Guest speaker tells IHP community that “healthcare is a human right for people of all sizes.”

Viral, size-inclusive sex therapist Sonalee Rashatwar — popularly known as @thefatsextherapist on social media — joined students and faculty at the MGH Institute on June 17 for a conversation on fatphobia in the medical field, as part of the Institute’s Pride Month event series. 

“Pride Month is an opportunity to uplift underrepresented voices within the LGBTQ+ community,” noted Callie Watkins Liu, the Institute’s director of JEDI education and programs. “Sonalee’s intersectional story should encourage present and future generations of healthcare workers to untangle their own biases against people of size.”

Chief equity officer Kimberly Truong said she invited Rashatwar to the IHP after having “multiple conversations” with students about fatphobia and misconceptions surrounding the LGBTQ+ community.  “We thought discussing this topic would give students a deep dive into how fatphobia exists in society and the health field, and how we can change things,” said Truong.

Rashatwar, who is nonbinary and uses “they” and “he pronouns, serves many LGBTQ+ clients who self-identify as “fat.” Together, they work towards dispelling the notions of fatphobia during sessions at Rashatwar’s counseling practice, the Radical Therapy Center. 

Throughout their presentation on size-inclusive healthcare, Rashatwar identified examples of fatphobia in the medical field and encouraged listeners to “pull that black and white thinking apart.”

“Food and exercise choices are not moral choices. We don’t have to deem them as good or bad,” Rashatwar told attendees.

Patients notice healthcare providers’ assumptions about their weight, explained Rashatwar, who identifies as “superfat,” meaning they wear clothing sizes 4X to 5X. They referenced an AMA Journal of Ethics report which compiled survey results indicating that doctors are the second most common source of weight-related stigma, behind family members. The same study found that many fat people turn to eating as a coping mechanism after experiencing fatphobia. 

“It's really important that we encourage fat people to accept and respect their bodies, only so that they are well motivated to care for those bodies,” Rashatwar said. “Healthcare is a human right for people of all sizes, including those at the highest end of the size spectrum.” 

Members of the Institute’s Coalition of OT Advocates for Diversity (COTAD) held a viewing party to watch the virtual event, which they co-sponsored alongside the KinsIHP club for LGBTQ+ students and allies. 

Karina Absalon, a second-year Doctor of Occupational Therapy student who is chair of COTAD’s community collaboration and a JEDI Fellow, said Rashatwar’s remarks underscored the importance of client-centered care, which she described as one of the main priorities of occupational therapy. 

“You never know what type of person you're going to work with and what sort of background they're going to come from,” Absalon noted. “As aspiring OTs, our role is to consider the whole person, and celebrating diversity is a huge part of that, whether that be looking at diversity through the lens of race, through gender identity, or through disability.” 

Kaelyn Mills, a member of KinsIHP and co-chair of COTAD, stressed the importance of learning about fatphobia directly from a self-identified fat person. 

“The literature and research are still emerging on best practices for size-inclusive healthcare,” added Mills, who also attended the JEDI Office’s Pride Reception on June 21. “Right now, the biggest thing that we can get outside of academia is people’s experiences and testimonies and what they found to be most meaningful for them.” 

For Rashatwar, simply using the word “fat” unashamedly without a negative connotation has been a meaningful step towards counteracting fatphobia — in the healthcare world and beyond. 

“When you have a stack of pancakes, you want a fat stack of pancakes. When you're getting a paycheck, a fat paycheck is a pretty nice paycheck,” Rashatwar told attendees. “Some things are so glorious and wonderful when they are fat.” 

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