Occupational therapists must consider the unique needs of transgender clients to create an inclusive healthcare environment that respects individual identities. Several recent legislation restrict various liberties, including medical treatments, bathroom usage, and preferred pronoun recognition. Transgender individuals often face distinct challenges related to mental health, social support, and healthcare access.  Occupational therapists play a vital role in addressing these challenges by tailoring intervention plans to meet the specific needs of transgender clients, which may include assistance with daily activities and serving as advocates. By embracing cultural humility and gender-affirming care, occupational therapists contribute to the well-being and empowerment of transgender clients, promoting healthier and more fulfilling lives.ResourcesPhiladelphia Trans Wellness ConferenceFenway Health & Harvard University “Advancing Excellence in Sexual Minority Healthcare”Harvard online course “LGBTQ Health Issues” ReferencesGender identity and expression. (2016, April 16). [PowerPoint slides]. Retrieved from personal email from PFLAG Health Disparities. (2015, September 1). [blog post]. Retrieved from https://www.cdc.gov/healthyyouth/disparities/index.htmHuman Rights Campaign & Trans People of Color Coalition. (2017). A time to act: Fatal violence against transgender people in America 2017. San Francisco, CA: Lee, M. Lynn, M. (2017). Here’s what transgender people with disabilities want you to know. BuzzFeed, Retrieved from https://www.buzzfeed.com/mahdialynn/heres-what-disabled-transgender-people-want-you-to-know? utm_term=.fdrrNNQX5m#.jbdx00AzGXNational Center for Transgender Equality and the National Gay and Lesbian Task Force. (2011). National transgender discrimination survey. Washington, DC: Grant, J. M., Mottet, L. A., Tanis, J., Herman, J. L., Harrison, J., & Keisling, M. National LGBTQ Health Education Center: Fenway Health. (2016). Affirmative care for transgender and gender non-conforming: Best practice for front-line health care staff. Boston, MAOccupational Therapy’s Commitment to Nondiscrimination and Inclusion. (2014). American Journal of Occupational Therapy, 68(Supplement_3), S23-4. Pan, L. & Moore, A. (n.d.). The gender unicorn. [blog post]. Retrieved from http://www.transstudent.org/genderParekh, R., (2016, February). What is gender dysphoria? [blog post]. Retrieved from https://www.psychiatry.org/patients-families/gender-dysphoria/what-is-gender-dysphoriaSingular ‘they’. (2018). [blog post]. Retrieved from https://www.merriam-webster.com/words-at-play/singular-nonbinary-theyState Maps of Laws and Policies. (2019). [blog post]. Retrieved from https://www.hrc.org/state-maps/transgender-healthcareUnderstanding the transgender community. (2018). [blog post]. Retrieved from https://www.hrc.org/resources/understanding-the-transgender-communityViolence against the transgender community in 2018 (n.d.). Retrieved from https://www.hrc.org/resources/violence-against-the-transgender-community-in-2018

Occupational therapy can provide services in many different areas within the prison system. From providing transitional services to inmates getting ready to be released, to focusing on occupational deprivation, to leading groups for an infinite number of topics.  This episode features Ariana Gonzalez, an occupational therapist, executive director, and founder of Life After Incarceration: Transition & Reentry (LAITR), an occupational therapy community-based program focused on reentry for individuals after incarceration. To learn more about Ariana Gonzalez and LAITR visit https://www.lifeafterincarceration.com/References Criminal justice data. The Sentencing Project. (2023, January 25). Retrieved July 29, 2023, from https://www.sentencingproject.org/research/us-criminal-justice-data/Dillon, M. B., Dillon, T. H., Griffiths, T., Prusnek, L., & Tippie, M. (2020). The distinct value of occupational therapy in corrections: Implementation of a life skills program in a county jail. Annals of International Occupational Therapy, 3(4), 185. https://doi.org/10.3928/24761222-20200309-01Gonzalez, A., & Tyminski, Q. (2020). Sleep deprivation in an American homeless population. Sleep Health: Journal of the National Sleep Foundation, 6(4), 489–494. https://doi.org/10.1016/j.sleh.2020.01.002Jaegers, L. A., Dieleman, C., Dillon, M. B., Rogers, S., Muñoz, J. P., & Barney, K. F. (2020). Justice-based occupational therapy initiative: Advancing occupational justice in criminal justice systems. Annals of International Occupational Therapy, 3(4), 200+. https://link.gale.com/apps/doc/A676585517/AONE?u=mlin_m_regis&sid=ebsco&xid=ed5dd4dbMuñoz, J. P., Moreton, E. M., & Sitterly, A. M. (2016). The scope of practice of occupational therapy in U.S. criminal justice settings. Occupational Therapy International, 23(3), 241–254. https://doi.org/10.1002/oti.1427 Tucker, S. (2020). Access to OT in the prison system: Assessing attitudes of OT students and practitioners...2020 American occupational therapy association annual conference & expo. American Journal of Occupational Therapy, 74(Sup1), 1. https://doi.org/10.5014/ajot.2020.74S1-PO1510Tyminski, Q., Gonzalez, A., & Synovec, C. E. (2020). The importance of health management and maintenance occupations while homeless: A case study. Work, 65(2), 297–301. https://doi.org/10.3233/WOR-203081Special thanks to Parker Sheridan for the background research!

By the end of 2022, a record-breaking number of people — 108.4 million — have been forced to flee their homes.  Refugees are people who are forced to flee from their country of origin due to violence, oppression, or substantiated fear of persecution based on sexual orientation, gender identity, race, religion, nationality, membership in a group, or expression of certain political opinions.Refugees experience occupational deprivation which is defined as a condition where an individual is unable to engage in meaningful occupations due to enforced contextual factors such as a lack of sources of sustenance, support, and services, diminished safety, and separation/loss of family members.  When occupational injustice occurs, humans as occupational beings are hindered from their right to have equal opportunities to participate in meaningful occupations that meet their occupational needs. Jill Maglio, an occupational therapist, is currently working with refugees in Greece on a CircusAid project.  She is the founding Director, Educator, and Occupational Therapist of both Holistic Circus Therapy and CircusAid, which are social circus programs that utilize circus activities as a therapeutic tool to increase occupational participation. Her work is nuanced with all the shifting barriers and bureaucracies in place but instills joy and laughter.  Her work promotes social connectedness and efficacy, as well as a possible reprieve from their distressing circumstances.For more information on Jill Maglio's work with refugees - https://www.circusaid.com/ Follow CircusAid on Instagram - https://www.instagram.com/circusaid/?igshid=OGQ5ZDc2ODk2ZA%3D%3DFor more information about circus as a therapeutic tool - https://www.holisticcircustherapy.com/References Darawsheh, W. B., Bewernitz, M., Tabbaa, S., & Justiss, M. (2022). Factors Shaping Occupational Injustice among Resettled Syrian Refugees in the United States. Occupational Therapy International, vol. 2022, Article ID 2846896. https://doi.org/10.1155/2022/2846896Maglio, J. & McKinstry, C. (2008). Occupational therapy and circus: Potential partners in enhancing the health and well-being of today’s youth. Australian Occupational Therapy Journal, 55, 287–290. https://doi.org/10.1111/j.1440-1630.2007.00713.xR. El-Bialy and S. Mulay, (2015). Two sides of the same coin: factors that support and challenge the wellbeing of refugees resettled in a small urban center. Health & Place, 35, 52–59. https://doi.org/10.1016/j.healthplace.2015.06.009The UN Refugee Agency. (14 June, 2023) Refugee data finder. UNHCR. https://www.unhcr.org/refugee-statistics/

In June 2022, the Supreme Court's decision on Dobbs v. Jackson Women's Health Organization turned the right to obtain or not obtain an abortion over to the states, which is very nuanced.  It is more than just a restriction of women’s rights but in some states, there is an aspect of criminalization.  This presents complications for occupational therapy practitioners in terms of how we practice with our Occupational Therapy Practice Framework, how we address occupational risk factors, and how it obscures our Occupational Therapy Code of Ethics.  Darya Nemati and Delany McKee, Boston University Occupational Therapy Doctoral Candidates, share their emerging research on recent changes in abortion laws and how these laws might influence occupational therapy practice. References Abdelfatah, R. & Araboluei, R. (Hosts). (2022, June 16). After Roe: A new battlefield [Audio podcast episode]. In Throughline. NPR. https://www.npr.org/2022/06/15/1105245445/after-roe-a-new-battlefieldAbdelfatah, R. & Araboluei, R. (Hosts). (2022, May 19). Before Roe: The physician’s crusade [Audio podcast episode]. In Throughline. NPR. https://www.npr.org/2022/05/18/1099795225/before-roe-the-physicians-crusadeAmerican Occupational Therapy Association. (2020). AOTA 2020 Occupational Therapy Code of Ethics. American Journal of Occupational Therapy, 74(Suppl. 3), 7413410005.  https://doi.org/10.5014/ajot.2020.74S3006American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), 7412410010. https://doi.org/10.5014/ajot.2020.74S2001Beddoe, L. (2022). Reproductive justice, abortion rights, and social work, Critical and Radical Social Work, 10(1), 7-22. Retrieved June 15, 2023, from https://doi.org/10.1332/204986021X16355170868404Levenson, M. (2023, June 24). Five things to know one year after the Dobbs decision. The New York Times. https://www.nytimes.com/2023/06/24/us/politics/roe-wade-anniversary-dobbs.htmlReagan, L. (2018, January 22). Roe made abortions legal, but it doesn't keep women and providers safe. HuffPost. https://www.huffpost.com/entry/reagan-opinion-roe-wade-harassment_n_5a63d88ee4b0dc592a096aa1?section=us_opinion

Toni Solaru OT, OTD, OTR talks about the unknown history of occupational therapy.  Dr. Solaru is a community-based mental health OT and the co-founder and Chair of Diverse-OT National, an organization dedicated to advancing the cultural climate within the OT profession and strives to create a community of critically reflexive OT(A)s and students. To follow Diverse-OT National on Instagram - https://www.instagram.com/diverseot_national/?hl=enTo access the full interview on YouTube – https://youtu.be/Au8sreLe8IEReferences American Occupational Therapy Association. (1953, November). Report of the Subcommittee on Schools and Curriculum. (Available from the Wilma L. West Library, 4720 Montgomery Lane, Bethesda, Maryland 20814)Black, R. M. (2002). Occupational therapy’s dance with diversity. American Journal of Occupational Therapy, 56, 140–148.Black History Milestones. (2019). LifeHistory.com. Retrieved from https://www.history.com /topics/black-history/black-history-milestonesBolden, J. A. (1993). Differential occupational outcomes among African American and white women in female-dominated professions: The case of occupational therapy. Unpublished doctoral dissertation, Boston University.Robinson, L. (2000). The Black occupational therapy caucus: The first 25 Years. Black Occupational Therapy Caucus.Skyberg, R., Grubb, Rachel. (2019). Evolution of occupational therapy practice: Life history of Lela Llorens, Ph.D., OTR/Ret, FAOTA.. Oral History Student Papers. 54.Wells, S. A., & Whiting, F. (1998, March). A celebration of diversity: Reviewing AOTA’s progress toward creating a more diverse profession. OT Practice, 2, 31–34.http://www.otcentennial.org/https://www.cleveland.com/news/2022/10/ex-cleveland-schools-therapist-who-rioted-at-us-capitol-on-jan-6-seeks-mercy-from-court.html

Victor Calise has had a diverse career path—he has gone from plumber to Paralympian to Policymaker.  He competed in sled hockey in the 1998 Paralympics in Nagano, Japan.  He worked for the NYC Department of Parks and Recreation.  He was appointed the Commissioner of the Mayor's Office for People with Disabilities by Mayor Michael Bloomberg, and then reappointed by Mayor Bill De Blasio, and reappointed again by Mayor Eric Adams.  He recently took on a new role as Director of Global Culture, Diversity, Equity and Inclusion at Walmart’s newly formed Accessibility Center of Excellence. Here are some additional links for the accessible accomplishments in NYC - Accessible NYC and Judy Heumann's #ManCrushMonday about Victor Calise.

As occupational therapy practitioners, we understand disability within the context of diversity, equity, and inclusion. In this two-part episode, occupational therapy student Meaghan Lawrence discusses the program, Empower Spinal Cord Injury (SCI) which supports individuals who have had an injury to their spinal cord. In the traditional rehabilitation model in the United States, rehabilitation stops a few months after injury. Often after discharge is when true rehabilitation needs to occur because the initial shock and comorbid conditions have diminished.  Through Empower SCI, the participants have the opportunity to take part in a more meaningful rehabilitation.Special Thanks to Meaghan Lawrence for writing and interviewing and special thanks to Michael Manhardt for sharing the Empower SCI story.  For more information about Empower SCI, please visit their website.

As occupational therapy practitioners, we understand disability within the context of diversity, equity, and inclusion. In this two-part episode, occupational therapy student Meaghan Lawrence discusses the program, Empower Spinal Cord Injury (SCI) which supports individuals who have had an injury to their spinal cord. In the traditional rehabilitation model in the United States, rehabilitation stops a few months after injury. Often after discharge is when true rehabilitation needs to occur because the initial shock and comorbid conditions have diminished.  Through Empower SCI, the participants have the opportunity to take part in a more meaningful rehabilitation.Special Thanks to Meaghan Lawrence for writing and interviewing and special thanks to Elizabeth Lima Remillard for sharing the Empower SCI story.  In our next episode Meaghan will interview, Michael Manhardt, who was a participant and peer mentor at Empower SCI. For more information about Empower SCI, please visit their website.

Dr. Ana Malfitano’s career is focused on Social Occupational Therapy, which has been developed in Brazil to repair various inequities and injustices. In Dr. Malfitano’s World Federation of Occupational Therapy 2022 Keynote address, she turns the lens of occupational therapy onto the idea of anthropophagy.  This concept was developed in The Manifesto Anthropophagic, by Oswald de Andrade, which proposes that metacognitive knowledge stems from alterity.  In a world where we coexist with many other cultures—understanding the “other” and consuming this knowledge, builds new understanding.  In this discussion of anthropophagy and its application in social occupational therapy, we question the construction of our therapeutic position and purpose.  Today’s world is fraught with relentless social inequalities and rather than cancel the colonial origins, perhaps recognition of the plurality of our histories & cultures, and questioning our actions will unite us in working towards a social life.Image: Abaporu, 1928 by Tarsila do Amaral 

In the United States the profession of occupational therapy was established in 1917 and in the UK it was established in 1922 but in Arab countries, like Jordan, Morocco, Saudi Arabia, Lebanon, Palestine, Kuwait, and others, occupational therapy was established less than 40 years ago. And most Arab countries saw the establishment of occupational therapy within the last 25 years.Of course, as the profession grew in Arab nations, theories, and models were brought in from Western countries that emphasized practices that had been developed in very different contexts.  These ideas about human occupation and its connection to health and wellness had to be translated and made to fit into the Arab culture.  These theories and models stem from the well-educated, privileged social positions, able-bodied, white Anglophones, who identify with Judeo-Christian cultural backgrounds.When Dr. Razan Hamed was studying occupational therapy at the University of Jordan, she noticed that some occupational therapy evaluations were missing some important aspects of Muslim life while holding onto items that were irrelevant in Jordan.  She set her sights on the Performance Assessment of Self-Care Skills or PASS and created the A-PASS, the Arabic Performance Assessment of Self-Care Skills