Perceived safety and trust shape transgender and gender diverse participation in exercise science: a consensual qualitative research study.

Introduction: Transgender and gender diverse people are substantially underrepresented in exercise science research. This limits the inclusivity and generalizability of evidence guiding exercise, physical activity, and physical rehabilitation practices. While prior health research has examined barriers and facilitators to transgender and gender diverse participation, little is known about how transgender and gender diverse individuals perceive exercise science research specifically. The purpose of this qualitative study was to explore factors that may influence transgender and gender diverse individuals' willingness to participate in exercise science research. Methods: Using a Consensual Qualitative Research approach, we conducted semi-structured interviews with 17 transgender and gender diverse adults recruited via LGBTQIA2S+ university and community organizations in the United States. Data were analyzed via Consensual Qualitative Research methods to identify domains, categories, and subcategories reflecting shared topics and patterns in responses across participants. Results: Three primary domains emerged: research participation, researcher decisions and behaviors, and safety. Participants described their willingness to participate as influenced by study design features, information clarity, and perceived benefits. Trust in researchers and institutions, inclusive recruitment procedures, and communication were also key facilitators of participation. Barriers included invasive study procedures, exclusionary eligibility criteria, ambiguous recruitment materials, and concerns about gender misclassification or misuse of data. Across domains, perceptions of political, physical, and psychosocial safety served as a central concern through which participants evaluated research opportunities. Participants emphasized that respectful communication, inclusive research practices, privacy protections, and culturally competent researchers were essential for safe and affirming research environments. Discussion: Our findings highlight the importance of intentional inclusivity in exercise science research design and recruitment. Implementing transparent communication, community-engaged recruitment, inclusive practices, and trauma-informed procedures may improve participation and representation of transgender and gender diverse individuals in exercise science research. Enhancing inclusion may address ethical responsibilities and strengthen the scientific validity and applicability of exercise science evidence.