Beyond the Binary: Using Inclusive, Non-Gendered Language in Bodywork

Disclaimer: all content written and hosted on this website is the express opinion of Bethany Ingraham and does not necessarily reflect those of any past, present, or future employers. Trans rights are human rights. Nazi punks, fuck off.

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In regards to the United States in 2025:

"No one else should be allowed to determine one’s gender. It cannot be measured, assessed or diagnosed. Every person is entitled to their own identity." (via Transgender Europe, TGEU, Guidelines to Human Rights-Based Trans-Specific Healthcare, 2019.)

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I'm not The Most Qualified Person(TM) to speak on this subject, but the LGBTQ+ community has been a special interest of mine since I was a Millennial teenager. I struggled with finding and forming my own identity for many reasons, and this community was one that felt the most accepting at the time.

As the person with seemingly the most lived experience in my limited social and professional circles, I have found that many people around me aren't as well-versed in the lingo as I am, particularly when it comes to the care and treatment of LGBTQ+ individuals -- and especially when it comes to transgender and gender diverse people.

Some basic definitions:

• Gender Identity: a person's core understanding of their own gender.
• Physical Sex: the development and changes of a person's body over their lifespan, as affected by their sex chromosomes, hormones, reproductive organs, secondary sex characteristics, related medical care, etc. 
• Assigned Sex at Birth: sometimes based on the set of observable physical characteristics of an individual (phenotype). Some people believe there are strictly two options (male or female) but biology isn't always so clear and simple.
• Transgender/Trans: people whose gender identity does not match their assigned sex at birth.
• Cisgender: people whose gender identity does match their assigned sex at birth.
• Intersex: people born with sex characteristics, such as chromosomes, gonads, and/or genitals, that don't fit the "typical binary notions of male or female bodies." These people are often subjected to medical interventions at birth with lifelong consequences.
• Gender Expression: "all the ways a person communicates their gender, including clothing, voice, mannerisms, names, pronouns, etc. Norms for gender expression vary culturally, generationally, spiritually, regionally, and between communities and peer groups." (via Trans Care BC's "Exploring Gender Diversity" handout.) Therefore, what's "traditional" for one group of people may not be the tradition of another.

A more comprehensive resource of definitions is this brilliant .PDF Document: Gender-Affirming Language, curated by Co-led authors: Bri Guillory, OTD, Boston University and Lili Rafalski, OTD, Emory & Henry College; Capstone Students; hosted by the American Occupational Therapy Association.

I don't have a lot of my own definitions and explanations for "what does this concept mean and why?" This post isn't meant to be all-inclusive (ha!) and cover everything there is to know on all the subjects. Originally, this was meant to provide guidance for, "how do we teach bodywork with non-gendered terms?" and I will come back to that.

One thing we're not going to use is the phrase "Biological Sex," as in, "biological men have ABC features and biological women have XYZ features." This is sometimes called biological determinism or genetic determinism: "the belief that human behavior is directly controlled by an individual's genes or some component of their physiology." Simply put: it is related to eugenics and scientific racism.

"'Biological Sex' -- common in scientific writing as a synonym for birth sex, natal sex, or assigned sex at birth. Outside of medical literature, 'assigned sex at birth' is preferable over 'biological sex'. Avoid using 'biological' in reference to people, rather than in broad references to the concept of biological sex. Noun phrases like biological men, biological males, biological women, or biological females are often used by anti-trans groups to invoke a person's assigned sex at birth as their 'real' gender, in contrast to their gender identity." - From TGEU's Trans Media Guide.

Usually I would save all of my resources to the end of a post, but many of these have been fundamental in my writing. Please consult these reputable resources to bolster your understanding:

• Trans Care BC -- a provincial clinical program operated by the Provincial Health Services Authority (PHSA) in British Columbia, Canada. "We work with our partners to set direction and provide leadership for trans health services across B.C. Our work helps ensure trans, Two-Spirit and non-binary people get the care they need when and where they need it." 
• I highly recommend their Education Centre which features webinars, eCourses, and free downloadable .PDF handouts on Exploring Gender Diversity, Gender Inclusive Language, and Making Mistakes.
• TransHub, "an initiative from ACON, NSW’s leading health organisation specialising in community health, inclusion and HIV responses for people of diverse sexualities and genders."
• If you read nothing else, you must read their .PDF document: "Trans-Affirming Clinical Language." 
• TGEU (Trans Europe and Central Asia) -- "a trans-led nonprofit for the rights and wellbeing of trans people in Europe and Central Asia."
• Check out their publication of "Trans Rights Are Human Rights: Dismantling Misconceptions About Gender, Gender Identity & the Human Rights of Trans People" here.
• I also recommend the "Trans Media Guide: A Community-informed, Inclusive Guide for Journalists, Editors & Content Creators" here -- it has a brief glossary of terms at the end. 
• World Professional Association for Transgender Health (WPATH) -- a 501(c)(3) non-profit, interdisciplinary professional and educational organization devoted to transgender health. "Our professional, supporting, and student members engage in academic research to develop evidence-based medicine and strive to promote a high quality of care for transsexual, transgender, and gender-nonconforming individuals internationally."
• While it's a long read, I recommend skimming over their highly detailed Standards of Care (SOC) document: "These internationally accepted guidelines are designed to promote the health and welfare of transgender, transsexual and gender variant persons in all cultural settings."

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Bodywork Education

"And so, life in the Shire goes on, very much as it has this past Age… full of its own comings and goings, with change coming slowly, if it comes at all." - Bilbo Baggins, Lord of the Rings: The Fellowship of the Ring

One of the biggest issues with traditional brick-and-mortar education is that many institutions still rely on physical, printed textbooks and publications. They are expensive. They fall out-of-date quickly, and updating and verifying written information takes time. Bias happens. Photography is an additional expense and doesn't always feature a variety of body types.

So, for those of us who want to embrace diversity and be inclusive in our teaching materials, what do we do? 

When it is brought up in a classroom setting and it is a resource outside of your control, acknowledge the things that are problematic. Affirm that feedback will be or has been heard and given to the correct people. Apologize (briefly) for genuine mistakes. Express gratitude for the opportunity to learn! Request patience and grace. Carry on with the lesson as best you can, offering adjustments and accommodations where appropriate.

If you are teaching anatomy and physiology, you may run into issues around discussing reproductive system anatomy and the development of secondary sexual characteristics. Again, textbooks will often still focus on the "male reproductive system" versus the "female reproductive system," without consideration of the percentage of intersex individuals who have a mixture -- or lack -- of features of either one.

Be proactive -- if you recognize that a resource is lacking in representation or information, plan to supplement the information you're sharing. It may take a little extra effort, but it will be appreciated.

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Language

Okay, but how do we actually talk about bodies and prepare to treat transgender and gender diverse students and clients respectfully? The simplest way is to use anatomic, gender-neutral terms. When appropriate, you can consider using the following standard of care:

"Statement 1.3  We recommend health care professionals discuss with transgender and gender diverse people what language or terminology they prefer. In providing health care to TGD [transgender and gender diverse] people, we recommend [healthcare providers] discuss with their patients what language or terminology they prefer be used when referring to them. This discussion includes asking TGD people how they would like to be addressed in terms of name and pronouns, how they self-identify their gender, and about the language that should be used to describe their body parts. Utilizing affirming language or terminology is a key component of TGD-affirming care (Lightfoot et al., 2021; Vermeir et al., 2018). [...] In electronic health records, organ/anatomical inventories can be standardly used to inform appropriate clinical care, rather than relying solely on assigned sex at birth and/ or gender identity designations." -- WPATH Standards of Care (SOC) document

Chest and abdominal massage, specifically, already holds a lot of emotions around it due to our Western society. This is sometimes compounded by gendered language and routines designed specifically "for men" and "for women." In these cases, it can be helpful to simplify routines and drop such distinctions altogether. 

In my personal notes regarding chest massage, I list the following points:

• Do not assume based on gender perception/presentation.
• Use anatomic, gender-neutral terms and language.
• Do not make comments about a person's body, even if you intend it to be a compliment.

One practice you might consider is to drape all chests the same way, regardless of presence or amount of breast tissue. Breast tissue massage is an advanced technique that requires continuing education; it is not something that was taught at my school. For people who have received chest surgeries, they may require specific bolstering to be comfortable or may have to receive work in side-lying instead of prone. Have strategies for this and remember to practice!

Another area to think about is draping and treating the legs in a way that is comfortable for all bodies. When it comes to performing psoas or adductor work, consider saying, "If you have external genitals, you can move them aside." Again, it's important to not make assumptions about a client's body based on their gender presentation. Saying these things out-loud can feel awkward at first -- that's why you need to practice saying them in an assured, confident way.

In Polarity Therapy, we discuss the "inner male" and "inner female." Personally, I prefer to discuss the inner masculine and inner feminine qualities of a person. Others will discuss Yin & Yang. You will find the terms that best fit you and your own spiritual practices.

Finally, I highly recommend checking out and printing TransHub's .PDF document: "Trans-Affirming Clinical Language." It contains many helpful suggestions in setting a welcoming tone, discussing reproductive anatomy, and how to address "specific needs, rather than making assumptions."

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Questions & Intakes

While we are not considered primary healthcare providers, there are questions we should ask to ensure a client's comfort and safety within our practice.

Are you pregnant? Not all pregnant people are cisgender women; pregnant individuals can be trans men, non-binary, genderfluid, agender, etc. Educate your clients on how bodywork can affect pregnancies.

Any recent surgeries or implanted devices? You don't need to know the specifics -- you need to know how far along post-surgery or -treatment they are and if their medical providers have cleared them for receiving bodywork. Some surgeries and treatments may include mastectomy, breast augmentation/implants, facial masculinization or feminization surgeries, body masculinization surgeries, Adam's apple reduction, etc. Cisgender individuals also receive these gender-affirming surgeries and treatments. Typical post-surgical precautions will apply.

Are you receiving any Hormone Replacement Therapies? If so, how? Gender-affirming masculinizing or feminizing hormone therapies can be received topically (on/through the skin), through oral medication, or via injection, so it's important for us to know for our client's wellbeing and also our own. Remember, Hormone Replacement Therapy is often used for folks (both cisgender and transgender) who are experiencing symptoms of menopause.

Have your providers discussed any concerns about your cardiovascular or bone health? If not, then proceed with the rest of your intake. As for why it matters: "Estrogen and testosterone both support bone formation and turnover. Decreased sex hormone levels are associated with a greater risk of osteoporosis in older age (Almeida et al., 2017)." - WPATH Standards of Care (SOC) document. If your client is at risk of osteoporosis, you would need to consider using precautions in their treatment.

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Other Considerations & Final Thoughts

While you might not want to ask specific questions, pay attention if a student or client discloses information about their mental health and whether they feel safe in their home and community. You may need to refer them to supportive resources and providers.

Provide sanitary products in your restroom(s). It's a small detail that can make a world of difference.

If you want to create an environment and a practice that is more inclusive, you will need to put in the time and the work to do your own research. This post barely scratches the surface of the issues facing the small percentage of the population that falls outside the gender binary.

I want to reiterate that mistakes will happen, particularly if this is all new language to you. You don't need to know all of the language -- you will likely be taught in-the-moment. Be sure to not only apologize for your mistakes, but also express gratitude for the opportunity to learn. 

However: when someone is purposefully malicious in disrespecting an individual's gender identity and expression, especially after their wishes have been communicated, that is harassment. 

Above all else: treat all individuals with dignity and respect. 

(I can't believe this is a revolutionary concept in the year 2025, but here we are.)

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Other Resources:

• Elm R's video on trans & nonbinary inclusion in massage! -- Elm has been a great resource and source of inspiration for me.
• Healwell.org: "Creating an Affirming and Inclusive Practice" Paid Course -- "Learn about the health disparities in the LGBTQ+ community. Gain a basic understanding of the needs of this community. Examine your own biases and assumptions, and learn some practical ideas for making your practice more welcoming and affirming."
• Folx Health --  "FOLX is the largest health and wellness platform for the LGBTQIA+ community, serving over 50,000 people. Get the health care you deserve."
• I can't speak to their actual healthcare, but I do appreciate their free library of articles and resources.
• Klein A, Golub SA. Enhancing Gender-Affirming Provider Communication to Increase Health Care Access and Utilization Among Transgender Men and Trans-Masculine Non-Binary Individuals. LGBT Health. 2020 Aug/Sep;7(6):292-304. doi: 10.1089/lgbt.2019.0294. Epub 2020 Jun 3. PMID: 32493100; PMCID: PMC7475086.

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Tips for Online Classes & Meetings

Photo by Surface on Unsplash

Technology has created more opportunities for people all around the world to communicate and share knowledge face-to-face, even when they are miles apart.

Since 2020, I have taught and watched hours upon hours of online lecture and theory classes, with very specific guidelines and expectations -- often dictated by an outside, faceless bureau. Holding students to such high standards helps to make them exceptional, but sometimes they need a little extra help to get there. I am especially sympathetic for neurodivergent folks and those living with chronic pain and illnesses.

Whether you're a student, a professional, or just interested in trying out and improving your participation in online classes and meetings, here is some advice.

Technology Considerations:

• High-speed internet is going to make your experience a lot smoother and reduce headaches. Mid-level internet will probably be okay.
• While mobile devices can seem convenient, not all devices and meeting software(s) will cooperate well together. I really recommend using a mobile device in conjunction with a laptop or desktop computer -- one can be your camera source while the other can be used to view slideshows and participate in chat or other activities.
• Mobile devices, in general, are distracting and may turn off your camera when notifications and text messages come through or when attempting to bring up other resources and activities.
• Have a single, stable set-up for your camera. If you're trying to hold your phone in your hand while moving all over the place, it's distracting and nauseating for the viewer.
• Double-check that your devices, programs, apps, and any other tools are up-to-date and have been recently restarted. This will reduce the likelihood that these things will try to update or restart themselves mid-class or mid-meeting.
• If your internet connection is unstable, make sure that you have only the most necessary programs or apps running in the background. Consider disconnecting any extra devices from your wifi.
• Let your host know if you're having technical difficulties. Since they may or may not be able to assist you, have the support website for your meeting-app-of-choice easily available for troubleshooting on your own:
• Official Zoom Support Help Center
• Google Meet Help

Set-Up Considerations:

• Face into a light-source, or position it so that it's at a 45-degree angle to you/your camera -- this is considered your "key light." Any light-sources behind you need to be less bright. Natural sunlight is considered the best, if available.
• Face your camera head-on, ensuring you are centered with your head, neck, and shoulders visible.
• Be mindful of your camera positioning.
• Be mindful of your wardrobe. 
• Yes, these two points are tied together. 
• No, you don't want to know why.
• Have a designated space for your meetings, if possible. It doesn't have to be fancy, but it gives you a place to keep supplies at-hand so you're not searching for them mid-meeting. It's also great for consistency and in telling our brains and bodies, "We are in work-/school-mode, now. It's time to focus."
• Ensure you have a distraction-free background since some classes won't allow you to use filters or blurring.
• Be able to sit-up straight and take notes. This shows respect to your instructor and fellow classmates; instructors appreciate you for setting a good, professional example to others.

During Your Meeting or Class:

• If your meeting is being recorded, you cannot have any people enter your camera's line-of-sight -- they have not consented to being recorded.
• Tell your housemates to leave you alone. This includes your pets. It's okay if they're laying quietly in the background; it's not okay if they're distracting you or the people watching you.
• If your human housemates can read and still won't leave you alone, holding up a sign that says "GO AWAY" can work wonders. For human housemates who can't read, consider hand signals -- with varying degrees of politeness.
• Refrain from eating or chewing gum. It is considered poor etiquette.
• Consider leaving the meeting and rejoining if you receive a phone call, someone arrives at your door, or some other unexpected event pulls you away.
• Do you struggle to focus while listening to information? Have tools within reach to keep your hands occupied, such as doodling in the margins of your notes or using a fidget (or three). Ideally, have resources available that will help to support your learning of the material being discussed.

Should You Be Online?

• If you can't fully focus on your class or meeting (i.e. you're trying to play videogames, watching or listening to other media, or otherwise multitask), then no, you should not participate.
• If you're too ill or in too much pain to sit up, then you are not able to participate and you're unlikely to retain new information.
• If you are driving -- and your meeting requires you to be on-camera and actively participating -- then, no, you should not be online. If you're allowed to listen, please consider using a hands-free device and ensure your microphone is muted.
• If you or a loved one are in the hospital or attending some other appointment, please do not attempt to participate.
• If you have family and friends who cannot respect your boundaries around online classes and meetings -- and/or you do not feel empowered to enforce these boundaries -- then it may be time to sit down and reconsider what you're trying to accomplish and why. Have tough conversations. Delegate responsibilities. Consider finding a space outside of your home that will better accommodate your needs. 

I hope that these tips will help you to improve your online learning and networking experiences!
 

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5 Reasons Why Massage Therapy School Might Not Be For You

You're squeamish.

Bodies are weird. If the sight and sound of someone cracking their neck sets you off, images of cadaver dissections gross you out, you swoon at the sight of blood, or any other bodily fluids and functions make you want to vomit -- this might not be the best career for you. 

You lack reliable transportation.

Some massage therapy programs are hours-based, so every minute has to be accounted for. You need to be able to get to school on time; if not, how are you going to show up to your future jobs on time? You can't rely on your clients to be understanding 100% of the time.

You're unable or unwilling to practice outside of school -- including asking friends, family, and acquaintances if they would like a free session.

If you can't give the work away for free, how are you going to market it and get paid for it? It also comes down to the quantity of sessions you give -- the quality will improve later. Sleeping with a textbook under your pillow will not, in fact, increase your knowledge by osmosis. You have to physically put your hands on people to develop your skills. 

You have significant physical disadvantages or health concerns that make giving and receiving massage difficult and/or inadvisable.

Giving a massage is physically demanding. You need to be able to stand, lunge, lean, squat, and lift -- and a lot of this movement comes from having strength in your knees, thighs, and core. If you have cardiovascular, nervous system, or liver or kidney disorders, receiving massage may be contraindicated (that is, "a bad idea") for you.

You're unable or unwilling to clean, follow rules and regulations, and/or otherwise be professional.

Your caregivers are not going to be following behind you during school or at work to make sure your space is clean. During your training, you will have opportunities to learn skills such as laundry, sweeping, vacuuming, and keeping a bathroom and other surfaces clean. Sanitation, infection control, and universal precautions are especially important considering our close-contact with complete strangers. You will be given specific expectations and guidelines to abide by that are often meant to prepare you for work after graduation; some rules and regulations are state-mandated, while others are in place to qualify you and your school to receive federal financial aid. Finally, you're going to need to be polite, civil, and a generally pleasant individual to work with. These are skills you will be able to develop and practice during school, but it's preferrable that you have some familiarity with them beforehand.

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Professional Licensing, Public Records, & Disciplinary Actions

I've now been through 10 renewal cycles with my massage license. If I could go back and change one thing on my initial application, I wouldn't have taken "Full Name" so literally and I would have left my middle name out. (It's nothing too terrible, but not something I'd usually share with the general public.)

One thing that might surprise you is that, with the exception of your social security number and credit card information, the information submitted is *not* confidential.

Per the current individual license application:

"PUBLIC RECORD:  This application is a public record for purposes of the Maine Freedom of Access Law (1 MRSA §401 et seq).  Public records must be made available to any person upon request.  This application for licensure is a public record and information supplied as part of the application (other than social security number and credit card information) is public information.  Other licensing records to which this information may later be transferred will also be considered public records.  Names, license numbers and mailing addresses listed on or submitted as part of this application will be available to the public and may be posted on our website. 

SOCIAL SECURITY NUMBER:  The following statement is made pursuant to the Privacy Act of 1974 (§7(B)).  Disclosure of your Social Security Number Is mandatory.  Solicitation of your Social Security Number is solely for tax administration purposes, pursuant to 35 MRSA §175 as authorized by the Tax Reform Act of 1975 (42 USC §405(C)(2)(C)(1)).  Your Social Security Number will be disclosed to the State Tax Assessor or an authorized agent for use in determining filing obligations and tax liability pursuant to Title 36 of the Maine Revised Statutes.  No further use will be made of your Social Security Number and it shall be treated as confidential tax information pursuant to 36 MRSA §191."

Upon your application being approved, your name (whatever and however you write it on the application), your mailing address's city/state/zip code, and your phone number may become accessible to the public. Your listing will also include your state professional license number, status (usually Active or Failed to Renew), expiration date, and how you received your license (schooling, etc). 

Massage therapy as a licensed profession in Maine falls under the Department of Professional and Financial Regulation's Office of Professional and Occupational Regulation:

"The Office of Professional and Occupational Regulation (OPOR) and its licensing boards and programs are established for the sole purpose of protecting the public by licensing qualified individuals in each professional area and by imposing discipline on licensed individuals and entities to prevent harm to the public."

The direct link to the Massage Therapy Licensure office is here: https://www.maine.gov/pfr/professionallicensing/professions/massage-therapy-licensure

"Massage Therapy Licensure was established to provide for the regulation of persons offering massage therapy services, in order to safeguard the public health, safety, and welfare, and to protect the public from incompetent and unauthorized persons in the State of Maine.

The primary responsibilities of the Office is to review and approve qualified applicants for licensure as a licensed massage therapists[sic], to promulgate rules as necessary, to investigate complaints, and to take appropriate disciplinary action for noncompliance with current laws and rules."

The office's website provides a handful of useful links and resources for both practitioners and consumers. The general public is able to search for individuals, companies, disciplinary actions, courses, and course providers here: https://www.pfr.maine.gov/almsonline/almsquery/welcome.aspx 

Ideally, the database would only ever need to be used to verify licensure.

Yours truly, however, is a nosy, curious person.

I have used the "Search Disciplinary Actions" feature to explore what sorts of cases have come up over the last few years. I was unsurprised but still disappointed that there were, indeed, cases of alleged misconduct on the part of licensed massage therapists. Another interesting incidence involved therapists not disclosing they had convictions prior to applying for licensure, or they had been convicted of misdemeanors while holding a professional license -- even if the misdemeanor had nothing to do with their profession. Such misdemeanors may include: driving with a suspended license, disorderly conduct, theft under $1,000, assault, and operating under the influence. 

In exploring the related rules and regulations, I learned that if you are ever convicted of a misdemeanor, you must report the conviction to your professional licensing board within 10 days of the conviction. 

Some consequences include fines, license probation, and license suspension. Some cases are consent agreements between the State and the massage therapist regarding probationary actions. Others include highly detailed accounts of evidence and testimonies given at adjudicatory hearings. 

And, friends, some of these details and pieces of evidence come from text messages and conversations within the therapist's office. They come from therapists failing to uphold the highest standards of professionalism, including avoiding dual-relationships. Draping -- respecting a client's need for privacy, modesty, security, and emotional expression -- must be impeccable at all times. Detailed intake forms, SOAP notes, and incident reports need to be created, taken, and kept secure.

Finally, we need to hold each other accountable.

If ever you meet a practitioner who doesn't abide by these ethical ideals and it can't be resolved with a polite conversation, you have a moral obligation to report them to their licensing board. If you can't do it for your own sake, then do it to protect the health, safety, and welfare of the rest of the public.

Ignorance of the Laws & Rules is no excuse. Blaming emotional and physical isolation due to the pandemic is no excuse. Pointing fingers like a schoolkid, saying, "But they're doing it and they're not in trouble!" is no excuse.

Protect your integrity and reputation -- for both your sake and the sake of our industry. Be lawful, ethical, and professional in order to be successful. 

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Professional Writing Advice

Omit needless words.

Vigorous writing is concise. A sentence should contain no unnecessary words, a paragraph no unnecessary sentences, for the same reason that a drawing should have no unnecessary lines and a machine no unnecessary parts. This requires not that the writer make all his sentences short, or that he avoid all detail and treat his subjects only in outline, but that every word tell.

Strunk, William. Elements of Style. Ithaca, N.Y.: Priv. print. [Geneva, N.Y.: Press of W. F. Humphrey], 1918; Bartleby.com, 1999. https://www.bartleby.com/141/strunk5.html. May 26, 2022.

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Massage & COVID-19: What Now?

Photo by Keenan Constance on Unsplash

I have a lot of strong feelings that are difficult for me to put into words. So much of this experience -- rooted in grief and trauma -- has been subjective, making it difficult (impossible, really) for each of us to remain objective.

I can't dictate what you should do. I can only present tools, opportunities, and resources so that you can decide what is best for you.

If nothing else, I implore you:

Make decisions not from a place of fear and anger, but with an informed, educated understanding.

Resources I've Collected:

• ABMP's "Back to Practice" letter of guidelines from the company's president, Les Sweeney.
• Healwell's Free On-line Course, "Back to Practice Guidelines (in Practice).
• BARBICIDE Certification Course -- a free on-line resource for salons and spas.
• A Google Document titled "Small Biz Resources for Massage Therapists during Pandemic Response," crowd-sourced and put together by practitioner Meg Donnelly from Virginia.
• US Small Business Administration's Coronavirus Relief Options.
• .PDF: US Dept of Labor, OSHA. Guidance on Preparing Workplaces for COVID-19
• "Massage Therapy and Corona Virus: 4 Reasons Why Masks and Clean Surfaces Aren't Enough."
• YouTube Video: Dr. Duc C. Vuong "How COVID-19 Kills - I'm a Surgeon - And why we can't save you."
• The Thinking Practitioner Podcast: Episode 12, "The Cytokine Storm of COVID-19."

Big Names in the Massage Industry That I Respect and Listen To:

• Tracy Walton: "Since 1998, she has developed, taught, and continually updated Oncology Massage Therapy: Caring for Clients with Cancer. ... For over 13 years, Tracy taught physiology and pathology at the Muscular Therapy Institute (now Cortiva Institute – Boston) where she also served as Academic Dean and Chair of the Science Department."
• Ruth Werner: author of six editions of A Massage Therapist’s Guide to Pathology, from 1998 until now; writer for Massage and Bodywork Magazine with her column "Pathology Perspectives;" past president of the Massage Therapy Foundation.
• Til Luchau: "With a diverse background that includes manual therapy, somatic psychology, transformative education, as well as organizational and leadership development, Til's ability to connect interdisciplinary, big-picture ideas to practical, real-world applications has made his talks, trainings, and events popular worldwide."
• Whitney Lowe: "Lowe’s been in the profession for over 30 years. He is the author of the profession’s first accessible assessment text, 'Orthopedic Assessment in Massage Therapy.' ... He is a member of the editorial advisory board of the 'Journal of Bodywork & Movement Therapies,' and is a regularly featured author in publications such as Massage & Bodywork, Massage Today, and Massage Magazine."
• Diana Thompson: a licensed massage therapist for 30 years, specializing in post-operative care; author of "Hands Heal: Communication, Documentation and Insurance Billing for Manual Therapists," now in its fourth edition; a past president of the Massage Therapy Foundation, a philanthropic non-profit organization whose mission is to advance the knowledge and practice of massage therapy by supporting scientific research, education, and community service.  

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Pro-Tip for Students & Graduates

Get to know your instructors — build good relationships with them. You may want or need professional references and letters of recommendation after you graduate.

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Overcoming Professional Performance Anxiety

Over the last decade, I've met and worked with hundreds of people. I've participated in local events, made friends with industry leaders through Facebook and Twitter, and impressed my work colleagues with my tech savvy and know-how.

I'm also an Introverted perfectionist with generalized, social anxiety. People I perceive as having any kind of authority intimidate me. While I still approach them with the utmost respect, it took a long time for me to loosen up around my current bosses (and their bosses).

I didn't come into this career with a lot of strong interpersonal skills -- like any skill, they had to be learned and practiced. Becoming a parent and working with young kids helped me develop other skills around empathy and communication in ways that I couldn't have predicted.

Some days are easier than others. I'm very good at being a duck: appearing calm and collected on the surface while paddling like crazy underneath. I've learned what things I can let go of and not take as seriously. When things go wrong, I approach the situation with my usual dry humor and say, "Thank you for your patience."

— And then there was the day at clinic when two massage tables broke down moments before we were due to take clients in to their sessions. It happens. It wasn't pretty in the moment, but we got through it and I got over it. The world did not come to an end, the school didn't close down or fire me, and the clients were likely none the wiser.

So what do you do when anxiety hits in-the-moment?

● Take some deep breaths. Drink some water. Clear yourself, if you're energetically inclined.

● Have a conversation. Build a relationship. Don't worry about making a sale or trying to impress every single person you come into contact with. Accept that you will connect with some people more easily than others; you're not going to be everyone's cup of tea (or coffee, or hot cocoa, etc.).

● Remember that when you're meeting prospective students and clients, they're probably more intimidated by you than you are of them. Think back to when you were in their shoes. What would you say to your past-self in encouragement?

● Remember your why: why did you choose this career path? Why did you say "yes" to this specific program? What did you envision at the end of your training? What does that professional-version of you look like? (A la Gramma Tala from Moana: "Who are you meant to be?")

● Call upon those pieces of you; bring in those characteristics. Square your shoulders and stand a little taller.

● Know that "Imposter Syndrome" is a valid fear -- that feeling of being a fraud in spite of everything you've accomplished thus far.

● Accept that you will make mistakes.

● And then push through it, anyway. It takes courage to stand up and put yourself out there. Each time you push through the discomfort and come out the other side, it gets easier.

"Fake it 'til you make it!" and "be yourself!" are cliches, but there is truth to them, making them effective strategies. You will stumble and struggle. Some tears may be shed. You are a real person with very big feelings and that's okay -- it's what makes you relatable, and that's what others are looking for.

Even professionals get anxiety. Even professionals make mistakes. Know that the best ones will see you, empathize with you, and encourage you to keep going.

"Take chances! Make mistakes! Get messy!"

- Ms. Frizzle, the Magic School Bus

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Music Legalities

(No affiliate links were included in the writing of this blog post. None of this should be taken as legal advice. Dang it, Jim, I’m a massage therapist —- not a lawyer.)

Jamakassi

Many of us strive to act and to run our businesses in an ethical manner by following personal and societal mores and norms. Ethics not only relate to how you interact with clients and peers -- it also can include obligations imposed by law.

The use of music in your office or massage space is governed by your country's laws surrounding copyright: protections given to authors for their original works. If you play copyrighted music "in public" without proper licensing, you could be hit with statutory damages of $750 at minimum to a maximum of $150,000 per song (depending on whether or not you knowingly/willingly violated the law).

The reason behind this being illegal is that when licensed music is played in a commercial space, it is played with the intention of creating an experience for customers that is conducive to the interests of the business (getting customers to pay money for the goods and services on offer). The business gains from the music being played. For that reason, the law says that the creators of the music should get a piece of the profit being made.

-- Can I Play Spotify, iTunes, YouTube, or Other Music Services in My Business? from Cloud Cover Music.

"But I've bought copies of my music and/or pay for a consumer-level streaming service!"

Sorry, no. You can't get around the copyright regulations if you've only paid for individual, personal services and products:

The law distinguishes between owning a copy of music, like a CD or a song saved on an iPod, and owning the rights to those songs, including the right to publicly perform them. When you purchase a CD or DVD or download an audio file, software, game or other product containing music, even those specifically marketed for business purposes, you are only buying a copy of the music and the right to play it “privately.”

... When music is streamed over the Internet, however, there is a distinct performance right with respect to the “sound recordings” of songs publicly performed via digital audio transmission. So, theoretically, streaming online music into shared spaces could also require a performance license from the sound recording copyright owners.

-- Music Licensing Basics for Apartments, by Cindy A. Tune, .PDF accessed 1/23/2020 11:00AM EST. 

There is one specific exception to be aware of:

There are exceptions to when a license is required to play copyrighted music; stores under 2,000 square feet, and restaurants and bars under 3,750 square feet, can play music over a radio, TV, or similar device [i.e. cable or satellite broadcast], but there have to be fewer than six speakers carrying the sound.

-- In-Store Music Laws in the U.S.: Licensing, Legalities, and Fines from Cloud Cover Music.

However, this exception strictly limits you to using those specific sources (radio, TV, cable or satellite broadcast) and only the music and visuals licensed by the Federal Communications Commission (FCC).

For any other device or music source, you need to have a Public Performance License through one or more Performance Rights Organizations (PRO). Rather than go through the individual PROs (the costs of which can be over $1000 annually), there are services that will provide you the public performance licenses and access to music covered under those licenses. These services will cost more than your standard consumer subscriptions, but you will be able to rest easy in knowing that your butt (and your business) has been covered.

"Okay, what are my (cheapest) options?"

Here are three under $30/month services to consider:

• Soundtrack Your Brand: high quality, wide variety, connection to Spotify and its playlists (as it was originally sponsored as "Spotify for Business"), and a free 30-day trial. After that, it's $26.99 a month.
• Cloud Cover Music: not quite as robust as Soundtrack Your Brand, but if you're only needing licenses in the USA and Canada, the ~$17 a month price tag is a little easier to swallow.
• SighTunes: specifically designed for massage therapists, providing 10-hours of royalty-free music, refreshed each month (so long as you're connected to WiFi... and remember to do it at the start of each month), for $9.99 a month. Plus, if you have a professional membership like ABMP, there is a discount code to take up to an additional 40% off. I have tried it... it's not my favorite due to the design of the app itself, the "blah" choices of music, and the aforementioned need to connect to the Internet before you drive out to a client's house on the first of the month and suddenly can't access the previous month's music. (ಠ_ಠ) (This may have changed since I last attempted to use it. I'm not holding my breath.)

Another option would be to actively look for music that is within the public domain (i.e. works written before copyright law was established, or the copyrights have expired/been lost, etc.), music that is considered royalty-free, or music where the copyright-holders have explicitly given their permission for public use. Artful Touch Music is one such resource:

Artful Touch Music was created for, and inspired by, the healing arts. We invite you to use this music in your professional bodywork offices and yoga studios.

These songs are effective as music therapy for all ages and are enjoyable as a soundtrack for massage therapy and yoga practice.

This music encourages relaxation, a resting heart rate, deeper breathing, a calm and centered mind, and a general sense of well-being.

-- Artful Touch

Other References:

I went down the rabbit hole so you don't have to.

• Top 10 Licensing Questions: How to Play Legal Music in Your Business from Cloud Cover Music (because they've done the work and likely have answers to the majority of your questions)
• "You Might Need a License to Play Music in Your Small Business" from NFIB
• "Can I use Spotify at my business or school?" from Spotify's Account Support
• Music Streaming Services for Business by Legis Music (offers a longer list of the more expensive, general PRO services)
• 11 Questions About Music Licensing from the National Restaurant Association (spells things out simply)
• Copyright Law of the United States, Title 17 -- if you're adept at reading and understanding legalese or need something to put people to sleep

"But wait! What about Pandora and SiriusXM?"

These companies are jointly owned by Liberty Media, the heads of which collectively gave $1 million to Trump’s 58th Presidential Inaugural Committee (currently under federal investigation). In 2016, Sirius moved to eliminate 80 percent of its Latin music channels. In 2017, they reintroduced Steve Bannon as a regular host on its Patriot channel until he stepped down in 2018. (Source: Pandora’s New Corporate Parents Gave Millions to Trump, GOP, Sam Lefebvre, January 2019, KQED.org)

Personal ethics are just as important as professional ethics. Therefore, I cannot and will not endorse these platforms.

---

When the Best-Laid Plans Go to Pot

August 10, 2019. I had two clients booked at my office on Main Street in Buxton, Maine. I was leisurely going about my morning at home when I was told there would be a parade going past my office that morning.

I was instantly gripped with anxiety. I called and messaged my clients to ask what they wanted to do, as there was no telling when the parade would end and whether or not we could get in and out of my parking lot.

I rushed to my office, frustrated with the cars doing 35 in a 40, frustrated with the town, and frustrated with myself for not connecting the dots sooner.

Pulling into my parking lot was easy; things weren't busy yet, though a local side-street was already reduced to local traffic only. As I finalized rescheduling my first appointment, I looked around my office...

And got to work.

"If you can't beat 'em" became my mantra as I put out my signs on the street, and then added Small Business Saturday balloons and business cards. I washed windows and mirrors and dusted surfaces, both inside and outside. I moved more signage and decoration around and tacked up an outlet cover to hide a hole in my wall. These are all things that I never would have made time for, otherwise.

I took a photo and shared it on Facebook, with a bit of (malaphoric) humor -- because that's how I deal with life when things go wrong.

The Importance of Being Adaptable

Yes, I allowed myself a few moments to wallow and bemoan the situation, as well as the (temporarily) lost income. Once that was over with, I made the best of it.

In massage school, I emphasize the importance of rolling with whatever situations arise -- because things can change in an instant, regardless of whether you're in a school clinic, working for someone else, or running your own private practice.

• You will have no-show clients.
• You will have five clients vying for the same day and time slot.
• You may plan to work on a client's shoulders but, when they arrive, you find out they have a sunburn.
• You may plan to start work on a client who is face-up, only to walk in and find them face-down.
• You may plan to have no clients at all and come to work to find three of them.
• You may expect to be fully booked and find out everyone cancelled at the last minute.
• The business next door will throw a road race and BBQ in your parking lot and not tell you about it.

Life happens.

It's easy to panic and get upset and run in circles, but none of these things accomplish much in the long-run.

• I can't guarantee that anyone is going to take my business cards while they walk up and down Main Street. 
• Probably nobody is going to appreciate the cleanliness of my windows and office. (Though, trust me, they notice when things aren't clean -- they are just too polite to mention it.)
• My landlord is going to have to pry that outlet cover off to fix the hole properly, someday.

But all of these little things add up. They didn't take much time or effort out of my day while my original plans were already thrown out the window.

So when life happens -- when your teachers ask you to do seemingly menial tasks, your boss needs you to come in after giving you the day off, or your client has to cancel due to sudden illness -- go ahead and take a moment to vent about it. 

Then take a deep breath.

Do what needs to be done.

Make the most of the situation.

And then be proud of yourself for remaining flexible and handling things with grace.

Job Hunting for Massage Therapists: the Bare-Bones Basics

"Hi, I have five years experience, give me a call at 207-xxx-xxxx."
"Why should you need more than that?"

An on-point massage may not be enough to land you your first (or next) massage gig. When it comes to job seeking, your first impressions should represent your best efforts at communicating who you are. Potential employers will notice your attention to detail -- and they will certainly notice when you fall short.

Your response to a job ad is, to employers, a simple test: "Can you follow a few very, very simple instructions? Can I trust you to provide world-class customer service or to follow a doctor's order on a complex case?"

How to Job Hunt:

• Before you start your search, sit down with a calendar and mark out the days and times you would be available to give if you got a job. What commitments do you already have in place? Be honest with yourself without stretching yourself too thin.

• Consider your long-term goals. It's easy to focus on needing to get paid right away, but be reasonable in your expectations. Once you start a job, you need to build relationships with your employer, other employees, and the clients you interact with. These relationships and related skills (communication, money-handling, etc.) may take six-months, a year, even two years to build. Be ready and willing to tough out the quiet times -- your dedication will impress those around you. (A steady work history will also help you get auto and personal loans.)

• Read the job description and requirements. If your availability or credentials don't line up with what they're looking for, move on.

• Introduce yourself and show your personality! A cover letter is a nice touch to say hello and answer any basic questions that were brought up in the job ad. It’s a way to let your personality and customer service skills shine. Some examples: What do you bring to the table? (Pun intended.) What are some of your experiences with complex cases? How effective are you at rebooking clients?

• Have a resume. Consider the point of view of the person who will read it. Do a quick Google or Pinterest search for inspiration. Proofread it and then ask someone else to proofread it, too. Send it with your cover letter or when asked; bring a copy or two with you to your interview.

• If you seemingly have no pertinent job experience? Write up a list of your skills: massage-specific, customer service related, sales specialities, computer and social media familiarities, etc. What do you know that would benefit a potential employer and their business?

• Have a list of resources and their contact information -- these should be trusted individuals who can speak to your work ethic and character. Ask their permission, first! You may also need this information for your own sake when filling out job applications. Keep a couple of printed copies on-hand.

• Return phone calls and e-mails in a timely manner. 24-hours, tops. If they ask for something specific, get it to them ASAP.

• Show up for interviews. Be on time. Silence your cell phone. Throw out your gum. Be clean and fragrance-free.

• Be professional in your dress, your words, and your demeanor. You don't need to wear a suit, but please don't wear your pajamas or holiest jeans. Keep your humor appropriate. Stay humble -- don't try to demand a high salary if you only just graduated massage school. (Likewise, don't try to tell them they're missing out on your skills if those skills aren't what they're looking for. I've done that. It's not cute.)

• Clearly communicate your availability and any potential scheduling conflicts that may arise. If you agree to work one schedule and then go back on your word -- for whatever reason -- it makes you look bad, inconveniences clients and other employees, and complicates their business.

• Along with copies of your resume and references, bring a copy of your massage license, proof of liability insurance, and your CPR/First Aid certificate if applicable.

• When in doubt, get a tutor, mentor, or counselor or find a career center to help you bolster your job-seeking skills.

• You are allowed to change your mind -- just give your contact the courtesy of saying, "Sorry, I'm no longer interested."

Job searching can be super intimidating and grueling, an additional source of stress and anxiety on top of other life obligations and monetary insecurities. Knowing that returning calls and e-mails quickly is important and actually following through with it can be complicated by a myriad of reasons. Take a few deep breaths. Call up a friend, mentor, or loved one for a quick pep-talk. And then do it anyway.

It'll all be okay. I promise.