up in numbers. That was the only meeting that I went to. I was mostly dissatisfied with it.

[00:59:10] Susan: Yeah. Because it is very exclusive, like the whole, I can get on a tangent about the term women's health. I get on my hat about that. But yeah, so now there is a pelvic health, right? And so we're focusing on Laura Rowan, who is one of the founders of this community of practice along with Lindsay and Tiffany Lee.

[00:59:25] Susan: Laura is very mindful of gender inclusion in her practice, in her language, in her terminology. She's more kind of progressive with that. And I think a lot of the other pelvic health OTs are catching on board with that, where again, where they used to use more terminology specific to women.

[00:59:44] Susan: Right now people are just acknowledging that anyone and everyone has a pelvis, not just women have a pelvis. So I think that there has been some growth. And yeah, so I feel like there's been a lot of progress in just a very short amount of time, especially in like the world of pelvic [01:00:00] health.

[01:00:00] Susan: And we actually just to segue into, talking about, as you mentioned, AOTA 2024. The big elephant is in the room, is that this is going to be held in Florida and There was a lot of concern. I know I put a post on the capstone and the gender and sexuality capstone and dissemination group that I recently created because I had met a lot of students doing this work, and the students were going back and forth with their advisors at their universities.

[01:00:28] Susan: I originally wanted to like, submit for the call for papers. The call for papers is actually already here, which I feel like is earlier than it was last year. But so now they're what do I do? I still really want to share this information. I want the experience of submitting a proposal, but I don't want to go to Florida.

[01:00:46] Susan: And that was my thing at first, and I still feel that way. I just told my partner the other day, I was like, I don't wanna support businesses in Florida. I want to make sure that if I go[01:01:00] I have a colleague who is another pelvic floor therapist identifies as queer.

[01:01:05] Susan: I said, okay, I'm gonna stay with you. She's awesome. And I was like, I'm gonna, I'm gonna stay with you. And she's yeah, totally. And I was like, okay, so I need to know, if I'm going to spend my money like whether that be at a hotel or at a restaurant or out doing something, like I wanna make sure that I'm going to a place that is not, anti L lgbtq q. I wanna make sure that I'm being really mindful in the places that I put myself into. And so AOTA just came out with kind of this like FAQ about 2024, I'm sure. It's out came out this week and it does say, we are not going to cherry pick through submissions just because the topic, I put in, I, after reading that, that actually really helped me because I was not sure I was on the fence about submitting again and I decided I'm gonna do this after reading that. And yeah. But it was even hard for me because I was like, I don't know what the right, is there a right answer here?

[01:01:59] Susan: Do [01:02:00] I, I need, do we need to disseminate this information? But is this the safest place? Is this the safest way to do it? And I think a lot of people were feeling that way. And it's like there's a 

[01:02:09] Andi: precedent, like big sports leagues have refused to house games in North Carolina when they were, messing with trans students.

[01:02:17] Andi: And like big companies have pulled out of states that have done really homophobic things. So it's not as though AOTA, just like there's not precedent for having some kind of making difficult decisions and not going to states that are actively pursuing some pretty bigoted policies. 

[01:02:35] Josie: And I have, these are messy questions.

[01:02:38] Josie: I think they're always gonna be messy questions. And sometimes too, there is a cost to retreating from the conflict in some cases. There are sometimes, especially in. Allyship, and I'm open to your feedback on this, especially in relation to trans type policies. But this is [01:03:00] part of where having community-based and collective approaches to injustice can be really helpful because in some ways cases that, that the desired effect of these calculated policies, Andi, that you brought up, that it's not always willful ignorance that manifest these laws and policies, that the effect of these policies is to stifle shut down and prevent dialogue and for trans support services to exist in Florida.

[01:03:29] Josie: So there's some ways where pulling out and retreating also doesn't resolve the injustice issues. Sometimes we need to show up even harder, which is why it can be good in partnering with marginalized communities if you have somebody of privilege, like in some cases, like I'm glad and I mean I'm open to Andi's perspective that you're going Susan, because as a cis woman, sometimes we're not. Our bodily safety isn't as at risk for bringing up these important topics and [01:04:00] awareness. Like we do actually have a great potential opportunity as OTPs with our code of ethics Vision 2025, and the OT p F four, to bring visibility to these occupational injustice issues and spaces where they would not otherwise go.

[01:04:16] Josie: I can be pretty confident that a lot of you that are listening in the audience, if you're practicing OTA A orOTP in the us you've likely worked at a hospital or a skilled nursing facility where you hear bigoted comments about trans folks or you've, most of the places I work don't have inclusive bathroom setups.

[01:04:37] Josie: I work with a lot of doctors that have been out of the loop on some of the developments of these things. And honestly, other than peds, I think I worked with the highest proportion of trans identities in pediatrics where I also had to be a mediator with a parent that wasn't as comfortable with their client, with their child's gender exploration.

[01:04:57] Josie: And that's one of the really practical ways like [01:05:00] gender identity. The last I checked in with it. Like it develops just like all of our traits develop, in many cases in that like first three years, like when you're working in birth to three and with peds, things like our gender identities are still developing.

[01:05:16] Josie: And so if you as an O T R or an O T A are using like really restrictive gender roles in your, craft activities or you don't let you know folks that are male appearing engage in more feminine occupations in their play, you're playing an active role in kind of policing gender rules or not allowing for authentic expression.

[01:05:42] Josie: So I think impedes, I worked with gender a lot, but second to that, in my own lived experience, I've worked with a lot of trans clients in the hospital systems that I'm at. And like you said Susan, that everybody peeps and peas and poops just about everybody gets joint replacement [01:06:00] surgeries.

[01:06:00] Josie: And when I worked in elective orthopedics, which was a very biomechanical discipline, I partnered with an amazing physical therapist. She had the biomechanical stuff down, but I worked with people with cerebral palsy that got joint replacements. People with down syndrome that got joint replaces people that are transgender, that got joint replacements.

[01:06:18] Josie: All of those occupational beings deserve. Culturally mindful care that's aware of their gender nuances and having a comfortable, experience receiving OT services. So we really actually have to bring these conversations in a lot of spaces where they tend to get shut down, and we have to be strong and supportive of allies that are willing to bring these spaces up so that our clients can receive the care they deserve.

[01:06:42] Josie: So it's I have some sensitivity around how much we retreat as the solution, and then how much we innovate in different ways to show up. 

[01:06:49] Andi: I think it would be different, Josie, if it was like a OTA was like, okay, we're behind our, trans OTs and trans people, [01:07:00] and so we're gonna go to Florida and we're gonna do a flash mob.

[01:07:02] Andi: And but instead it's like a, it's a willful ignorance. It's a choice to not recognize what's happening and to just pretend like everything's fine. 

[01:07:13] Josie: Yeah. Yeah. So you would receive it as a really almost like compassionate. Resolve and like upholding the occupational rights and wellbeing of trans occupational beings.

[01:07:26] Josie: If AOTA out of solidarity with these communities really refused to support the policies that were there as a form of activism and as a form of protest. So let it be known to any AOTA folks that are listening to this podcast. Maybe we'll get the president of a o t to listen to this. That's, this is a member of ourOTP AOTP community that wants it to be known, that it feels almost like a voice on the side of the oppressive policies that AOTA is continuing to partner with many of the [01:08:00] economic interests, the socioeconomic interests by hosting our national conference in a space that currently is making it very known through their policy vehicles, that they don't want human rights to be received by everybody in the country.

[01:08:13] Josie: So it's like a OTAs No, it's like Florida's current policy trajectory is not supporting Vision 2025, and we need to think about what that means if we are going against our values, right? Yeah. Our stated values. How are we grounding it while also taking those actions? They're 

[01:08:31] Andi: making a lot of the movements that you've spoken about on this podcast, Josie they're intentionally lying about history.

[01:08:37] Andi: Florida is, they're, Doing human trafficking of, people who have arrived in this country. They're making things so unsafe and dangerous for queer people. 

[01:08:47] Josie: Yeah. So I'm hearing from you that it would, you would feel maybe more supported and represented by our body if they considered making some really tangible [01:09:00] stances and statements and possibly considering relocating the conference.

[01:09:04] Andi: You you vote with your money and that is the only thing that politicians care about. And we see this when Rhon DeSantis is fight with Disney, like it's costing him a lot of money. And we are voting with our money by going to this state. There's a lot of wonderful people in Florida.

[01:09:18] Andi: I'm not writing off Florida and all the one queer people there or the good advocates, but you are putting a lot of money into an economy when you do a conference and we're, that's voting with our money, 

[01:09:30] Josie: yeah. Interesting. And do you think what are some things that OTPs can be contemplating about, thinking about when we're thinking like a year and a advance about like how can we be of support in allyship, especially to the trans community during this time?

[01:09:45] Josie: And to a certain extent too, also with marginalized sexual orientations and queerness in general is being attacked with legislation in a variety of cultural contexts. I think that, like probably in the show notes of this podcast, I would like to put some [01:10:00] resources that folks can engage with to gain more gender literacy and things like that.

[01:10:05] Josie: But maybe if you're open to sharing with us maybe some forms of allyship that have been really well received for you, or suggestions that you have that we could consider to partner in activism with this current context that's emerging. 

[01:10:19] Andi: Yeah. I recently actually did a training on this for new L MFTs and one of the things I said was to participate in our culture, read our literature, watch our movies, there's a lot of amazing entertainers, comedians, all kinds of things.

[01:10:33] Andi: And, queerness and transness have existed since Speaking of time and I'm sure you know this, but the part of trans history was destroyed by the Nazis. So the, yeah, so there's been a concerted effort for hundreds of years to destroy our presence and gender expresses itself or people express their gender differently in certain indigenous cultures as well.

[01:10:57] Andi: But yeah, participate in our culture. [01:11:00] I don't love it when people want to learn through me when they're. Everybody's got like all the information in the world on their phones. So if you can go to P Flag or Glisten or Plaid and learn some of these terms and I'll actually shut somebody down if they're taking too much space about it.

[01:11:20] Andi: Okay, I'm thinking about a very entitled cis straight man right now. But I'm like, okay, you've got a computer in your hand. You don't need to keep making me do the mental labor of of teaching you these things. But that's not most OTs. Most OTs are much more nimble than that. But yeah, that's generally what I recommend.

[01:11:40] Josie: That's cool. And I think Susan, I imagine I'm, you might make a similar offering to other OTs that are listening to this too, especially in your capstone group that maybe you're open to people joining that are curious to see how some of these topics are also, continue to evolve in the OT space.

[01:11:57] Josie: But that's one of the forms of allyship too. It sounds [01:12:00] like Susan, you more, maybe more recently I did a real deep dive on occupation around trans identities back in 20 10, 11, 13. And that was like my first academic conference post was like this idea of being gender mindful and the way it worked for me, it's similar to some of the resources I'm putting out on this engaging os things that like.

[01:12:22] Josie: Sometimes if you look at these tools in relation to your own life first, it can be like a respectful way to inquire about these phenomenon because the presentation I shared on yours it was almost like me investigating my gender identity as a cis person and trying to make gender visible in my own life because often when you're in a privileged position or you're in a way that the socialization that you're in is developing as expected, it becomes invisible to you. But really gender is this water that we're swimming in on a daily basis, and it affects almost everything you do, even if you're a cisgendered person and Andi was [01:13:00] sharing.

[01:13:00] Josie: When you start to learn about your gender and how that manifests in culture and our gender roles, it can be very liberating and joyful to know that you actually have more options in how you perform as an occupational being, just because you were raised and shown these very fixed expectations about what's appropriate.

[01:13:20] Josie: Like I was taught from a very young age. It was my job to become a housewife and to have children, and I've faced criticism and judgment constantly for pursuing. In prioritizing my formal education over those traditional roles, but knowing that gender is actually expansive, even for me as a cis woman, has added much more joy in creativity in my OT treatments.

[01:13:47] Josie: I have more options because I don't just have to play with the pink toys with this group and with this one. There's ways that you can engage in gaining gender literacy and mindfulness without [01:14:00] overburdening the trans community. We have resources that we've been making and you can reach out to people like Susan and I to ask these questions if you're nervous about bringing things up or gaffing and saying the wrong things.

[01:14:13] Josie: Even though this agenda is not will for ignorance, there is genuinely willful ignorance, I believe in theOTP community of folks that just haven't been given the information about this to say the things that won't have you offending somebody. Part of what we wanted to talk about a little bit is about some of the fear around having these conversations around cancel culture or what I'm calling like Karen culture, where whenever these con conversations come up, That interest of shutting them down.

[01:14:44] Josie: We often escalate in forms of violence, whether it's weaponizing our emotions, trying to report people to practice boards, trying to get somebody fired from their job. We need to start engaging these conversations without this level of fear that we're [01:15:00] gonna attack each other and put people at systemic risk of violating their livelihood.

[01:15:05] Josie: When we act like this. We're not in alignment with Vision 2025. We're not supporting the wellbeing of all we need to figure out how to have these conversations without microaggressions and coming at each other. We need to create spaces, more spaces to have this where it's not overburdening to different identities.

[01:15:24] Andi: I think that it's worth clarifying. Like it's I have made big mistakes in my career in terms of, you can go into any kind of thing, but I had a patient whose hair I didn't care for correctly and I really had to do a lot of learning about. And it's one thing to. This is a black man.

[01:15:43] Andi: It's one thing to say, man, I made a mistake or I need to learn. And the fear of admitting that you need to learn is very vulnerable, I was really fortunate. There was a great, I wish I could remember the speaker now, great presentation that a aota that really helped me [01:16:00] learn.

[01:16:00] Andi: And there's a really strong fear of looking stupid. But I don't think, I think the problem with not liking cancel culture is that sometimes how powerful people will say cancel culture is bad as a way of saying nobody should disagree with me. So like you, you're gonna hear like Tucker Carlson, like super privileged white dude being like, cancel culture is terrible.

[01:16:26] Andi: And that's just because he's, he doesn't like that people disagree with him versus So that's why I feel I have a really I don't 

[01:16:34] Josie: think you can't, I don't think you can be against council culture and for people calling the police for minor discrepancies in pedantic disputes or frivolous things.

[01:16:47] Josie: Looking at Vision 2025, how we can start supporting us as occupational beings, creating some capacity to be an observer and being open to these conversations and learning from [01:17:00] them and how we maybe need to work at getting some supports to be in community to help us emotionally regulate through these disruptive conversations.

[01:17:10] Andi: Yeah. Yeah. I think that's a really good point. And I also wanna acknowledge, I feel like I've steamrolled you a little bit, Susan. I, I know you have really important things to say, and I don't, I hope you didn't feel like you couldn't speak, no, not at all. No, you're good.

[01:17:23] Andi: Okay.

[01:17:24] Josie: Yikes. I, and that might not be, maybe this conversation won't hit on that. I think there was some of an intention of like, how do we prepare to make space for these conversations? What happened at AOTA as well where we can develop more of awareness of microaggressions and how to protect the space.

[01:17:44] Josie: And it is such a nuanced conversation. It's hard to know how to have it. Yeah. But it seems like we need to get to a place where, and it sometimes it's like creating more spaces, like sometimes we're expecting more from than what maybe [01:18:00] a o t is gonna be capable of in the next five years. But maybe we still need to build some alternative spaces where we're building community around these questions so that the movement isn't following AOTA a's pace.

[01:18:12] Josie: The movement can still follow at its own space. Yeah. And a OTA might have to catch up on its own time too. Or what do we do about when we have an organization that's resistant to these changes or that if we're fearing backlash for bringing things up, how are we gonna build community around this so we can keep going?

[01:18:30] Josie: And I think that 

[01:18:30] Andi: there are like specialists about this. They may not initially be OTs, but there, there are a lot of conflict resolution specialists and communication specialist that I think would be really interesting on your podcast to have some of those discussions. Okay. I don't feel super qualified to do it, 

[01:18:46] Josie: but Oh, no, totally.

[01:18:48] Josie: No. Susan too. I'm curious do you wanna bring up anything about, because maybe we could just bring some of the context, because we wanted to have this conversation because there were some challenging discussions [01:19:00] that came up at AOTA this year, and you were at AOTA. Could you speak about your experience there?

[01:19:06] Josie: Yeah, so 

[01:19:07] Susan: my experience was, I've been to AOTA before pre covid, and this felt, it did feel very different kind of in general. And I started to, I wasn't familiar with anything with Dr. A that happened before I was there at conference. And so I was quickly brought up to speed though, because I noticed like there were like stickers everywhere that said just, and they were just on all of the AOTA signs and then someone was going around and like peeling them off.

[01:19:40] Susan: And I was like, what is that? And finally I asked someone and she gave me all of the information on what had happened. And I was not at the, I did not go to the SLA lecture, but I did hear about what had happened there. There was I guess you could call it a silent protest, I don't know that had happened there.

[01:19:59] Susan: [01:20:00] And then once I got home, I had heard about the presentation that apparently some things were, I wasn't at that presentation either. Some kind of comments were made towards about race in the eighties and things like that. So I felt like I wasn't, I was there, but I wasn't really interactive in a lot of that just for, I wasn't in those kind of places or spaces, but it did feel a little overall tense.

[01:20:23] Susan: And it was a little strange. I noticed like the in the expo hall for example, like the Cota the diversity right group and some of the other it was, what was their name? I can't, it's split slowing me now, but they had a big sign that said orgasms count. And like those two expo were like way in the back, like where nobody could see them.

[01:20:43] Susan: They were like tucked away, this and anyway, it was just it just felt a little stuffy, for lack of a better word, if it just feels 

[01:20:49] Josie: weird. It is weird. 

[01:20:51] Susan: But yeah, overall it was a fair experience, I would say. And I felt like our, public health as I mentioned, like those were really well [01:21:00] supported, and I think that's a great way for us to like segue into more talk about gender diversity and inclusivity.

[01:21:07] Susan: But yeah, I, most of what I heard about it was from the after aftermath. And so I know that there's been a lot and that kind of led to even more, I know we've had some discussions about, and we were just talking about like how to hold space, right? For these kind of conversations without taking offense to everything and just going to from zero to 10, right?

[01:21:29] Susan: And maintaining our ability to be emotionally regulated throughout a conversation, even if it's a sticky, awkward conversation. 

[01:21:38] Josie: So is there, yeah, I think they're important. Yeah. Sorry. I know like in 

[01:21:42] Susan: academia, I know I have a colleague who's in academia and she and I were talking about it because her students, wanna have these conversations and she's not even sure how to approach it in like an academic setting.

[01:21:55] Susan: It's again, like a big elephant in the room needs to be addressed, but it's like,[01:22:00] How do we address 

[01:22:02] Josie: these things? And this is a role model. Get started on that too. Yeah. This is just one example where it's not always gonna go perfectly, but we can get the process started hopefully with aligned and good attention intentions for everyone.

[01:22:17] Josie: That's something I like about Vision 2025. It's actually quite inclusive especially with the addendum post George Floyd activism, like it is wanting to maximize the health, wellbeing, and quality of life for all people. And so that comes with making space for a broader table and how, and being open to hearing where, how our current systems haven't been designed to support everyone.

[01:22:41] Josie: I still think it's a little bit of a gaff how, inaccessible our conferences are how inaccessible OT education is, how it's not accommodating to students with disabilities, let alone, gender identities in all these spaces. And even if there's a space where you feel like there's always gonna be more to [01:23:00] learn, there's always gonna be more to learn.

[01:23:01] Josie: And as the world keeps changing and evolving around us the nuances of everybody's identities that we support, we gotta exercise this muscle of being receptive and understanding and building tools to support our own emotional needs and trauma that's gonna come up as we interact with these systems that are dense, resistant to change, resistant to inclusion.

[01:23:22] Josie: So it's not, and I'm welcoming too. Like in Andi's feedback, there's parts of this conversation where it's so easy to have misinformation or to frame things inaccurately. And that's where I'm open to learning with other specialists. I'm not an expert in this just because I've been trying, I'm trying.

[01:23:39] Josie: There's gonna be areas where you're not gonna do things perfectly as anOTP, even if you consider yourself culturally competent from your training. I, my ot, original OT training is 10 years ago now. Things have advanced since then. 

[01:23:52] Josie: Do you wanna say any final words or interest in this conversation that you want to leave OTPs [01:24:00] contemplating? And then Susan and I will round it off. 

[01:24:03] Andi: I just wanna say thank you for including me in this conversation. I. Air on the side of wanting more allies. So I know that that sometimes people can just based on some other conversations with Susan and some other people can feel unwelcome.

[01:24:18] Andi: And for me, I want more help and I want people to do some of that emotional labor that I just don't, I don't have all of the space for. So I appreciate people that are going to bat for us. And and then even as you do that allyship, I think part of why I say participate in our culture is part of allyship is also, promoting trans voices and having that conversation.

[01:24:44] Andi: Nothing about us without us, as they say in the disability rights community. 

[01:24:48] Josie: Exactly. Thank you so much for joining us. Andi and I look, go forward to being an ongoing supporter of your work and learning from the communities that you're connecting to [01:25:00] from a variety experience. And especially as an occupational science researcher who's also a clinician that's really who I'm wanting to support with this platform and this community.

[01:25:08] Josie: Would love to stay in touch over time and I think that Susan and I are also interested in possibly creating some space for dissemination of gender literacy and gender expansionist content in some of these spaces, maybe outside of AOTA. Yeah, and hopefully look forward to partnering with you and the resources that you have to share and helping us get this information outside of these exclusive spaces.

[01:25:31] Josie: So thank you for showing up and joining with us. And really also just. I just think it's there's a certain level. I know sometimes it can feel insulting to say, oh, I think it's so brave that you exist as a human. You on a formal podcast. So I don't wanna discourage that, but I just want all of us to know that being an out trans person, especially as a clinician, is not without risk in our current context.

[01:25:56] Josie: And we need a fo support folks like [01:26:00] Dr. A and Andi, where we have representation of marginalized identities in theOTP community. They often need protection and support because we need their leadership and they need to know that they are included within our community because they're likely to face pushback and at risk of violence.

[01:26:18] Josie: So reach out to your OTPs that are of marginalized status and be open to hearing how you can support them, being able to sustain in their work and being open to their wisdom and how we can partner together. And I hope that over time I can learn to offer that to you, Andi. And I just really appreciate you supporting this podcast too.

[01:26:36] Josie: And I look forward to supporting your growth as a researcher, as an occupational being, and especially as somebody doing very powerful work to support the human rights for your clients in Massachusetts. And I hope we see more work like yours spread and be successful in all. 50 Saints because trans youth and adults deserve to live in all 50 states.

[01:26:59] Josie: And let's [01:27:00] try to create that reality together and maybe occupational science will help us do that. Yeah, I love that, Josie. Good. Thank you for joining, Andi. Great to meet 

[01:27:09] Susan: you. 

[01:27:09] Josie: Bye bye. Awesome. Susan, do you have any kind of concluding thoughts on this? I know that we actually, we probably just need to have more conversations in the future to touch on all the things that we were interested in in the dialogue, but I like the direction it went in.

[01:27:26] Josie: What are you thinking? Yeah 

[01:27:28] Susan: yeah, you're right. It is, it's a lot to unpack in such a short amount of time. And, but I think it's good to at least, to help others that are, much more, I consider myself to be, pretty knowledgeable, right? I work in LGBTQ plus community and I live in this community, so I'm very grateful for that.

[01:27:47] Susan: But I know that not everyone has that experience. But I would just say, in working with this community, right? Like I, I don't know everything. I'm still learning. I just had a conversation [01:28:00] with a trans patient the other day about their sexuality and about Pan. I learned a lot about pansexuality and what that means to them, and just knowing that.

[01:28:10] Susan: Sexuality and gender. Gender is so fluid. And there are many days when I am like, I think we're all just born queer, right? And then because we're, ha we're humans and we have to put everything in these neat little boxes, right? The doctor categorizes us in one way or the other for the most part.

[01:28:30] Susan: And I think it's just important to sometimes just remember, there is a lot of history, right? There's a lot of history with intersex individuals and with gay men, with transgender people. And so it's really important, I think, to acknowledge that and to know that even if you don't know the details of that just have that empathy and understanding of why someone might present the way they do.

[01:28:54] Susan: And again, not taking it personally, it's not about you, but just holding space for that patient [01:29:00] and just, the way I like to frame my decision making is does this move the client forward? Does this move me forward? Or does this move OT forward? And if it's none of those things, then it's probably not, it's probably moving us backwards.

[01:29:14] Susan: Hey, so we need to like, yes, acknowledge the history, but also just continue to move forward. And you can choose, right? You can make the decision to, this is my big gripe with social media is. I'm not going to sit there and spoonfeed education to people on social media posts in OT groups. If you wanna do the work you can.

[01:29:33] Susan: It's not hard. Everything is so accessible to us. If you wanna learn more about race, if you wanna learn more about a diff a new culture, if you wanna learn more about sexuality or gender, you can literally go online, and go on YouTube. You can go on and find free good content or low cost content.

[01:29:51] Susan: Right? And you can make those decisions. You can read a book, you can listen to a podcast. Like it doesn't have to be anything huge or grand. It can be [01:30:00] something five minutes, 10 minutes. But you can make that decision or you can decide that you're not going to do that. That's really up to you.

[01:30:07] Susan: And so we can't, you nor I we can't change anyone's mind. We can't make anyone understand. If they're not ready to understand. But just know, yeah. That there are people out there, there's other people besides us too, that are doing this and who are very active in social justice, in occupation.

[01:30:29] Susan: And you're gonna make 

[01:30:30] Josie: mistakes, but it's okay. It feels easier when you're in community. And I, I think some of this can be problematic. And this might be some places where I have work to still do too. And, I'm not gonna claim to be perfect about any of this stuff. Like I am.

[01:30:46] Josie: The bulk part of my main, like a lot of the, a lot of your architecture and like the wiring of your brain in that first like 13 years of life can be hard to access once you're an adult, right? Like [01:31:00] that core learning, that fundamental learning, it takes a lot of self-reflection and inner work to get to those inner child parts of ourselves that maybe still need healing.

[01:31:11] Josie: And there's a lot of emotions and trauma and speaking as somebody that grew up with a lot of like heavy Christian socializing, some of what I went through in Kansas and in Wyoming, it, there's a threat of violence in those communities for engaging in these questions. And I, in my embodied experience, there is some trauma that comes from the fear of backlash for being, wanting to play with kids that are a different color than you or didn't go to the same church you went to, or saying something that a woman was not supposed to say.

[01:31:51] Josie: Being too uppity. And if you fear that backlash from that family of origin, it sometimes, [01:32:00] even though it's a podcast or reading a different book, it can feel really scary. To being, going outside of those lines. And I'm not saying that those emotions about the fear of that backlash, even for you as a somewhat privileged person in the context, those emotions are not more important than my client's emotions and the clients that are experiencing active systemic injustice in the community and that the emotions that I get from reading about gender violence and racism and the historic things, those those aren't anybody else's responsibility to manage besides mine. But I do wanna acknowledge that when these conversations come up, we are gonna get triggered a lot of us. And if we're transgressing social norms and gender norms and what's political, what's appropriate, like even just saying things that you have an opinion that's different than the physical therapist that you work with.

[01:32:57] Josie: Even it's a clinical opinion that can be scary to [01:33:00] be assertive and to think about things as an activism. Activism's scary. You fear your livelihood sometimes. And sometimes those emotions can be really strong. And we can sit with and process them. And OT gives us so many tools to process through emotions, and we can make space for that to happen outside of these community spaces so that our emotions don't become an additional barrier to the work happening and those conversations happening.

[01:33:30] Josie: And so I just wanna acknowledge that if you're like me and grew up in these cultures that are more insulated, sometimes the education itself can be a scary step. But if you really think about it, if you think about it, listening to a podcast in and of itself can't harm you that much. Reading a book isn't going to cause you to lose your job the next day.

[01:33:53] Josie: So what I'm hearing from Su Susan is try to carve out some of your own safe space where you can start to engage with this [01:34:00] learning on your own without being so fearful of being like, if you're worried that you might get called racist, or you might get called a bigot. One of the ways that I tried to prevent that from happening, cuz I was afraid of that, is I did what Andi was suggesting about reading things around the community in my own space, in my own time, and trying to understand it before I brought things through.

[01:34:23] Josie: And what I found is I earned some respect with those communities because they could tell that I had put some work in to try to understand it before I brought up questions. And when I, it's like building trust in a relationship with anyone. And really I think part of what I love about occupational science is it's challenging us to humanize everyone, to humanize these systems and know that like I believe all of us are humans first.

[01:34:50] Josie: And with that there's potential for change and growth. Even in these systems that feel so fixed and so rigid and unchangeable, they were created by humans and they can be [01:35:00] changed by humans. If we find the bravery and we show up for the work and we let the transformation happen, I think it's therapeutic for all of us.

[01:35:08] Josie: So I just wanna say if you can carve out and create that space and know that challenging emotions is gonna be part of this work. And it's important work. And we can get through it. And I think there are options that we can be genuine allies to these movements to help OT and our word in general be more inclusive and healthy for everyone and not just those that are in scars.

[01:35:32] Josie: Little cohort. We gotta build an ecosystem, which means we are gonna have gender diversity, we're gonna have body diversity, we're gonna have disability diversity, we're gonna have political diversity, and we have to be open to that all being in the same container. It's not gonna be easy, but this is the work we signed up for his OTPs.

[01:35:53] Josie: Join Susan's capstone dissemination group and if you, in interested in those contexts, that could be one of those initial safe [01:36:00] spaces to go through some of the presentations and see the work that students are doing, dip your toe in the water and be open to learning about this.

[01:36:08] Josie: And just listening from a culturally humble mindset that's you actually starting to put work in that's gonna help. Get us there to the AOTA Vision 2025. Check that out if you haven't already. And many of the professional organizations, and if you have concerns about AOTA being in Florida in 2024, don't hold back.

[01:36:29] Josie: Let AOTA know what you think and connect to others members of, the gender expansive community and the queer community to see how they would like to, be supported with this decision from AOTA and see if we can help them in their advocacy efforts. All right. Thank you everybody.