Insights:

1. “Two spirited individuals” & gender inequality for trans folks in healthcare

Aside from the fabulous, and most confident drag queens, I haven’t crossed paths with
many trans-identifying individuals. In the gender inequity section, my mind immediately went
out to women, but my eyes were soon opened to many of the great challenges the LGBT
community faces. Hearing about the vulnerability necessary for trans-males to still receive
regular screenings, like Pap smears, it makes sense that many would simply decide not to go
through with them. I really loved the discussion about how many in the LGBT community are
seen as “two-spirited individuals, ” and are revered in other cultures. In Native American
Tribes/First Nations these individuals intervene when a man and women fight, and Indian
cultures are asked to perform religious ceremony. I foresee that I may be unsure how
to encourage someone in the LGBT community to share this information with me as their
physician. Yet, this new perspective appeals to my spiritual side and gives me a new way to wrap
my head around their approach to the world. Since I do not find myself in this group, I feel, but
do not know if this label as a “two-spirited” individual would be accepted or appreciated. I can
only hope that sharing these above examples with my future patients in the LGBT communities
would be an avenue to open up greater discussion about gender identity and its impact on their
daily life.

2. The power hunger in America evolved the country as a “utopia” for whites that quickly,
systemically, and perpetually turned into a dystopia for all.

From many of the videos, I saw what white suburbia looked like when it was first forming after
WWII. It was outrageous to me, the overt racism that existed within the housing arrangements,
and even the REorganization of housing when POC were finally granted access to move into
homes with mortgage plans (as white families had been able to do for years). Sub-prime loans &
giving white families economic incentive to move into other all white communities is nothing
but social injustice. Seeing how once affluent, white communities were devastated and
left without funding once POC migrated in, the property value marginally increasing for whites
and decreasing for POC over the years,  and the embedded nature of a culture of whiteness
perpetuated even after there was a chance to rebuild with a bit more equity after instance
like hurricane Katrina, heavies my heart. 
  
I was completely unaware of how and when this came to be, only seeing the manifestations of it
in my own home city of Chicago - the divisions between the safe and unsafe neighborhoods,
north side and south side - poor & well-off - white & black. Now, we look at the world, and
many in our current generation are waking up to these inequities that have existed for as long as
our country has lived. Protests in large numbers show us that we the people, of all races, cultures,
and color, are unhappy. We have been fed the illusion that we are taken care of by
our government and protected by the law. Before now, we have had but the illusion of choice,
blindly following our expectations based on our whiteness or our coloredness & the unspoken
truths about our gender identity. 

Our dystopia [was] one of colonialism, homophobia, employment discrimination, the result of
racism, class oppression, and gender inequality. A source for trauma, mental illness of all shapes
and sizes, labor camps, instability, behavioral issues, chronic illness and overall, exhaustion. 

Our utopia, reimagined, can be one of honor and respect for our fellow human beings, not just
our fellow man. It is a society that is inclusive, valuing belonging and diverse expression that
adds to the richness of the human race. We are united by our humanity, our vitality for life, our
desire for freedom from illness and oppression. 
Health Inequity & Root Causes of Health

The root causes of health parallel the root causes of disease. As naturopaths, who operate by the
principle of “tolle causam,” to identify and treat the cause, it is our duty to go beyond the scope
of the biomedical cause of a symptom picture to notice the systemic roots, which we may find to
instigate & perpetuate illness in our patients. Health is, in part, the accumulation of our living
and working conditions. Embedded in these conditions are subtle, and sometimes blatant,
inequities in work opportunity, labor laws & treatment.  For example, health problems can result
from overwork in physical labor & ergonomics, from nutritional deficiencies and access to
healthy foods, or from toxicity in the air, water, food, or other environmental factors. 

History has made it clear that there are some communities who are not only geographically, but
systemically at higher risk for natural disaster and air/water pollution. These communities may
also find themselves in a food desert and with lower property values for their homes, solely
because they are designated red zones: low-income, high in density of POC, and underfunded. 

Working conditions are frequently oppressive to minorities, women, and those in the LGBTQIA
communities. Lack of unpaid sick days means patients with medical diagnoses who need
immediate or consistent care are less likely to get the care they need, resulting in  greater
progression of disease, economic insecurity, and higher healthcare costs. Without a voice to
express inequities in pay, discriminatory hiring and firing, sexual harassment, and denial of
promotions, these populations will continue to be taken advantage of, working under lees-than-
optimal conditions that often have adverse affects on mental, physical, social, and spiritual
health.

To treat the whole person “tolle totum," naturopathic physicians must address all facets of a
patient’s life. It is our role to dive deep into the reasons why our patient’s present the way they
do, including the psychosocial factors. These experiences of oppression and inequity are often
swallowed and kept quiet. As a physician, we must key into the subtleties of the patient’s history
and body language to discern if there are any levels of abuse, addiction, anxiety or depression at
play. These may be important clues in what is at the core of limitation for our patient, what’s
suppressing the vitality, the core of healing, the vis medicatrix naturae. 

As partners, supporters, and teachers for our patients, at the very least, if we cannot change
the inequities, we can empower our patients to step into their full potential and achieve greater
levels of health and wellness than they ever thought possible.
Social Justice in Naturopathic Practice

1. Social & Economic Equity: serve the underserved by being open later on weekends and
weekdays after the typical workday for those who are not afforded sick days or days off
for regular screenings/checkups or maintenance of other important health concerns.
2. Political Equity/Democracy: as a health practitioner & health facility, visibly & vocally
support community organizations and political leaders who uphold these values. Support
movement organizations and form alliances with other health clinics or providers with the
same views. 
3. Liberation & Emancipation: show respect for group differences by practicing cultural
humility personally and having regular conversations with other staff and health
employees about these topics to destigmatize the unique expressions of marginalized,
LGBTQIA, and otherwise socially excluded populations. Actively show support for these
groups with materials in the office: stickers, window signs, pins, and verbal affirmations.
4. Autonomy: facilitate freedom from oppressive conditions for patients who may not be
getting their basic needs met. Act as a point source for resources for good nutrition in
cost effective ways, like sharing information about local food banks. Ensure contingency
plans and alternative diagnostic criteria for individuals who don’t have insurance or are
unable to follow through with the costs of medical care necessary for their well-being, as
well as their families.

    Overall, as a naturopathic physician who finds him or herself imbedded in any particular
community long-term may gradually learn more about the community to better serve its
populations. This may look like getting involved in the decision-making process for laws and
health policy, enforcing laws, and playing a part in public health surveillance of communicable
diseases.