Best Practices in Occupational Therapy to Promote the inclusion of 2SLGBTQIA+ people
- Giovanni Arcuri
- 5 days ago
- 3 min read
By Giovanni (Gio) Arcuri, Occupational Therapist, MSc
Clinique de santé inclusive Vivago
I am pleased to announce that my document “Promoting the Inclusion of 2SLGBTQIA+ People in Occupational Therapy: A Call for Transformation Grounded in Occupational Justice” is now published by L'Ordre des ergothérapeutes du Québec (OEQ) and available:
• on the OEQ’s official website
and
• in the journal Occupation: ergothérapeute, Volume 6, Number 4, Fall 2025, on page 28
The full document can be found here:
This work reflects a deep commitment to accessible, safe, and context-adapted care that honours the diversity of LGBTQ+ experiences. It aligns with the mission of the occupational therapy profession, which places occupational participation, occupational justice, and human dignity at the heart of its practice.
A project supported and encouraged by the Order
I would like to acknowledge the essential leadership of:
• Alexandre Nadeau, President of the Ordre des ergothérapeutes du Québec
• Marie-France Jobin, Director of Quality and Professional Development
Their support made it possible to bring these inclusive directions to the forefront and to offer the profession a document grounded in evidence and real clinical needs.
Why this document?
As I write in the introduction:
“2SLGBTQIA+ people encounter numerous barriers in the healthcare system: stigmatization, discrimination, invalidation of their identity, medical violence, and lack of inclusive training among professionals.”
Recent research confirms these findings:
• systemic stigmatization (Comeau et al., 2023)
• refusal of care or inadequate interventions (Safer et al., 2016)
• mistrust toward institutions (Scheim et al., 2021)
• increased risks in mental health (Liu et al., 2023; Kingsbury et al., 2022)022)
And as I remind readers:
“Because of our capacity to look beyond the individual and transform environments, we are among the best positioned to meet the complex needs of historically marginalized populations.”
INCLUSION STRATEGIES
(from the table on p. 7–8 — reproduction)
1. Create a safe space
As mentioned in the document:
" Display inclusive symbols (LGBTQ+ flag, Safe Space sticker), ask and use chosen names and pronouns, use inclusive language, adapt forms.”
• Inclusive symbols (flag, Safe Space)
• Chosen name and pronouns
• Neutral, inclusive language
• Non-binary and open-ended forms
References: MacDonnell et al., 2019; WPATH, 2022; LGBTQIA Health Education Center, 2017
2. Adapt care to LGBTQIA+ realities
“Review assessment tools, adapt the sensory environment, and develop sensitivity to distress linked to minority stress.”
• Revised and non-gendered assessments
• Soft lighting, calm space
• Sensitive approach in the context of minority stress
References: Warrier et al., 2020; Liu et al., 2023
3. Support affirmative occupations
“Encourage identity-affirming activities (queer arts, drag, activism, inclusive sports) and formulate identity-centred goals.”
• Queer arts, drag, activism, inclusive sports
• Affirming therapeutic goals
• Co-construction with communities
References: Tintinger et al., 2024; Morrison et al., 2024; CBRC, 2024
STRATEGIES TO REDUCE IMPLICIT BIAS
(from the table on p.6 — reproduction)
As I write in the document:
“Our experiences, education, and identities influence how we see the world. This creates implicit biases — unconscious beliefs that may influence or distort our perception.”
1. Ongoing self-reflection
Supervision, co-vision, clinical journaling
References: Morris et al., 2019; Hammell & Iwama, 2012
2. Competency development
Participation in training and social-justice events
Reference: Yu et al., 2023
3. Skills development
Consulting experts, targeted training
References: Kokorelias et al., 2025; Konidaris et al., 2025
4. Reflective pause and reflexive practice
Suspending judgment, recentring
References: Lee et al., 2021; Agner, 2020
5. Open-ended questions about identity
e.g., “Are there aspects of your identity that influence how you receive care?”
References: Braybrook et al., 2023
6. Naming oppressions
Racism, transphobia, ableism, colonialism
References: Trentham, 2022; Pooley, 2021
7. Critically analysing tools used
Identifying normative biases
References: Townsend & Wilcock, 2004
8. Targeted continuing education
Team discussions, shared readings
References: Primeau et al., 2023
Key Theoretical Foundations
“Intersectionality helps us see how identities intersect with systems of oppression. The PEO model invites us to intervene on the person, the environment, and occupation.”
• Intersectionality (Crenshaw, 1989; Hill Collins, 2000)
• Occupational justice (Townsend & Wilcock, 2004)
• Cultural humility (Agner, 2020; MacKenzie & Hatala, 2019)
• Neurodivergence and gender diversity (George & Stokes, 2018; Strang et al., 2018; Warrier et al., 2020)
Conclusion
Inclusion is not an add-on: it is at the core of every practice.
.
This document aims to offer:
• concrete strategies,
• grounded in evidence,
• aligned with our professional mandate,
• and applicable across practice settings.
I invite you to read the full document on the Order’s website and to share it within your teams.
Comments