








































EDITORIAL 

 

5 
Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                      Volume 4 – Issue 3 – November 2021 
 

The Need for Diversity, Equity, Inclusion, and Social Justice in the 
Southwest Athletic Trainers’ Association 
Meredith Decker, PhD, LAT, ATC* & Shaketha Pierce, MS, LAT, ATC† 
*University of Texas at Arlington, Arlington, TX; †Newman Smith High School, Carrollton, TX 
Moderator: S. Andrew Cage, MEd, LAT, ATC  
 

 
Key Phrases 
Patient-centered care; LGBTQIA 
 
 
Full Citation 
Decker M, Pierce S. The need for diversity, equity, inclusion, 
and social justice in the southwest athletic trainers’ 
association. Clin Pract Athl Train. 2021;4(3): 5-9. 
https://doi.org/10.31622/2021/0004.3.2.     
 
 
EDITORIAL 

The Southwest Athletic Trainers’ Association 
(SWATA) is excited to begin this new partnership 
with Clinical Practice in Athletic Training. As part 
of this partnership, the SWATA Free 
Communications and Research Committee 
provides double-blinded peer review abstracts 
from credentialed athletic trainers who presented 
their works in the Free Communications Program 
at the Annual SWATA Symposium. Out of an 
abundance of caution, the 2021 symposium was 
held virtually, and those free communications 
presentations were disseminated via social media.  

The SWATA Mission Statement states that the 
purpose of the organization is to enhance the 
quality of healthcare for the physically active; to 
promote and advance the athletic training 
profession; to promote a better working 
relationship among those who work toward care 
and prevention of athletic injuries; enhance the 
healthcare of persons served by the membership; 
safeguard and advance the membership; and to 
promote the free exchange of information with 
SWATA. To this end, the SWATA Free 
Communications and Research Committee has 
entered into collaborative efforts with the district’s 
Lesbian, Gay, Bisexual, Transgender, and Queer 
(LGBTQ+) Advisory Committee and the Ethnic 
Diversity Advisory Committee. Through these  

 

efforts, the hope is to promote a community of 
athletic trainers who embrace their collective roles 
as clinicians, educators, and scholars, working 
toward a common goal of enhancing the holistic 
health of physically active individuals from all 
populations. 

At the 2021 SWATA Virtual Symposium, the 
district expressed the explicit need for continuing 
professional development and programming to 
improve diversity, equity, inclusion, and social 
justice in athletic training. To this end, the SWATA 
Free Communications Committee interviewed our 
district LGBTQ+ Advisory Committee Chair, 
Meredith Decker, and Ethnic Diversity Advisory 
Committee Chair, Shaketha Pierce. The SWATA 
Free Communications and Research Committee 
Chair, Andrew Cage, gained insight into the 
committees’ current initiatives. 

Cage: Please tell the readers the roles and 
responsibilities of these committees within SWATA, 
and the athletic training profession as a whole. 

Pierce: The great thing about the Ethnic Diversity 
Advisory Committee is that our role is that we get 
to bring awareness to ethnically diverse situations 
for patients and athletic trainers. We get to serve 
as advocates for information and research 
relating to healthcare issues and conditions that 
affect the health of physically active ethnic 
minority patients. We identify and address issues 
related to cultural distinctions in healthcare 
delivery. We advocate for recruitment and 
retention of athletic trainers from ethnic minorities, 
and bring attention to healthcare disparities 
affecting ethnic minority patients. 

https://doi.org/10.31622/2021/0004.3.2


The Need for Diversity, Equity, Inclusion, and Social Justice in the Southwest Athletic Trainers’ Association 

 

 
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Copyright © Indiana State University   Clinical Practice in Athletic Training 
ISSN Online 2577-8188         Volume 4 – Issue 3 – November 2021 
 

Decker: The role of the LGBTQ+ Advisory 
Committee is to serve as an advisory committee 
Our main goal as a committee is to facilitate 
inclusive athletic training practices. We 
specifically do so by providing resources on the 
wide range of LGTBQ+ topics. Whether that is 
creating and disseminating articles or 
infographics, putting together research, or just 
sharing the most relevant resources tied to 
LGBTQ+ issues in the community. 

Cage: What are some of the challenges the 
patient populations you serve encounter in 
healthcare? 

Pierce: The challenges that the populations that I 
serve encounter tend to be health disparities. 
When these patients have been sent to physician, 
the physician is not always aware of the cultural 
conditions that these patients are faced with. The 
patients may not receive the best care possible 
due to different biases healthcare providers have. 
There are also language barriers patients may 
encounter. Some patients do not have insurance or 
have other financial issues leading to them being 
turned away. Along with that, we also have to 
make sure that we send our patients to healthcare 
providers who we know will give them the best 
care. We also have to make sure that our patients 
are getting the best patient-centered care from us 
and other healthcare providers. 

Decker: For the LGBTQ+ patient population, this 
is a really broad category of individuals. There 
are a lot of different challenges that the 
community as a whole faces. It relates to the 
identities within the LGBTQ+ community. Whether 
it is an identity related to gender or sexual 
orientation within the community. It depends on 
those factors what challenges those people will 
face. Overall, the LGBTQ+ community is still 
looking to gain equality in this country. I think that 
spans into healthcare as well. We can see that 
nowadays with the various anti-transgender and 
anti-LGBTQ+ legislation that is occurring within 
our country. Specific to that, there are a lot of 

issues related to access to healthcare. A lot of 
people in the LGBTQ+ community have trouble 
finding inclusive healthcare providers that are 
willing to treat their individualized patient needs. 
It really boils down to providers not truly 
understanding those patient needs and getting to 
know the patient on that individual level and 
providing patient centered care. Another big issue 
is that patients and patients may not feel like they 
are in a safe and inclusive environment. They may 
not feel like they can be themselves or disclose 
their identities for fear of repercussions from an 
acceptance standpoint and access to healthcare 
standpoint. 

Cage: What are some of the challenges the 
clinician populations you serve encounter in their 
clinical practice? 

Pierce: A lot of challenges ethnically diverse 
clinician populations face come down to the first 
challenge that usually comes up, microaggressions. 
It could have to do with the clinician’s hair, how 
they speak, how they express themselves. A 
clinician may talk with their hands or elevate their 
voice, which can be perceived as aggressive by 
those who do not understand how the clinician 
expresses themselves. That does not mean the 
clinician has attitude, which is just how they 
express themselves. It is often misperceived. 

Decker: A lot of LGBTQ+ athletic trainers may 
feel that there are negative repercussions if they 
are their authentic selves in their patient care 
settings. That may limit them from being out or 
sharing their authentic selves. They may be out in 
their personal lives, but not in their work lives for 
fear of acceptance or their job security. It is an 
unfortunate reality that people can still be fired 
for being LGBTQ+ in their work environment. Also, 
not being fully understood in the identities that we 
all share in the LGBTQ+ community. This impacts 
us as an individual person, and we want our 
coworkers and others to take that into account. I 
would say the biggest challenge is the feeling that 



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Copyright © Indiana State University   Clinical Practice in Athletic Training 
ISSN Online 2577-8188         Volume 4 – Issue 3 – November 2021 
 

there is not a safe space to be clinicians, similar to 
our patients. 

Cage: How does someone who is unfamiliar gain 
a better understanding of what athletic trainers 
and patients from ethnic minorities and the 
LGBTQ+ community deal with while trying to do 
their jobs or participate in sports? 

Pierce: I would say for ethnic minorities the biggest 
thing is, last year the National Athletic Trainers’ 
Association (NATA) came out with the Listen First 
Initiative. That would be the first thing, listen first. 
If a patient comes in and is trying to tell you that 
they feel a certain way about care they have 
received or someone they have encountered, the 
biggest thing is to listen and try not discredit what 
they are telling you. Try not to say “I didn’t see 
that”. You may not have, because it did not 
happen to you. While you are listening, work to 
be an active listener. Make sure you are listening 
to understand, not to try to counter what you are 
being told. Also, work to be able to have 
uncomfortable conversations. With ethnically 
diverse populations, we are used to being the only 
ones in the room. We are used to being 
uncomfortable. Often times, when others we speak 
with are uncomfortable it makes them feel a 
certain way, and they are not use to that. So work 
to get used to having uncomfortable conversations 
and having those encounters where you can ask 
questions in that safe space that Meredith 
mentioned earlier. Next, make sure to remove 
personal opinions and beliefs. Make sure that 
whenever you go into your clinic or facility, 
whatever person beliefs that you have do not 
keep you from treating your patients the way they 
should be treated. Even if there is something you 
do not agree with, your patient should never know 
that. 

Decker: I am going to echo the first point that 
Shaketha made about listening and 
understanding. I think that is the first step 
regardless of which community or patient we are 
talking about. It is really the ability to try to 

understand people on an individual level that 
makes us patient centered clinicians. Also, become 
educated more about the LGBTQ+ community as 
a whole; dive into understanding different 
populations. This may just start with some of the 
basics of understanding the difference between 
gender identity and sexual orientation. Try to 
understand the specifics, but also the community 
as a whole and the challenges that they face. The 
part about education that I really want to 
emphasize is that it has to be self-driven to fully 
understand the LGBTQ+ population. We cannot 
fully rely on those within the LGBTQ+ community 
to share their experiences and to direct our 
learning for us. We have to be a self-directed 
learner where you seek out that information on 
your own and then can come back to the patients 
and providers that you are working with and show 
that you have gained and are using that 
understanding. 

Cage: What specific knowledge and skills do you 
think athletic trainers need in order to best serve 
a patient population that includes members of 
ethnic minorities and the LGBTQ+ community? 

Pierce: I would say one of the skills would be 
interpersonal skills, to be able to have 
conversations with patients and colleagues and be 
able to ask about families, life, and to get beyond 
the typical patient information. Another skill is 
cultural competence, a lot of times we shy away 
from it and go back to the mindset of “I am just 
doing what I have always done.” The beauty of 
athletic training is that we are always learning. 
We are never at a standstill, we are lifelong 
learners. Also, having an inclusive mindset. Maybe 
one of your patient populations is not being well 
served, so having awareness is a crucial skill. 
Next, basically provide grace. Understand that 
your patients may not understand what you are 
saying. They may not understand what athletic 
trainers do because they have not been around 
them. They may come in and they are very 
independent, and we are trying to educate them 



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Copyright © Indiana State University   Clinical Practice in Athletic Training 
ISSN Online 2577-8188         Volume 4 – Issue 3 – November 2021 
 

and do not understand why they do not 
understand. So, we have to provide grace but 
also ask for grace in this case. The last skill I would 
say is patience. Understand that this is a process 
that is new for a lot of athletic trainers. Have 
patience with your colleague, but ask for patience 
in return as well. 

Decker: I agree with Shaketha. I also think the 
biggest factor is going to be soft skills. It is not 
going to be the tangible skills you learn in your 
athletic training program. It is going to be soft 
skills that you have and you continue to develop 
as a professional. Those are the most important 
factors to serving patients in the LGBTQ+ 
community. It goes back to what we have talked 
about regarding providing patient-centered care. 
There are no two patients within the LGBTQ+ 
community are the same. You may be treating two 
gay men that may identify similarly from a sexual 
orientation standpoint, they are going to have 
individual needs. It is critical to understand those 
needs and factors about our patients and their 
individual preferences throughout all of their care. 
We also need to move away from “treating all 
patients the same” regardless of their individual 
factors and differences. I think people have good 
intentions when they say that, but the reality is you 
are not being patient centered when you are 
treating every patient the same. When we take 
those individual factors into account, we are truly 
being patient centered and we can understand 
the unique aspects of the patient’s needs. 

Cage: What advice do you have for your fellow 
athletic trainers as we moved forward as a 
profession and try to uphold our responsibilities as 
healthcare providers to provide quality 
healthcare to all of our patients regardless of 
their demographic? 

Pierce: Do not make assumptions. Do not assume 
every patient and their situation are the same. Do 
not assume that two patients’ households are run 
the same just because they come from the same 
cultural background. Everyone is different. Make 

sure you ask questions. Try not to be offensive. If 
you have a question you need to ask but are 
worried it might be offensive, it might help to pose 
it as “May I ask this question, this is something I 
would like to know to better serve you.” Next, do 
not pass judgement on the athlete. Whatever their 
situation is, do not judge them. Meet them where 
they are and try to make sure that you are 
providing patient centered care. Make sure we 
uphold the role as liaison for our patients. We are 
there to treat, we are there to serve as a liaison 
between our patients and our clinics. Make sure 
we do not feed into a bias we know may be held 
against the patient we are serving. 

Decker: I think the first thing that we all have to 
do, regardless of our experiences, is to constantly 
self-reflect on the NATA Code of Ethics and the 
Board of Certification Standards of Professional 
Practice. Those are our guidelines to being the 
best, most inclusive, and competent healthcare 
providers that we can be. Instead of just assuming 
that we are doing those things, we should always 
go back to those and do an audit of ourselves to 
truly identify if we are upholding those guidelines 
to the best of our ability. Beyond that, it really 
starts with understanding and addressing our own 
biases. We have a responsibility to be inclusive 
healthcare providers. We are not only 
responsible for ourselves, but we are responsible 
for those around us as well. I think it is important 
that within that understanding and audit that we 
are doing, that we are continually committing to 
ourselves and our profession that we are going to 
hold others accountable as well as ourselves. 

Cage: What are some ways members of SWATA 
and other districts can get involved to help your 
committees and committees like them? 

Pierce: Definitely support our committee efforts. 
The biggest thing with Ethnic Diversity Advisory 
Committee is that every year we aim to have an 
education event and a community service or 
project. With that, when there is a sign up form for 
our projects, do not be afraid to sign up and 



The Need for Diversity, Equity, Inclusion, and Social Justice in the Southwest Athletic Trainers’ Association 

 

 
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Copyright © Indiana State University   Clinical Practice in Athletic Training 
ISSN Online 2577-8188         Volume 4 – Issue 3 – November 2021 
 

participate. Do not assume that the project is only 
for ethnically diverse athletic trainers. The 
committee aims to serve ethnically diverse 
populations, but our committee projects are a 
representation of every athletic trainer in SWATA. 
Next, attend education sessions. Do not assume 
that just because you see title, that it does not 
include you. Do not assume from the title of a 
presentation that you cannot learn anything from 
it just because you feel you are already culturally 
competent and inclusive. There is always 
something new to learn. Too often people assume 
that a presentation with the topic of diversity or 
inclusion is not for them. We need everyone to be 
there. Make sure that you want to include yourself 
on what there is to learn. Also, sign up to be a 
volunteer on the volunteer list. Even if you are not 
on our committee, you may still be able to serve 
in other ways. When you see us in the exhibit hall, 
come over and see how you can be involved. In 
the month of March we usually highlight athletic 
trainers. When we send out those forms, some 
people are still in the mindset of “Well, I am not 
ethnically diverse; this is not for me.” You do not 
have to be ethnically diverse to participate, 
March is National Athletic Training Month. We 
want to make sure that we highlight everyone. 
When we try to provide unity and break down 
those walls, we want to remove as many obstacles 
as possible. 

Decker: The first two steps to take are attending 
lectures, workshops, and events and consistently 
staying up to date with the committee and the 
committee’s efforts. A lot of this information is 
changing rapidly. Make sure that you are 
constantly attending those events. Also, sign up to 
volunteer. You do not have to serve as a 
committee member. There are so many ways to 
get involved. Reach out to the committee and see 
if there are side volunteer opportunities. Lastly, I 
think beyond just the committee or the scope of the 
athletic training profession I would encourage 
people to get involve at your school or 
organization. I had a colleague who completed 

Safe Space Training and then reached out to me 
and said “Our athletic department is not as 
inclusive. I am worried I am not going to be able 
to make as big of an impact as I had hoped.” My 
advice to her was to explore her campus 
environment and determine if she could make an 
impact outside of just the athletic department. This 
also goes into your community. If you can 
volunteer in your community, that is indirectly 
helping the initiatives of the committee to try to 
make our profession more inclusive. If we have a 
community that is safer and inclusive, people in the 
LGBTQ+ community can feel safer being their true 
and authentic selves.  

Cage: What is one step athletic trainers could take 
today to make their clinics more inclusive? 

Pierce: Work to understand the demographic 
characteristics of the patients you are serving. In 
my clinic, I serve a lot of Hispanic and Latinx 
patients. One thing I did was making sure I have 
physical forms in English and Spanish. This 
provides a more inclusive environment right from 
the start. This helps the patient come into the room 
and not feel that the room is not inclusive of them, 
and it creates a safe space. 

Decker: Have something visible that shows that 
you run an inclusive facility. I do not think this is the 
most important step to take, but I do think seeing 
those visible images makes people feel safer. 
Maybe it is a Safe Space sticker or a Pride sticker, 
but it might help people let their guard down. That 
is a very superficial step, so I think there needs to 
be more to that. I think you have to actually act on 
those images and show people that you are 
inclusive beyond just showing them. Other 
additions could be displaying a non-discrimination 
policy, and having a zero tolerance policy to 
anything other than inclusivity in your facility from 
everyone who walks in the door. 


