Transgender, Gender-Diverse, and Nonbinary Experiences in Physical Therapy: A Descriptive Qualitative Study

Area of Science:

• Physical Therapy
• Gender Studies
• Health Equity

Background:

• Access to healthcare, including physical therapy, can be challenging for transgender, gender diverse, and nonbinary (TGNB) individuals.
• Understanding the specific experiences, barriers, and facilitators of physical therapy utilization for TGNB populations is crucial for improving care.

Purpose of the Study:

• To explore the physical therapy experiences of TGNB individuals.
• To identify barriers and facilitators influencing their utilization of physical therapy services.

Main Methods:

• A qualitative descriptive study was conducted using semistructured interviews with TGNB individuals in New Zealand.
• Participants were recruited from a community-based clinic offering gender-affirming services.
• Data were analyzed using reflexive thematic analysis.

Main Results:

• Seventeen TGNB individuals participated, reporting experiences across four themes: challenging cisnormativity, ensuring safety and trust, inclusive care experiences, and sensitivity to body discomfort.
• Barriers and facilitators were identified at policy, environmental, clinic, and therapist levels.
• Key facilitators included affordable care, demonstrated TGNB inclusivity, and physical therapists with TGNB health knowledge and a biopsychosocial approach.

Conclusions:

• TGNB individuals encounter significant challenges in accessing safe and culturally sensitive physical therapy.
• Improvements are needed at multiple levels (policy, environmental, clinic, therapist) to foster trust and engagement.
• This research offers insights for clinicians and clinics to provide more equitable and affirming physical therapy care for the TGNB community.