Trauma-informed and inclusive Care are particularly important for the male pelvic health area of occupational therapy practice due to stigma, prior trauma, beliefs, gender, & sexual orientation.
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Trauma-Informed Care refers to the awareness and recognition of various forms of trauma and to the impact of organizations or systems on individuals, families, groups, and communities.
Inclusive Care: person-inclusive care, which emphasises respect for identity, holistic health, and safe health-care environments.
Inclusive Care
Inclusive Care
As an occupational therapist, it is highly likely that you will work with individuals whose beliefs differ from your own. It is important to recognize this and remain aware of personal implicit and explicit biases, ensuring they do not interfere with the therapeutic relationship. Occupational therapists should provide client-centered care by respecting each client’s values, beliefs, and perspectives and by tailoring interventions to the client’s individual needs and priorities.
Autonomy & Client-Centered
Inclusive care is initiated by acknowledging the client's control of assessment & intervention. It is essential to educate clients on their role in the therapeutic relationship and process, and give them autonomy over their health and journey throughout rehabilitation services.
The following are some ways in which practitioners can promote autonomy:
Educating the client on the intervention and condition to ensure informed decision-making.
Forming a sense of a "Therapeutic alliance" with the client needing care (Mason, 2023).
Shared decision making in consideration of preferences for types of care (Mason, 2023).
Awknowledgement of clients perfered way of learning & recieving information.
When working with a diverse population, keep the following in mind:
Being sensitive to clients' needs
Acknowledging & respecting differences
Avoiding bias as a care provider
Avoiding Microaggressions, which are comments/ actions that subtly and often unconsciously or uninitrntionally expresses a prejudiced attitude towards a member of a marginalized group (Merriam-Webster Dictionary)
Examples:
"You speak English so well."
"No, where are you really from?"
Asking a person if they "have a boyfriend/girlfriend/ husband/wife" based on their gender expression."
"Believing disabilities signify no sexual function/engagament"
Guiding Principles for Inclusive Communication (CDC, 2023)
Avoid use of adjectives such as vulnerable, marginalized, and high-risk
Avoid dehumanizing language. Use person-first Language instead
Acknowledge that there are many types of sub-populations
Avoid saying targey, tackle, comback or other terms with violent connotation when referring to people, groups, or communities
Avoid unintentional blaming
Religious /Cultural beliefs
Acknowledging/ respecting clients' religious beliefs
Recognizing different cultural beliefs
Acknowledging Stigma & Taboo associated with the pelvic floor and organs
Asking about gender preferences as it relates to rehabilitation service delivery
Promoting celebration of holidays in various religious/Cultures beliefs (such as Lent, Christmas, Diwali, Ramadan)
LGBTQAI+
According to the Gallup Poll, 9.3% Americans self-identify as Lesbian, Gay, Bisexual, Transgender, or Something Other Than Heterosexual. Thus, promoting an LGBTQAI+-inclusive environment is essential to the delivery of rehabilitation services and patient outcomes, as stated in AOTA policy E.17. According to legal and colleagues (2010), Individuals from the LGBTQ+ community do not feel as if healthcare is tailored to them, and healthcare providers lack the knowledge to provide them with adequate and quality care. Furthermore, over 50% of Lesbian, Gay, Bisexual, and Transgender individuals and over 70% transgender/ gender-nonconforming individuals have expressed experiencing medical discrimination at some time in their life (Legal, 2010).
Here are some ways to promote an inclusive environment for your clients in the hospital and clinic settings (AOTA, 2026):
Placing LGBTQIA+ symbols, such as the Human Rights Campaign equality symbol, Safe Zone signage, lanyards, or Pride flags, immediately tells clients that the environment is LGBTQIA+ friendly.
Use open-ended questions to give the patient space to provide relevant information without potential cisnormative or heteronormative assumptions.
Legal name; Name used ;Pronouns; Spouse; Parent Caregiver
Harmony HealthCare states that inclusive healthcare involves recognizing and respecting patients' diverse backgrounds, identities, and needs. Utilizing this approach improves patient satisfaction and enhances health outcomes by ensuring everyone feels understood, respected, and valued.
Promote gender diversity
Enhance sexual orientation Diversity
Encourage generational diversity
seeking cross-generational mentoring
Promote Ethnic Diversity
Recognizing and celebrating culutural holidays and heritahe months fosters a sense of inclusion.
Support Disability Diversity
Foster religious Diversity
Eliminate Biases
Recognizing/ identifying bias- emphasis we all have biases based on lived experiences
Implicit bias - attitudes or stereotypes that affect our understanding, actions, and decisions in an unconscious manner, which can be activated involuntarily without our awareness. (National Education Associate)
Explicit bias is a conscious preference or aversion toward a person or group, resulting from deliberate thoughts that we can identify & communicate to others. (National Education Associate)
Trauma-Informed Care
What is Trauma?
Trauma occurs following an event, a series of events, or a set of circumstances that someone experiences as physically or emotionally harmful or threatening. Trauma can have a negative effect on a person's functioning and mental, physical, social, emotional, and spiritual well-being (Substance Abuse and Mental Health Services Administration)
Acute Trauma results from a single distressing event such as a car accident, natural disaster, or attack (Jae,2024)
Chronic Trauma occurs due to prolonged exposure to distressing situations or repeated exposure to traumatic events such as ongoing domestic abuse and bullying (Jae, 2024).
Complex Trauma is characterized by exposure to multiple, repeated traumatic events, often in an interpersonal context, such as childhood abuse or ongoing domestic violence (Jae, 2024).
Trauma Prevalence
More than 1 in 6 men (16.9%), or approximately over 2.5 million men in the U.S., experienced some form of contact sexual violence in their lifetimes (CDC, 2025).
According to the CDC and Kaiser Permanente, among male participants (N=7,970), 27.9% had experienced 1 Adverse childhood experience (ACE), and 34.1% had experienced 2 or more ACEs.
What is Trauma-Informed Care?
Trauma-informed care is a way of creating a safer environment for people who have experienced trauma (SAMHSA).
Trauma- Informed Care Principles
Principles of TIC (Center for Health Care Strategies)
Safety
Truthworthiness+ Transparency
Peer Support
Collaboration
Empowerment
Humility+ Responsiveness
Utilization/ Implementation of TIC in practice
Shifts the focus from "what's wrong with you?" to what happened to you?" (Center for Health Care Strategies)
Adopting trauma-informed practices can potentially improve patient engagement, treatment adherence, and health outcomes.
Way to Implement Trauma-Informed care into practice
Trauma-informed care is a framework that involves (SAMHSA):
Understanding the prevalence of trauma and adversity and their impacts on health and behavior
Recognising the effects of trauma and adversity on health and behaviour
Seeking Training or ongoing training on responding to patients with best practices in trauma-informed care;
Integrating knowledge about trauma and adversity into practices and treatment planning
Avoiding re-traumatisation by offering non-judgemental support to the patient who experienced adversity.
Asking what someone is comfortable with
Asking & educating the client on intervention, & allowing them to decide if this is ok before implementation
Being aware of always asking the patient for consent to touch them during assessment & intervention
Promoting open communication
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