Recently, there has been an increase in media attention surrounding transgender and gender-diverse (TGD) individuals between discriminatory legislation efforts and changing participation policies within organized sports. These changes and the historical lack of competence and education regarding the transgender patient population have resulted in sub-par patient care, and a misunderstanding of the athletic trainer's (AT) role within the healthcare and compliance systems. This literature review is the second part of a two-paper series and the objective of this paper was to educate ATs on the processes relevant to medical affirmation including compliance considerations regarding medical eligibility and to establish the AT's role.

The gender affirmation framework includes social and legal components which are discussed in part one of this literature, and the medical component is thoroughly discussed in part two. AT's and all health care providers involved in the patient care of TGD individuals should work collaboratively on an interprofessional care team and have a general knowledge of the gender affirmation process including GAHT, surgical options, known risks and complications, and the general health needs of TGD patients. By being more knowledgeable, ATs are uniquely positioned to help reduce health and healthcare disparities as they are point-of-care providers as well as members of the interprofessional care team. Furthermore, ATs can use their knowledge to facilitate medical compliance and eligibility within the evolving policies of sporting organizations.

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