As a competitive gymnast and representative netballer while growing up, Megan often sought physiotherapy for the management of various sporting injuries. Always inquisitive and fascinated by the human body, she went on to study a Bachelor of Physiotherapy (Hons) at the University of Queensland, from 2009 to 2012.

During this period, Megan began her research journey. She says that despite loving research as an undergraduate, she was keen to obtain some clinical experience before deciding on a career path.

‘After I graduated, I worked as a musculoskeletal physiotherapist for three years; however, my love of research and desire to constantly be learning led me to embark on a PhD in 2016 though the University of Queensland.’ The aim of her thesis was to characterise the clinical presentation of tibialis posterior tendinopathy.

‘During my PhD, I also developed an interest in qualitative research and understanding the more sociocultural aspects of healthcare. This resulted in me developing and leading a qualitative research study looking at the experience of physiotherapy for individuals who identify as lesbian, gay, bisexual, transgender, intersex, queer or related identities (LGBTIQ+)’.

In March this year Megan’s PhD was conferred, and she is working as a postdoctoral research fellow at the RECOVER Injury Research Centre. 

Megan received $9961 through the PRF Seeding Grant to develop an online interactive and educational resource to enhance the provision of physiotherapy care for individuals who identify as LGBTIQ+.

‘This project builds on the study I led that found that people who identify as LGBTIQ+ can experience challenges when attending physiotherapy in Australia,’ Megan says. ‘These challenges were related to assumptions of gender and/or sexuality by their physiotherapist, feelings of discomfort about physical proximity, touch and undressing, fear of discrimination and that their physiotherapists had a general lack of knowledge about LGBTIQ+ specific health issues.

‘There were also instances where people reported that they did not disclose aspects of their lives or health that were relevant to their condition and could have improved the quality of their care. Some people also delayed (or avoided attending) physiotherapy.

‘Participants highlighted a number of ways to improve their physiotherapy experiences and this project builds on this knowledge to develop an educational resource that will hopefully address the knowledge gaps we identified’. 

Megan states that her ultimate aim for this project is to contribute to improving the physiotherapy care for people identifying as LGBTIQ+.

‘We know that poor physical and mental health are pervasive in the LGBTIQ+ population, and that unequal access to healthcare, and discriminatory treatment, continue to exist for LGBTIQ+ people.

Although there were some positive experiences reported, our recent study identified that these issues are relevant for the LGBTIQ+ community when accessing and receiving physiotherapy treatment, specifically. We found that interactions with physiotherapists and the physiotherapy environment may lack inclusivity, which is inconsistent with national and global policies that advocate for inclusive healthcare.

‘I strongly believe that people of all sexual orientations and gender identities deserve equitable access to socially and culturally sensitive healthcare, including physiotherapy. As well as access to high-quality healthcare, equality and freedom from discrimination are fundamental human rights that belong to all people irrespective of gender identity and/or sexuality. Like any health professional, we have a responsibility to care for the wellbeing of all patients, which includes providing a safe environment to discuss all relevant aspects of their bodies and lives.

Improved education of physiotherapists and implementation of participant-suggested changes offer ways forward for improving physiotherapy for LGBTIQ+ people, which is the ultimate focus of this project.’

Explaining why she applied for the PRF Seeding Grant, Megan says it was clear from her previous project that individuals who identify as LGBTIQ+ experience challenges when attending physiotherapy, and there was a lack of physiotherapist knowledge of LGBTIQ+ specific terminology and health issues—and, at times, discrimination currently exists.

‘Rather than create a one-dimensional resource, summarising findings and recommendations for physiotherapists, the PRF grant scheme offered an opportunity to engage an industry partner to scale up and evaluate a more interactive and engaging resource. This topic, improving the provision of culturally and socially competent physiotherapy care for all individuals, regardless of gender identity and/or sexuality, is of particular relevance to the APA and the PRF.

‘The grant has provided me with an opportunity to lead and be successful in a competitive funding scheme before I had even finished my PhD. It has also given me the opportunity to establish my own area of research and research independence, outside my PhD area of work.

'In practical terms, the funding has enabled me to conduct a study with real-world applications, that is, to develop a world-class resource that can have an immediate and positive impact.’

Megan is about to begin phase one of her PRF-funded project— an online questionnaire for Australian physiotherapists to explore attitudes, beliefs and knowledge gaps in relation to provision of care for individuals who identify as LGBTIQ+.

‘This will be followed by interviews with a diverse sample of physiotherapists to enable additional in-depth insights into how these attitudes do (or do not) play out in clinical practice,’ Megan says. 

‘Together the survey and interview data will be used in conjunction with the findings from our previous project with patients to develop the targeted online interactive educational resource. Development of the resource will be completed with a consumer panel of LGBTIQ+ individuals to ensure that it remains relevant and involves pilot testing in a group of physiotherapists. Ethical approval has been obtained and the survey is now available to complete online.’ 

Take part in the questionnaire here: http://tinyurl.com/physioforlgbtiq

Dr Megan Ross is a physiotherapist and postdoctoral fellow at the RECOVER Injury Research Centre, the University of Queensland. Her research focus is in digital health, but she is interested in the experience of LGBTIQ+ and other vulnerable populations, including veterans, accessing and utilising healthcare.