By Syd Young (pictured right), PT, DPT, CSCS, FAAOMPT
I trained to be a physical therapist here in Texas. From day one, my professors drilled two things into us: evidence and empathy. Evidence tells you what to do. Empathy helps you figure out how to do it for the actual human in front of you. That’s why the news coming out of the Texas Tech University System this week hit me like a gut punch. Reporting on the Texas Tech University System highlights new restrictions when it comes to mentioning transgender and nonbinary identities in the classroom, following an initial directive at Angelo State.
If you’re not living this every day, Texas Tech’s restrictions on discussing LGBTQ+ identities might sound abstract — like “curriculum housekeeping.” It’s not. It’s a directive that tells educators and future clinicians to look away from a real part of our patient population. And as someone who treats people in pain, post-op, in pelvic health, and across the lifespan, I can tell you: when training tells you not to see people, you miss what matters.
What Happened — And Why It’s Bigger Than One Campus
On Sept. 25, the Texas Tribune reported that Angelo State University (part of the Texas Tech System) told faculty not to discuss transgender or nonbinary identities in class in its piece on the Angelo State directive. The next day, the Texas Tech chancellor issued guidance across the system — summarized by the Tribune’s coverage of the system guidance and letter. Regional outlets echoed those developments, including Spectrum News’ rundown of the five-campus directive.
Here’s a key point buried under headlines: there is no Texas law that explicitly bans university faculty from discussing LGBTQ+ topics in class. Higher-ed reporting situates these moves within a broader academic-freedom context, such as Inside Higher Ed’s coverage of Angelo State policy changes affecting classroom speech and the Chronicle of Higher Education’s piece on a public university instructing employees to avoid transgender topics in instruction.
Whether you call it a ban, a restriction, or “compliance guidance,” the effect in classrooms is the same: faculty chill their speech, syllabi get sanitized, case studies disappear, and students graduate with fewer tools to care for real people.
Health Care Isn’t Neutral — Training Must Reflect Real People
If health education only trains us to treat an imaginary “average patient,” we fail everyone who isn’t average. That includes trans and nonbinary patients — who are already your patients even if you don’t know it. They show up for back pain and ACL rehab, for TMJ issues and pelvic floor dysfunction, for return-to-sport programs and post-op protocols. They deserve clinicians who can take a history without making the exam room feel unsafe, who can discuss hormones or surgical timelines as part of functional planning, and who can navigate pronouns and names without derailing rapport.
Censoring classroom discussion of identity doesn’t make those needs disappear. It just ensures new cohorts of clinicians are less prepared to meet them. That’s not “neutral.” That’s negligent.
We’ve Seen This Before: Weight & Dermatology Biases
If you’re thinking, “Can’t we just teach anatomy and biomechanics?” here are two cautionary examples every clinician knows:
- Fatphobia in Care. When patients in larger bodies are told “lose weight” as the answer to every complaint, serious conditions get missed. In PT specifically, bias can creep into load progressions (“you can’t handle that weight”), assumptions about adherence, and misguided exercise prescriptions that ignore joint tolerance and conditioning history. Erasing trans people from curricula follows the same pattern: stereotypes replace assessment, and dogma stands in for individualized care.
- Dermatology on Darker Skin. For years, medical images and teaching cases underrepresented how rashes and inflammation present on Black and brown skin. The result? Delayed or incorrect diagnoses, lower trust, worse outcomes. When you don’t teach for the full spectrum of humanity, people get hurt.
These are not “culture war” issues. They’re patient-safety issues. And they’re solvable—if we let classrooms do their job.
What Gets Lost In The Clinic When Classrooms Go Quiet
Here’s how curricular erasure shows up on my side of the table:
- Communication Errors. Intake forms that force people into boxes. EMRs that don’t reflect the names patients use. Clinicians who avoid clarifying questions because they’re afraid of “saying the wrong thing.” Small things—until they fracture trust.
- Screening Failures. If a patient shuts down after being misgendered or dismissed, you miss red flags, relevant surgical history, or adherence barriers at home.
- Adherence And Outcomes. People don’t return for care that feels unsafe. That means more pain, more disability days, slower return to sport/work, and higher long-term costs.
- Faculty Self-Censorship. Even when a ban isn’t explicit, the message is received. Instructors cut case diversity, simulations avoid realistic social contexts, and students lose opportunities to practice respectful, evidence-based communication.
These are practical consequences, not political talking points. And they land on real bodies.
“But Can’t We Just Teach The Anatomy?”— Why That’s Not Enough
I love anatomy. I can talk your ear off about joint arthrokinematics and tendon remodeling timelines. But PT is applied problem-solving with living humans. Context shapes pain, return-to-work timelines, and whether or not a home exercise program gets done.
If you’ve ever worked with a patient whose recovery derailed because childcare fell apart, a boss retaliated, or a clinician brushed off their fear — you know this already. Identity-respectful communication is not “politics.” It’s a clinical skill. It keeps the exam room open long enough to get the history right and the plan tailored.
What Students And Programs Can Still Do (Right Now)
Even within restrictive climates, there are lawful, patient-centered steps programs and clinical sites can take that focus on function, safety, and communication:
- Case-Based Labs That Center Respectful Practice. Use neutral, function-focused scenarios that nevertheless model good communication: confirming names/pronouns, asking relevant surgical/hormonal history when it affects tissue healing timelines, and documenting without editorializing.
- Simulation Checklists. Build objective checklists for intakes and patient education that include name/pronoun confirmation, instructional language options (body-neutral cues), and discharge handout templates.
- Clinical Rotations That Model Care. Preceptors can demonstrate how to keep evaluations patient-centered without “teaching politics.” It looks like this: listen, validate, tailor the plan, and move.
- Journal Clubs On Bias-Aware Practice. Students can analyze literature on communication, adherence, and disparities—areas firmly within health-outcomes research.
- Forms And EMR Hygiene. Where institutions allow it, use intake forms that reflect the names patients use and capture relevant history without forcing disclosure.
These measures are not radical. They’re just good medicine.
For Patients And Community: How We’re Showing Up
At OutWellness, we train for the world we actually live in. That means:
- Inclusive Evaluations. Every eval starts with the person, not a template. We confirm names and language, we ask relevant history, and we adapt our education accordingly. (Here’s exactly what to expect at your evaluation.)
- Post-Op Support That Respects Identity. Whether you’re recovering from gender-affirming procedures or you simply want care that doesn’t make you shrink yourself to be treated, we have protocols and a team that meet you where you are. Learn more about our post-surgery support and why we’re different.
- Training For Partners. We share communication and intake best practices with local providers, coaches, and community orgs— because safe, effective care is a team sport. Explore our full menu of services at OutWellness and browse our guides and articles on queer health and movement.
If this news leaves you anxious about seeking care, please reach out. Ask questions. Tell us your needs. We’ll meet you there.
In Closing
I became a PT to help people move with less pain and more dignity. That’s bigger than quads and glutes; it’s about whether people feel safe enough to tell us the truth so we can actually help. If classrooms teach future clinicians to ignore or erase parts of their patients, we’re not protecting students from controversy—we’re training harm. Texas taught me empathy and care. I plan to keep practicing both.
