Digging into the Roots of the Problem: Advancing Trans-inclusive Perinatal Healthcare Through Indigenous Knowledge and Decolonising Practice.

Dismantling matrixes of domination that contribute to health inequities for queer and trans people requires acknowledging and attending to all of the oppressive structures which shape health outcomes. Within the context of colonised countries like Aotearoa New Zealand, this means attending to the role that colonisation and Eurocentric views of gender and sexuality play in queer and trans peoples' experiences of marginalisation within healthcare. In this paper we argue that intersectional decolonising approaches to gender and sexuality are central to transforming trans inclusion within healthcare settings. We demonstrate this through drawing on examples from Warming the Whare, a 3-year participatory action research project focused on increasing trans inclusion within perinatal mental health services by centring Te Whare Takatāpui-an Indigenous health and wellbeing framework. Our research practices demonstrate how Indigenous knowledge can be centred within trans-inclusive work to attend to the root causes of marginalisation and harm resulting from colonisation. The examples from our practices illustrate the importance of relational research partnerships, intersectional research teams and being accountable for our research practice as necessary ways to get to these root causes of harm. We do not present ourselves as perfect examples of decolonising research practice; instead, we position ourselves as taking up the call for continued learning and reflection that drives decolonising practice in research. We present our work as an example of what queer medical humanities might offer the broader discipline of medical humanities, calling for innovation, intersectionality and changes that centre and support the humanisation of healthcare.