This publication is designed to support health centers in providing affirming care and
services for Two Spirit and LGBTQIA+ American Indian/Alaska Native (AI/AN) people.

Two Spirit describes an Indigenous person who expresses their gender identity, spiritual identity, or social role in a traditional, non-Western way. The term Two Spirit was developed by LGTBQIA+ AI/AN activists in 1990 as way to unify tribal traditions that
historically embraced diversity and fluidity of gender identities and sexual orientations.