Abstract
CONTEXT: Sexual and gender minorities (SGMs) are individuals with sexual orientations, gender identities, or expressions (or a combination of these) that differ from cultural norms. Sexual and gender minorities often face workplace discrimination and report decreased physical and emotional well-being from discrimination. OBJECTIVE: To explore the workplace climate of SGM athletic trainers (ATs). DESIGN: Sequential mixed-methods study. SETTING: Web-based survey and interviews. PATIENTS OR OTHER PARTICIPANTS: Criterion sampling of SGM ATs (117 survey participants and 12 interview participants). DATA COLLECTION AND ANALYSIS: We modified the LGBTQ Inclusion Assessment and the Organizational Self-Assessment for the survey and developed a semistructured interview script (scale-level content validity index = 0.94). We used means ± SDs, frequencies (%), and the consensual qualitative research tradition to characterize participant responses. Trustworthiness was established through reflexivity (researchers checking bias throughout the research process), member-checking, multianalyst triangulation, and internal and external auditing. RESULTS: Participants indicated their workplace was inclusive (24 [20.5%]), somewhat inclusive (29 [24.8%]), or not inclusive (14 [12.0%]) or did not indicate at all (50 [42.7%]). Respondents most often noted they were unsure of which stage of change their organizations and organizational units were in addressing lesbian, gay, bisexual, transgender, queer, questioning, pansexual, intersex, asexual, 2-spirit, and all within the community of queer and transspectrum identities (LGBTQPIA+) concerns in the workplace as well as specific actions taken for inclusion. Two domains emerged from the interview data: safety and inclusion. The safety domain represented aspects of the workplace climate that made participants feel safe and includes organizational initiatives (12/12), patient-centered policies (7/12), local and federal regulations (7/12), and signaling (12/12). The inclusion domain represented how participants felt a sense of belonging to the organization through their own experience (12/12), through the experiences of their patients (9/12), and through an infrastructure designed for inclusion (12/12). Participants expressed both affirmative and negative feelings of safety and inclusion throughout their responses. CONCLUSIONS: Organizations must take both structural and cultural actions to address the concerns of exclusion and lack of safety.