The intersection of sports and gender has long been a complicated one. As the weather warms up, so do the training and health needs of LGBTQ+ athletes.

Athletic trainers (ATs) play a critical role in the lives of LGBTQ+ athletes. Their services are aimed at supporting both the mental and physical health of the athletes they work with. In an environment hyper-focused on gender, a group of AT researchers is now working to change how their profession serves transgender athletes.

Recent research out of the Center for Sexual Health Promotion at Indiana University produced a short 10-question survey to assess AT attitudes towards trans athletes. The Attitudes Towards Transgender Patients (ATTP) instrument assesses three AT factors using a simple 1-to-5 scale (recreated below). A higher overall score is associated with greater AT bias towards trans athletes.

The final instrument was validated with the Transphobia Scale in a sample of over 300 ATs. The results highlighted the greatest negative attitudes in the “Transgender Sports Participation” questions. The average AT score was an 8.2, with a theoretical minimum of 3.0 (least negative attitude) and maximum of 15.0 (greatest negative attitude). This is concerning given the focus of these questions on the particular AT provider-trans athlete relationship compared to the other two more general sections. For reference, the average for “Clinician Education” was a 7.0 (max 15) and for “Clinician Comfort” was a 7.8 (max 20).

Through recent stories of athletes like Mack Beggs, the trans wrestling star from Texas, and historical stories of athletes like tennis star Dr. Renée Richards, ATs see the importance of gender affirmation in sports settings all the time. Survey development and studies like these in the mainstream AT literature are important to systemic behavior and attitude change in the AT profession. This novel research opens the doors to future studies with ATs, including interventions to reduce explicit and implicit bias towards transgender athletes.

Attitudes Towards Transgender Patients

Strongly Disagree (1), Disagree (2), Neutral (3), Agree (4), Strongly Agree (5)

Clinician Education (Min = 3, Max = 15)

  1. I would be interested in learning how to talk about sensitive issues with the transgender population.*

  2. I believe it is important to receive training on transgender issues.*

  3. I would be comfortable learning more about the transgender population.*

Transgender Sports Participation (Min = 3, Max = 15)

  1. I think male-to-female transgender individuals should not be allowed to participate on female teams.
  2. I think female-to-male transgender individuals should not be allowed to participate on male teams.

  3. I think transgender individuals should be allowed to participate in athletics for the gender which they identify with.*

Clinician Comfort (Min = 4, Max = 20)

  1. I feel safer treating a transgender patient in a group setting.

  2. I would be comfortable treating a patient whose gender identity is unclear.*

  3. I would be comfortable treating a transgender athlete/patient in a private treatment room.*

  4. I would be comfortable treating someone I know to be on hormone therapy.*

*Reverse score (Strongly Disagree (5), Disagree (4), Neutral (3), Agree (2), Strongly Agree (1))

QSPACES is available for transgender diversity+competency training with athletic teams, recreational+school staff, ATs, gyms and more:

Read more about the research and survey tool in the Journal of Athletic Training here:

Read more about the Transphobia Scale in Sex Roles here:

Read more about Dr. Renée Richards’ story in the American Journal of Public Health here: