You Can Start an LGBTQ+-Friendly Niche Practice

How to engage the community effectively and empathetically

By Lizzie Bellinger, PT, DPT

In March 2023, I turned the key in the door of my new private practice. I moved in my treatment table and waiting room chairs — and also a sheet of pronoun stickers and a Pride Flag.

I had a vision to provide top-notch physical therapy to Baltimore’s LGBTQ+ population, but also a hefty dose of doubt. Would my target market be too narrow, limiting my referral base? Would the carefully crafted gender and pronoun questions on my intake form offend someone, or confuse cis people? Was there even a need for this type of care in Baltimore City?

My fears turned out to be baseless. As the caseload grew, LGBTQ+ patients started referring their friends, and I had to pinch myself to make sure it was all real.

The numbers speak for themselves. The practice’s revenue exceeded its monthly expenses within three months. The schedule was full with a waiting list in the fourth month. I just hired a physical therapist to join my little team.

More than 50% of our patients self-identify as LGBTQ+.

The product I offer appeals to the population here, and I believe this model can work for other practices, too.

NICHE PRACTICE: YES YOU CAN

If you want to create an explicitly LGBTQ+-friendly space, let go of the idea of being “everyone’s therapist.” Think of WalMart’s “low price promise.” People who are willing to spend more for higher quality products can shop somewhere else; WalMart doesn’t market to them.

It’s working.

Use your inclusive philosophy to guide your business decisions. Pick a documentation system that highlights pronouns and gender identity on both the intake form and the schedule. Choose a relevant logo and a practice name that evokes inclusion. Write a mission statement that explicitly states who you intend to serve and include it in your business plan.

Practice your elevator speech. Once, at a marketing event, someone asked me, “Why queer physical therapy?” I took a breath, knowing this was a critical opportunity to define my practice niche. “Queer folks have different needs than straight/cis folks,” I said. “I’m trying to provide services that meet those needs.” It can be as simple as that.

DO MARKET RESEARCH

Once you establish your target population, find out who else in your area is marketing to them. If gender-affirming care is legal in your state, find out which surgeons and primary care doctors specialize in gender diverse patients. If state laws prohibit gender affirming care, you’ll need to find providers that, like you, make LGBTQ+ folks feel comfortable enough to seek them out. Try acupuncturists, chiropractors, and talk therapists. Expand your professional network.

If other physical therapy practices are marketing to the LGBTQ+ population in your area, find out everything you can about them. Do they accept insurance? Do they offer specialty services like dry needling, cupping, or pelvic floor therapy? How far are they from your practice location? Get to know the providers. If they’re not in your social network, offer something concrete to get them to talk to you, such as referring patients to their specialty services or giving them free seats in a CEU course you teach.

Strategies like these have contributed to the rapid growth of my practice. Within Baltimore city limits, there are two pelvic floor practices that market to LGBTQ+ patients. I talked over Zoom with a physical therapist at one of these practices, and within a few weeks I started seeing referrals from them.

WHAT ARE THE KEY INGREDIENTS?

The first ingredient is you. Your genuine desire to create an inclusive space will guide your decisions in hiring, choosing continuing education opportunities for yourself and your staff, and even decorating your practice.

In order to create inclusive practice policies, you’ll need structured guidance. The Health Equality Index (HEI) is an established set of recommendations for inclusive healthcare practices. It’s geared towards large organizations, but small practices can use it as a guide. It’ll get you thinking about aspects you might not have considered, such as internal policies for employees undergoing gender transition or caring for children they’re not biologically related to.

MARKETING

Find your local LGBTQ+ community, then go where they go. Tap your professional network; providers who already care for LGBTQ+ folks may be aware of upcoming events or help you reserve a table at the local Pride celebration. In Baltimore, I offered free 15-minute screenings at Queer Climb Night at the local climbing gym and at a craft show called Queer-Made Market. These events resulted in 12 new patient conversions before my doors even opened.

If you identify as LGBTQ+, you’ll have more access to queer spaces. In Baltimore, there is a closed Facebook group for members of the queer community. When my practice opened, I posted there, and many of my new patients mentioned that was how they heard about me. I also posted my job listings there and have gotten applicants for both administrative and physical therapy positions as a result.

Personal experience with your local LGBTQ+ community will give you a sense of the local population’s needs, interests, and conventions. If you aren’t active in the community yourself, talk with trusted folks in your social or professional network about local trends. For example, LGBTQ+ communities in Baltimore are finding community in sports and activity groups rather than bars and restaurants. That’s an opportunity for me to do some targeted marketing, such as an injury prevention clinic or sports conditioning workshop.

WHO CAN DO IT?

New practices can start from scratch, making each business decision with the LGBTQ+ community in mind. But established practices can start LGBTQ+ programs, too. If you’re not the practice owner, make sure they’re on board. Prepare a presentation outlining the scope of the work that needs to be done to get the project off the ground, including staff training, marketing, and website or social media development.

Market the endeavor as your practice’s new LGBTQ+ program. Make your presence known at queer events and on social media; market hard at the start to build momentum. Once you reach enough people, there will be a tipping point and word-of-mouth referrals will do the rest of the work for you.

Lizzie Bellinger, PT, DPT, OCS, COMT, owns Alliance Physical Therapy in Baltimore and teaches as adjunct faculty in the University of Maryland Baltimore DPT program. When she’s not wearing her practice owner hat, she’s doing partner acrobatics and working on a memoir. She can be contacted at lizzie@allianceptbaltimore.com or @allianceptbaltimore on Facebook and Instagram.