Transgender Athletes' Experiences With Health Care in the Athletic Training Setting

Abstract

Context: The term transgender refers to individuals whose gender identity does not match their sex assigned at birth. Transgender people often report negative health care experiences, leading many to avoid seeking care. The experiences of transgender athletes with athletic trainers (ATs) are currently unknown.

Objective: To describe common experiences they have had with ATs and to identify barriers transgender athletes may encounter when seeking care.

Design: Qualitative phenomenologic study.

Setting: Individual phone interviews.

Patients or other participants: Nine transgender participants from high school (n = 2), collegiate (n = 4), club (n = 2), and semiprofessional (n = 1) athletics (age = 23.56 ± 5.32 years). Participants were either current athletes or had been athletes within the past 5 years. They consisted of transgender men (n = 3), transgender women (n = 3), and nonbinary or genderqueer people (n = 4), with 1 participant identifying as both a transgender man and nonbinary.

Data collection and analysis: Participants completed semistructured phone interviews that addressed positive and negative experiences, avoidance, and perceived AT knowledge of transgender concerns. The interviews were analyzed for themes and evaluated with a peer reviewer. Member checking was conducted to validate the findings.

Results: Three main themes emerged. Education described ATs' knowledge of transgender concerns and receptiveness to learning. Primacy of the patient addressed ATs' behaviors when interacting with transgender athletes. Environment involved how social environments affected transgender athletes' comfort with ATs. Participants commonly perceived a lack of clinician education on transgender needs, which combined with a lack of support or hostile environment to lead to discomfort and avoidance. Respecting privacy, demonstrating support, and being open to education led to positive experiences.

Conclusions: Athletic trainers can improve their care of transgender athletes in several areas. Information about transgender people should be included in athletic training curriculums. Athletic trainers can also use inclusive language, signal that facilities are safe for all, and be familiar with resources for transgender athletes.

Keywords: bisexual; gay; gender minority; lesbian; transgender individuals; inclusion.