Rogers dietitian helps highlight the need for diversity12/18/20 11:31:am
Kia’ikai “Kai” Iguchi, registered dietitian in adult inpatient Eating Disorder Recovery, was interviewed and featured in a recent article by the New York Times, which highlighted the lack of education, resources, and attention that is devoted to non-Western culture and to people with different body types and identities.
Their contribution emphasized the problems that are caused by not providing identity-affirming care and the discomfort that can be caused by health materials with blatantly feminine imagery. The full article can be found here.
Kai says that they were hesitant at first to accept the interview and worried if the article would align with their and Rogers’ mission and values, but accepted after reviewing the author’s past work to gauge their trustworthiness in discussing the subject.
“This is a topic that we do not talk about enough and it’s been long overdue,” Kai says. “Changing current dietetic curriculum will not happen overnight, but we need to start having conversations about what’s lacking first to make necessary and much needed changes.”
Kai says there is a need for more discussion of how current standard dietetic curriculum can be harmful in treating people with both a diagnosed eating disorder and subclinical disordered eating.
“I believe that this all comes down to us polishing our critical thinking skills and owning our past mistakes,” Kai says. “Think about why things are taught in the way they are now, think what potential harms they can do to folks with marginalized identities, folks with eating disorders, folks in larger bodies, etc. And own our past mistakes and corrective action.”
The topic is one that Kai has a deep passion for, as they hold multiple marginalized identities and have faced adversity in getting where they are today. Despite their experience and education, it was difficult for Kai to find employment. As a non-U.S. citizen, they were under extra pressure due to the requirement to be employed within 90 days of graduation.
“I was extremely lucky that folks from Rogers advocated for me after having had me as a dietetic intern,” they say. “I cannot thank them enough and the only way I can show how much I appreciate is through my work, work ethic, and contributions to things like this highlight, the New York Times article, and many other projects that I am working on.”
As a nonbinary person with other LGBTQIA+ identities, Kai also experiences difficulties in having their correct name and pronouns used, not being able to change their legal name, etc., and is cautious with their gender expression when moving to a new area. Kai says that they’re “very lucky to be mostly surrounded by affirming folks” and is grateful to co-workers who help correct others on their pronouns.
“The other day, my manager at the time pulled someone aside and informed them of my correct pronouns,” Kai says. “This led to this person coming to apologize me directly. This must have taken a lot of courage from everyone, and I very much appreciate this advocacy.”
Understanding patient experience is crucial to quality care
While it’s not possible to fully understand exactly what each patient is going through, Kai says their experience does “inform and affect how I provide care to my patients.” Having grown up in Japan, they can also relate to those who grew up with different cultural backgrounds.
“I recently had a conversation with someone of a similar cultural background about how the concept of self-compassion feels so foreign to many of us because there is simply no direct translation of ‘self-compassion’ in Japanese,” they say. “In some languages, there is no translation for the term ‘Eating Disorders’ either.”
Kai adds that having a background of being marginalized isn’t a “magical way of building rapport with patients” and continuing to educate oneself is crucial for providing multi-dimensional care for our patients. “For example, I need more education and training in working with neurodivergent people. I also have a lot of privileges that I need to continue to recognize.” they say.
For those interested in further education, Kai recommends this article on the difference between affirming and tolerating, and the following resources for providing gender-affirming care:
- A Clinician’s Guide to Gender-Affirming Care: Working with Transgender and Gender Nonconforming Clients
- The Queer and Transgender Resilience Workbook: Skills for Navigating Sexual Orientation and Gender Expression
- A Clinician’s Guide to Gender Identity and Body Image Practical Support for Working with Transgender and Gender-Expansive Clients
- Supporting Transgender Autistic Youth and Adults A Guide for Professionals and Families
- You and Your Gender Identity: A Guide to Discovery
- Sick Enough
- Trans Folx Fighting Eating Disorders
- In a Word That’s Wrong About Us