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Context Previous researchers have indicated that athletic trainers (ATs) had a favorable view of treating transgender patients, yet the ATs did not perceive themselves as competent in their patient care knowledge or abilities. Objective To gain more in-depth information about ATs' knowledge and experiences regarding the health care needs of transgender student-athletes. Design Mixed-methods study. Setting Individual, semistructured follow-up interviews. Patients or Other Participants Fifteen ATs (4 men, 10 women, 1 transgender female; age = 34 ± 9 years, experience = 11 ± 8 years) who took part in a cross-sectional survey in April 2018. Main Outcome Measure(s) The interviews were audio recorded and transcribed verbatim. Member checking was completed to ensure trustworthiness of the data. Next, the data were analyzed via a multiphase process and 3-member coding team who followed the consensual qualitative research tradition. The coding team analyzed the transcripts for domains and categories. The final consensus codebook and coded transcripts were audited by a member of the research team for credibility. Results Four main domains were identified: (1) perceived deficiencies, (2) misconceptions, (3) concerns, and (4) creating safety. Participants described knowledge deficiencies in themselves, health care providers within their units, and providers able to provide safe transition care. The ATs demonstrated misconceptions when defining transgender and transitioning and when describing how the body responds to hormone replacement therapy. They expressed concern for the mental health and wellness, self-image, and potential cost of transgender health care for transgender student-athletes. However, participants also described efforts to create safety within their units by validating transgender patients, instilling trust, adjusting the physical environment, and engaging in professional development to improve their knowledge. Conclusions Athletic trainers wanted to create a safe space for transgender student-athletes but lacked the necessary knowledge to treat transgender patients. Professional resources to improve their knowledge, skills, and abilities in caring for transgender patients are a continuing need.

Providing Transgender Patient Care: Athletic Trainers' Compassion and Lack of Preparedness