Transgender and Nonbinary Pelvic Health – An interview with Heather Edwards and Tuesday Feral

Pelvic Guru Academy is offering three 2-day courses on Transgender and Nonbinary Pelvic Health this year. It’s going to be instructed by a team, both of which are enthusiastically queer and really like to dig in with the nerdy awesomeness of anatomy, sexuality, gender, and our current social structure. Heather (a pelvic PT and sex counselor) and Tuesday (licensed mental health counselor and educator) have been friends for years and this course is a natural evolution of both of their passions colliding into one hot-mess-of-a-weekend that will likely be loads of fun while challenging participants to search for deeper understanding of the transgender and nonbinary experience in the US in 2019. We caught up with them for an interview about how they met and why they’re teaching this course. Check it out below!

Courses for 2019:

Asheville, NC July 20-21

Portland, OR August 17-18

Phoenix, AZ November 2-3, 2019

The Interview:

PG: Tuesday and Heather, how did the two of you meet and decide to teach together?

Heather: Tuesday showed up to an event that I was hosting. The FIRST Vino & Vulvas in January 2015, actually. I was nervous about it because I was trying to do this public sex education event that was focused on bodies with vulvas and vaginas but was not trying to target women. I hadn’t ever seen that done before and felt a lot like I was on uncharted territory. Tuesday showed up in a pair of jeans and a green t-shirt that said “I eat glitter for breakfast”.

Tuesday has a gender presentation that makes many scratch their heads… but when I saw Tuesday, I remember thinking, “Yes!! That’s it!! That’s what I’ve been missing all my life”! We had a conversation about them being on a panel at some point to talk about vulvovaginal stuff without it being all feminized and they were extremely game. Tuesday has been on my panels multiple times since then and is absolutely a crowd favorite – for good reason! They have a way of dropping truth-bombs in ways that people can receive them in immediately tangible ways. I often tell them, “I can’t wait until you’re super-famous”.

Tuesday: I’m always curious about accessible sexual health education, especially when it’s potentially trans-inclusive, so I went to Vino & Vulvas to check it out and see what it was all about. I’m a total nerd for understanding how bodies work, talking about taboo things, and pretty much anything that empowers people with vulvas to have more knowledge about how their bodies function.  Especially when it’s in a format that’s not horribly transphobic and gender essentialist!

Anyway, I went to check it out and it was great! Nerdy, fun, accessible, empowered, and yes, even trans-inclusive in ways that didn’t feel tokenizing. Heather and I met, she asked me to be on a future panel, I loved it and kept doing it whenever possible and, as they say, the rest is history.

Since then we’ve been geeking out on trans pelvic health and other related topics as often as possible, and a natural evolution of that was creating workshops together. So basically Heather has been giving me a voice on these panels, in these workshops, and doing her darndest to make me famous ever since! 😉

Heather: Honestly, Tuesday, I’m just so glad you keep saying “YES!” to all of my crazy shenanigans. 🙂

PG: How did you become interested in transgender pelvic health?

Tuesday: I’m pretty sure that being a trans person with a pelvis who also interacts with other nonbinary and trans people (and when I’m lucky, their pelvises) gives me an understandable interest in trans pelvic health. 😉

But, really, on a more serious note, I have worked with nonbinary and trans people for well over a decade now and I see the barriers we have to accessing any kind of competent care and how much mistreatment we often face in medical settings and how much damage this can cause. When you see that reality and then consider the extra layer of vulnerability required from trans people in accessing any kind of pelvic healthcare, it’s pretty heartbreaking to consider how many of us will not be able to find competent care even if we can manage to find the courage to seek it out. It inspired me to want to help providers to cultivate cultural humility and hopefully reduce these all-too-common barriers to competent care for nonbinary and trans people.

Heather: If I hear that “X is great for 98% of the population”, my reaction is nearly always, “but what about the other 2%? What are we doing for them”? Having had experiences of my own gender that leave me often feeling like an outsider in “women’s groups” and often falling outside of medical heteronormativity as a queer person, I realize that it sucks to continually have to “come out” as different from the preconceived narratives forced on us by societal categories and norms.

So, to me, if I could figure out how to make pelvic health care more competent and compassionate for queer, trans, and nonbinary folks, I could contribute to a system that grants freedom for EVERYONE. So… I started talking about it. And I asked friends like Tuesday to help me out.

PG: What are the most common questions that come up for pelvic health providers in regards to transgender pelvic health?

Heather: The most common question is almost always something like “Help! I’ve got a transgender man(?) I don’t know… they had a vaginoplasty and now they’re on my schedule and I don’t know what to do”! So, even at the level of not understanding what a “trans man” or a “trans woman” is, people have questions. There tends to be this idea that just treating all people kindly is good enough, but having a therapist that doesn’t even understand a single thing about your gender is a pretty fundamental flaw in the system. This is where the well-meaners will then ask lots of questions about a person’s gender as a sign of acceptance, but it’s one of the biggest issues that trans people face when trying to get health care. They go in for pelvic pain but then spend a great deal of their limited time educating their doctor about their body. We need more competent providers!

PG: Is your course mostly about transgender surgeries?

Heather: No! We will absolutely cover transgender surgeries (vaginoplasty, phalloplasty, metoidioplasty, etc.) however this course will be focused also on the issues to consider when folk have non-aligning genitals and how to provide thorough and competent care for all genders. We’ll also talk a good deal about sexuality and understanding how to open up conversations about sexuality and sexual function that stay far away from heteronormative narratives.

Tuesday: Most of what I bring to the table is actually about person-centered care that is grounded in the trauma-informed cultural humility required to create a welcoming, affirming place for nonbinary and trans folks in your practice. As a nice bonus, these tools will help your relationships with the cisgender* people you serve, too!

(*cisgender = someone who is not trans/nonbinary)

PG: For therapists who don’t usually see trans patients, is there any reason to take this course?

Heather: Absolutely. This course really is about how to change the way you practice so that you’re not making assumptions about people based on their gender.  It’s about learning how to connect more authentically with all of your patients! There will be time to answer questions and have discussions. This topic is often challenging with some concepts that are sometimes hard to grasp. Believe me, I’ve been doing this work for a while and occasionally I still feel I’m going through “concept childbirth” to let something settle into my working knowledge. There’s probably more to UNLEARN than learn, really.

Tuesday: For sure! For one thing, you never know when a nonbinary or trans person is going to show up in your office/practice! You might even already have some nonbinary and/or trans folks in your practice without even knowing it (you truly CAN’T always tell just by looking, even if you are looking at our pelvises). But even aside from that, the majority of what we’ll be discussing will be useful in working with any clients, especially any clients from marginalized groups.

PG: If you could list one takeaway you would like participants to go home with after your course, what would it be?

Tuesday: Let’s see, I want you to have more comfort in your interacting with gender; both your own gender and others’, and more ideas of ways to engage with nonbinary and trans folks that are affirming and empowering. I want to give information to help you avoid making common mistakes AND tools for making repairs when you flub it up.

Heather: There are so many people out there who need us and have so many barriers to make that happen. Just sticking a rainbow sticker isn’t enough! I would argue that we’re on this planet to connect with one another. Transgender and nonbinary people really need us right now. Let’s make sure we show up in the best way!!

PG: I see that there’s an additional event about therapeutic kink? That sounds fun! Tell us more about that!

Tuesday: Honestly this is one of my favorite things to nerd out about, lolz! I think that there is SO much potential for empowerment and healing for people to be gained by approaching sex and ways of relating through a BDSM negotiation type framework. Even (and maybe especially??) for vanilla folks, looking at communication about ways of engaging in relationships and sexual encounters through this lens can be incredibly enlightening and empowering. Basically, I want to explore ways that we can bring “agreements”/expectations/communication (and lack thereof) that are usually implicit or assumed into an explicit and intentional place for people, whether they are kinky or not!

Heather: Yes! For the Asheville event, there will be an official Vino & Vulvas event to talk about this with folks in the BDSM scene on Saturday night. This is a topic that is near and dear to my heart and I LOVE talking about it with Tuesday, we’re going to make sure that we include a conversation about this at Saturday night dinner at each course we teach. We’re still getting the details together, but we’ll make sure we get to cover some kinky talk in each venue.

More information on the courses can be found here:

Asheville, NC July 20-21

Portland, OR August 17-18

Phoenix, AZ November 2-3, 2019

More information about Tuesday and Heather

Heather Edwards, PT, CSC (she/her or they/them) has been a pelvic physical therapist for 15 years in western North Carolina. She is a University of Michigan trained Sexuality Counselor and Educator and nationally certified by the American Association of Sex Educators, Counselors, and Therapists (AASECT) as a Sex Counselor (CSC). She founded Vino & Vulvas in 2015 and it quickly became her favorite thing to do. She teaches community classes such as “Field Guide to Your Crotch” and “How to Talk to Your Doctor about Your Nonbinary Crotch” for transgender and nonbinary folx. Heather created the Transgender Pelvic Health Survey (currently in progress) and teamed up with Nova Southeastern University and the Pelvic Health Research Initiative for its implementation and data analysis. In 2016, she presented at the Southeastern Transgender Health Summit on the topic of pelvic PT considerations for the surgical trans patient. She presented at the 2018 AASECT conference on the topic of BDSM/Kink and Pelvic Health and then in January 2019, presented as part of a team on transgender health at the American Physical Therapy Associations Combined Sections Meeting for a pre-conference workshop.

Despite all the clinical stuff, Heather considers herself an artist… and if truth be told, she’d love to just draw fantastical crotch doodles and outside-the-box anatomy illustrations all day. This unusual hobby led to the creation of her first self-published book, Important Parts: A Coloring Book for the Crotch Enthusiast. She’s in the process of the second one in the series.

Mx. Tuesday V. Feral (they/them) is an artist, mental health professional, and educator and Support Programs Director for Tranzmission, an Asheville-based organization that does education, advocacy, and support for the transgender and nonbinary community in western North Carolina and beyond. They have worked with Tranzmission for the last ten years. Tuesday is passionate about building resilient networks of support within our extended community. To that end, they oversee the Asheville Transformers peer support and social group and the Youth and Family Program. Tuesday has trained on a national, state and local level with Tranzmission. Tuesday is also a frequent, and crowd-favorite panelist on Vino & Vulvas for their ability to present and package difficult concepts in such a tangible way that can easily be taken directly to heart.

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