Championing Inclusion Among ‘Hidden’ Disability: The Case and Opportunities for Deaf and T1D Communities

Abstract

Sport is widely promoted as a vehicle for inclusion, yet inclusive policies do not necessarily translate into inclusive experiences for all participants. This is particularly evident for individuals living with hidden or conditionally visible impairments, whose support needs may not be immediately recognised within sporting environments. Using D/deaf and Type 1 Diabetes (T1D) communities as illustrative case studies, this paper examines how visibility, identity, disclosure and recognition shape experiences of sport participation and inclusion. Although both groups may be protected under disability legislation, many individuals do not identify with disability as a personal, social or cultural label, challenging conventional understandings of disability in sport. Drawing on literature relating to disability, Deafness, chronic illness and sport, we demonstrate how barriers arise not only through inaccessible practices and environments, but also through the failure of sporting systems to recognise diverse forms of impairment and support need. The experiences of D/deaf and T1D athletes highlight the challenges of negotiating disclosure, managing visibility and accessing appropriate support within sporting cultures that often privilege normative assumptions of physical competence and independence. In response, we propose three opportunities for advancing inclusion: moving from policy to practice, from individual adaptation to anticipatory inclusion, and from access to belonging. We argue that meaningful inclusion requires community-informed, flexible and relational approaches that recognise hidden impairments, value diverse identities and foster genuine belonging within sport.

1. Introduction

Sport is frequently presented as a vehicle for inclusion, offering opportunities for participation, belonging, health, achievement and social connection (e.g., [1]). National governing bodies, government policies and sporting organisations increasingly emphasise their commitment to diversity and inclusion such as Sport England’s Unite the Movement [2], the Football Association’s (FA) Football without Limits Strategy [3], and protections afforded by the Equality Act 2010 to marginalised communities, including disabled individuals, against discrimination. Collectively, these initiatives advocate for organisations, including those in sport, to make reasonable adjustments and ensure that disabled individuals have equal opportunities to participate [4]. However, the existence of inclusive policies does not necessarily guarantee inclusive experiences. For many disabled people, participation in sport remains embattled by structural barriers, inequitable opportunities and systems that fail to recognise diverse needs [5,6,7].

This paper is informed by a social–relational understanding of disability [8,9,10]. This perspective moves beyond understanding disability as either an individual condition, or a consequence of external barriers. Instead, this paradigm recognises the embodied experiences of impairment and chronic health conditions, as well as disability as produced and reproduced through social relations. This includes structural and environmental barriers that restrict access and participation, as well as interpersonal interactions and the psycho-emotional consequences of exclusion [11]. For example, an inaccessible environment may generate feelings of frustration, anger, hurt or exclusion, while everyday interactions with other people (such as being stared at, ignored, receiving unwanted comments, prejudice or even abuse) can further reinforce experiences of difference, stigma and marginalisation [9,11]. Disability is enacted not only through the organisation of space and practice, but also through how people respond to and relate to one another.

We also recognise that disability is neither a fixed nor universal experience or identity [12]. How individuals understand, experience and identify as ‘disabled’ is shaped by intersecting aspects of politics, culture, social norms, language, ethnicity, gender, age, community affiliation and past experiences. These identities interact in complex and shifting ways, influencing how individuals recognise and understand themselves, and how they are recognised and understood by others [13].

Within this framing, inclusion extends beyond providing access to sporting opportunities or making individual adjustments [14]. It requires addressing the structural, interpersonal and psycho-emotional conditions through which exclusion is produced, and transforming sporting environments and cultures so that diverse ways of being are recognised, valued and supported [7]. Drawing on Valet [15], inclusive participation involves not only being ‘among others’ and having opportunities to participate ‘with others’, but also being ‘valued by others’. This highlights that inclusion is concerned not simply with participation, but with the quality of that experience and whether individuals feel accepted, respected and a sense of belonging [16]. While disability and sport scholarship has advocated for advancing understanding of participation and inclusion [17,18], much of this work has focused on visible impairments, where support needs may be more readily recognised by coaches, organisations and policymakers. Consequently, disability is often understood as something observable, immediately apparent and, at times, homogenously adaptable [18]. Such assumptions can obscure the experiences of individuals living with hidden or invisible impairments1 such as multiple sclerosis (MS), fibromyalgia, those with chronic pain, D/deafness and Type 1 Diabetes [T1D] as examples. Hidden disabilities encompass a diverse range of conditions (such as those mentioned) and may be chronic, fluctuating, variable, and unpredictable [19,20]. This manifests in a unifying challenge despite the differences of each condition; while impairment effects are not always apparent to others, symptoms may substantially affect everyday life and sporting participation. As a result, individuals frequently encounter misunderstanding, scepticism, ableism, and under-recognition of their support needs, creating additional barriers to participation and inclusion [21,22].

The hidden nature of some impairments creates a particular tension in sporting environments; individuals may experience significant impairment-related challenges whilst simultaneously being perceived as non-impaired by coaches, teammates and sporting organisations [23]. For example, people with T1D may not disclose their condition, coaches may deliver a high intensity session without opportunities for carbs or insulin to be taken onboard, and the athlete may experience a contraindication such as a hypo without the coaches being aware of how to support or provide care. Similarly, an individual with MS taking part in a session in high temperatures may need to take repeated breaks or find somewhere cooler as heat can exacerbate symptoms, but these breaks may be perceived as laziness or attitudinal by coaches. Such challenges are especially pertinent within sporting cultures that often privilege ideals of physical competence, healthism, neoliberalism, and independence [7]. Consequently, decisions surrounding disclosure become particularly important.

Individuals often have to balance the potential benefits of revealing an impairment against the risks associated with doing so. Disclosure may facilitate access to support, reasonable adjustments and safer participation experiences [24]. However, it may also expose individuals to stigma, stereotyping, differential treatment, or assumptions regarding competence and capability [22,25]. Furthermore, some individuals possess the ability to “pass” as non-disabled, avoiding potential stigma but simultaneously limiting opportunities for support and accommodation [26]. Consequently, disclosure represents not simply the communication of medical information, but a negotiation of identity, belonging and risk. That is, disclosure could result in a safer and more understanding sporting experience, but could also result in marginalisation and exclusion.

Taken together, non-inclusion within sport is not simply the result of individual barriers or a lack of reasonable adjustments, but is shaped by wider organisational, cultural and interpersonal conditions. Sporting environments are often structured around normative assumptions of physical competence, independence, resilience and performance, which can render different communication practices, health management needs and forms of participation less visible or less readily accommodated [5,6,7]. These assumptions are reinforced by gaps in policy, limited organisational knowledge and uncertainty among coaches and practitioners about how to support people with different impairments and health conditions [27,28]. In some contexts, risk aversion and perceived liability can further restrict participation, particularly where organisations lack clear guidance or established procedures [22,28]. Responsibility for negotiating these conditions is consequently displaced onto individuals, who may need to disclose, explain or justify their support needs, sometimes at the risk of stigma, stereotyping or differential treatment [24,25,29]. These structural and organisational conditions are also reproduced through everyday interactions and sporting cultures that determine whose needs are recognised, whose participation is valued and who is perceived to belong [9,11]. These contextual drivers highlight why experiences of non-inclusion cannot be understood solely through the presence or absence of impairment, or the availability of sporting opportunities. They also raise important questions about how disability is recognised, understood and negotiated across different communities and contexts. These complexities are particularly evident among D/deaf and T1D populations, where impairment, identity, visibility and legal recognition do not necessarily align.

2. D/deaf and T1D Communities and the Politics of Identity

D/deafness encompasses a diverse spectrum of hearing experiences, identities, and cultural affiliations and occupies a particularly complex position within disability discourse. While hearing loss is medically and legally recognised as a sensory disability that may create barriers in everyday life, many Deaf people reject the notion that they are disabled and instead position themselves as members of a linguistic and cultural minority. Central to this perspective is Deaf culture, Deafhood, and the use (in the UK) of British Sign Language (BSL), which provide a shared sense of identity, community and belonging. Consequently, Deafness is often understood not through a deficit-oriented lens, but as a valued cultural identity. The distinction between “Deaf” and “deaf” is therefore important. The capitalised “D” is commonly used to denote an affiliation with Deaf culture, whereas the lower-case “d” typically refers to the audiological condition of hearing loss. For the purposes of this manuscript, the term Deaf is adopted (except when explicitly discussing deafness as a condition) as it reflects the cultural identity and sporting structures associated with the Deaflympics movement.

With an estimated 18 million D/deaf and hard-of-hearing people in the United Kingdom, including approximately 54,000 children [30], deafness affects a substantial proportion of the population. Despite its prevalence D/deafness remains frequently misunderstood within disability discourse. Deafness challenges simplistic distinctions between visible and invisible disability. Rather than occupying one category or the other, D/deafness may be considered conditionally visible. Assistive technologies such as hearing aids and cochlear implants can provide visual markers of hearing impairment, while the use of BSL may similarly signal Deaf identity. However, for many individuals there are no immediately apparent indicators of deafness, and awareness of impairment often emerges only through interaction and communication. As a result, recognition of support needs is frequently contingent upon disclosure, context and social engagement.

A comparable, but distinct, tension exists among individuals living with T1D. T1D is a chronic autoimmune condition affecting approximately 430,000 individuals in the United Kingdom [31]. The condition destroys insulin-producing β-cells, requiring ongoing management through insulin injections or pumps and increasingly through technologies such as Continuous Glucose Monitors (CGMs) [32]. Challenges associated with glucose management may result in acute complications such as hypoglycaemia, hyperglycaemia and diabetic ketoacidosis, alongside longer-term complications including neuropathy, nephropathy, cardiovascular disease and cognitive decline [33]. Given the lifelong nature of the condition, effective management remains a continual priority across different stages of life [22].

Like Deafness, T1D is often invisible to others. While technologies such as insulin pumps and CGMs may occasionally render the condition visible, much of the labour associated with diabetes management remains hidden. Individuals must continuously monitor blood glucose levels, make decisions regarding insulin administration, manage nutritional intake and anticipate physiological responses to daily activities. Consequently, the condition often remains unnoticed despite exerting a profound influence on everyday life, health and wellbeing. Recent estimates suggest that people living with T1D lose an average of fifteen years of healthy life, illustrating the substantial burden associated with the condition [34].

Despite significant differences in aetiology, lived experience and community identity, Deafness and T1D converge around a number of shared issues concerning disability, visibility and recognition. While both groups are protected under the Equality Act 2010, individuals do not necessarily identify with the label of disability and may actively resist it. For many people living with T1D, the condition is understood primarily as a chronic health condition requiring continual self-management rather than a disability [35]. Similarly, many Deaf individuals locate themselves not within disability communities, but within a distinct linguistic and cultural minority defined by shared language, experiences and identity [36]. Consequently, both communities challenge assumptions that disability is universally recognised, uniformly experienced or universally accepted, echoing broader critiques of simplistic understandings of inclusion and disability in sport [17].

Further, the legal categorisation of disability does not always align with personal identity or social experience. Under the Equality Act 2010, a person is considered disabled if they have a physical or mental impairment that has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities. Importantly, this assessment considers the impact of an impairment without mitigating measures. As such, insulin therapy, CGMs, hearing aids and cochlear implants do not negate entitlement to legal protection. Within this framework, both T1D and hearing impairments may meet the threshold for disability, providing access to protection from discrimination and entitlement to reasonable adjustments.

Collectively, T1D and Deafness expose the instability of disability as a category and reinforce calls to understand disability from both individual and organisational perspectives rather than as a fixed personal characteristic [37]. While disability is often treated as a fixed, visible and universally recognised state, these communities demonstrate that disability may be simultaneously legal and contested, experienced and concealed, recognised and resisted. Rather than fitting neatly into binary categories of disabled and non-disabled, visible and hidden, both groups occupy a liminal position shaped by social recognition, cultural identity, disclosure practices and legislative frameworks. It is this intersection of impairment, identity, visibility and recognition that provides a compelling lens through which to reconsider contemporary understandings of disability and inclusion.

These tensions become particularly salient within sport and physical activity contexts, where access to participation, support and belonging frequently depends upon the recognition of need. For individuals whose impairments are hidden, contested or only conditionally visible, inclusion may therefore be shaped not only by available opportunities, but by whether sporting systems are capable of recognising and responding to diverse ways of being.

3. Deaf and T1D Sport Experiences

Deaf people provide a particularly important illustration of how impairment can remain hidden within sporting systems. Deaf people remain among the least physically active group in society. Sport England [38] reported that 51% of Deaf adults are inactive compared with 20% of non-disabled adults. Further, Activity Alliance’s [39] impairment-specific analysis found that fewer than one-third of people with hearing impairments saw people like themselves playing, working or volunteering in sport and physical activity. Such disparities highlight persistent barriers to participation, including communication challenges, inaccessible coaching environments and a lack of awareness of Deaf culture. These barriers may begin well before entry into organised sport, given that more than 90% of Deaf children are born to hearing parents who often have little prior experience of deafness and therefore rely heavily upon professional guidance following diagnosis [30].

Exploring the literature highlights important issues surrounding Deaf participation across both mainstream and Deaf-specific sport. Deaf athletes participating in mainstream sport may use hearing aids or cochlear implants around the sporting environment, but participants may choose not to utilise their hearing technology during sport participation for fear of damaging it, being treated differently, judged or stereotyped, or it negatively impacting their experiences [40]. Consequently, Deafness may become less immediately visible to others, particularly during sporting activities where hearing technology is not worn, e.g., swimming. The relative invisibility of Deafness can contribute to an implicit assumption that Deaf athletes can participate in mainstream sport in the same way as hearing athletes, without changes to how sporting environments are organised. Yet mainstream sport frequently relies on auditory communication as an unremarkable part of participation. In athletics, for example, the start of a race is signalled acoustically through a starter pistol, requiring Deaf athletes to rely on visual or alternative cues rather than the auditory signal available to hearing competitors. In team sports, tactical information, calls between teammates and changes to activities may similarly be communicated verbally and spontaneously, with the Deaf athlete the last to know or not being included in communication at all. Indeed, research with Deaf athletes highlighted barriers involving communication with coaches and teammates, inaccessible environments and limited awareness of Deaf athletes’ communication needs [27]. Such barriers are therefore not necessarily the result of overt discrimination, but can arise from the taken-for-granted assumptions embedded within mainstream sporting practices that all athletes can hear instructions, respond to verbal cues and participate in informal communication surrounding sport.

For some Deaf athletes, Deaf-specific sport provides an alternative sporting context in which these assumptions can be disrupted. However, access to this pathway is not necessarily straightforward. Foster, Fitzgerald and Stride [41] found that Deaf athletes had initially been socialised into sport through mainstream hearing environments and were often not made aware of Deaf sport during their formative years. Their eventual discovery of Deaf sport was frequently incidental, rather than through an established sporting pathway. This is significant because mainstream participation can appear to demonstrate successful inclusion while simultaneously limiting awareness of other opportunities available to Deaf athletes. Deaf-specific sport should therefore not simply be understood as a separate alternative to mainstream provision, but as part of a wider sporting landscape through which athletes may move between different contexts according to the opportunities available to them [41].

Yet the existence of a Deaf-specific pathway does not remove structural inequalities. Deaf sport has itself been positioned as lesser in relation to hearing sport, with differences reported in funding, media coverage, access to facilities and coaches’ attitudes (Foster et al. [41]). At elite level, these inequalities can have direct consequences, with athletes reporting the use of substantial personal finances, including savings and loans, to compete internationally, alongside little or no institutional funding or recognition for their achievements [41,42]. Limited media visibility and institutional recognition further contribute to the marginal position of Deaf sport with athletes describing the Deaflympics (an elite multi-sport event similar to Olympics and Paralympics) as effectively “invisible” compared to Olympic and Paralympic counterparts. Thus, Deaf athletes can encounter barriers across both forms of provision; mainstream sport may be organised around assumptions of hearing, while Deaf-specific sport can be constrained by its comparatively limited recognition, resources and visibility. The issue, therefore, is not simply whether Deaf athletes have access to sport, but how sporting systems determine whose participation is visible, valued and adequately supported.

T1D provides a further example of how a hidden impairment can be overlooked within mainstream sport. T1D is classified as a hidden disability under the UK Equality Act 2010, yet athletes with T1D participate primarily within mainstream sporting environments rather than through a separate disability-sport pathway [29]. The relative invisibility of T1D can contribute to an assumption that athletes interact with sport in the same way as their peers, without consideration of the ongoing hidden management that participation may require. Physical activity, including sport, involves continual monitoring and adjustment of blood glucose and insulin, with the demands of management varying according to the intensity, duration and timing of the activity [43]. These demands can become particularly problematic when diabetes management interrupts the expected rhythms of sporting participation. The need to monitor glucose, administer insulin, consume carbohydrates or respond to changes in sugar levels may require an athlete to pause, modify or temporarily withdraw from activity. Research has documented experiences of participants being perceived as “lazy” or unwilling to participate, alongside inadequate support from activity providers [22,44]. Participants have also described negative comments from teammates, competitors and facilitators when T1D becomes visible through CGMs, insulin administration or the consumption of glucose during sport. A key barrier is therefore the extent to which sporting environments understand, facilitate and support the realities of T1D management.

The hidden nature of T1D can also create pressure to conceal the condition or its management. For example, a study of footballers with T1D found that participants were concerned that revealing their condition could be interpreted as weakness within a sporting culture that values resilience, physical capability and peak performance [29]. Participants described hiding T1D and delaying diabetes management in order to avoid being perceived as different, with one participant explaining that he had postponed insulin administration until he was alone, despite the consequences for his blood glucose. Similarly, Richardson et al. [22] found that participants actively sought to conceal aspects of diabetes management, including wearing clothing to hide monitoring equipment, turning off device alarms or removing devices altogether. These experiences demonstrate that the hidden nature of T1D can shift the burden of managing its visibility onto the athlete, who may feel compelled to negotiate when and how their condition becomes visible within sporting environments.

The case studies of Deaf and T1D sport demonstrate that being present within a sporting environment does not necessarily mean being included within it [15]. Inclusion depends upon whether sporting systems recognise different ways of communicating, participating and managing impairment, and whether athletes can access appropriate support without repeatedly having to justify their needs or conceal aspects of their identity. The experiences of Deaf and T1D communities illustrate the consequences when these considerations are absent; barriers can remain largely invisible to sporting organisations while becoming an everyday responsibility for individual athletes to “overcome”. These experiences therefore challenge a narrow understanding of inclusion as simply providing access to sporting opportunities or preventing overt discrimination. Although both Deafness and T1D may be recognised as disabilities under the Equality Act 2010, legal recognition does not necessarily translate into inclusive application in everyday sporting environments. The following section therefore considers concepts and opportunities for championing inclusion among people living with hidden impairments, asking how sporting systems might move beyond formal recognition towards meaningful experiences of inclusion.

4. Championing Inclusion in Sport Among Communities with Hidden Impairments

Building from the case studies of Deaf and T1D communities, we advocate for three different ways to reimagine inclusion in sporting systems that celebrates, amplifies and supports those with hidden impairments; (1) from policy to practice, (2) from individual adaptation to anticipatory inclusion, (3) from access to belonging.

4.1. From Policy to Practice

The Equality Act 2010 provides important legal protection and establishes a basis for reasonable adjustment, while Article 30.5 of the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) recognises the right of disabled people to participate in recreation, leisure and sport on an equal basis with others. Together, these frameworks position participation as a matter of equality and rights rather than simply an opportunity that sporting organisations may choose to provide. The challenge, however, is translating these formal commitments into policy and practice within individual sports. This aligns with wider debates regarding how inclusion is operationalised within sporting organisations and whether policy commitments are reflected in lived experiences of participation [17,37]. For people with hidden impairments, this requires governing bodies, coaches and other practitioners to recognise that support needs cannot necessarily be inferred from appearance, and that individuals may experience their impairment, identity and support needs differently.

Policy work around T1D provides a useful illustration of this translation gap. Abdel-Magid et al. [28] found that, of 185 UK sport National Governing Bodies, only 20 mentioned diabetes within their policies or guidance, and just four had dedicated policies addressing diabetes. The absence of explicit recognition is concerning given evidence of people with T1D being refused swimming lessons, gym sessions and opportunities to join sports teams because of perceived safety and liability concerns [22]. Where sporting organisations lack clear guidance, decisions about participation can instead be shaped by individual perceptions of risk, potentially leaving athletes to negotiate inclusion on a case-by-case basis. Policy therefore matters not simply as a statement of intent, but because it can establish a basis for consistent, informed decisions about participation and solid evidence that a person is welcome in that sport.

There are, however, emerging examples of individual sports beginning to translate this principle into practice. The Lawn Tennis Association (LTA) provides guidance to support players with T1D, while changes within tennis have enabled players with T1D to monitor glucose and administer insulin during competition, including through the use of medical time-outs where required. Such changes are significant because they recognise diabetes management as a legitimate component of sporting participation rather than an exceptional interruption to competition. Futsal Wales has similarly developed a ‘Diabetes Awareness in Football’ initiative addressing the practical and physiological considerations of participating in football, with input from Breakthrough T1D, Diabetes UK and NHS diabetes specialists. These examples demonstrate the value of sport-specific approaches, recognising that the demands, routines and risks associated with T1D will differ across sports and that appropriate responses therefore cannot be reduced to a single generic policy.

UK Deaf Sport provides a complementary example of how policy and practice can be developed through community-informed infrastructure and pathway development. Its Destination Deaflympics programme provides resources for schools, community groups and sports clubs working with Deaf young people aged 8–16, alongside funded inclusion training for teachers, Deaf instructors, volunteers and club or school staff [45]. The programme’s ‘Have a Go Day’ funding extends this approach by enabling local organisations to bring Deaf young people together to experience Deaflympic-inspired sport. Here, inclusion is not simply achieved by modifying an existing sporting opportunity but supported through creating a sporting environment in which communication, representation, peer connection and Deaf identity are part of the provision itself.

These examples also highlight the importance of co-production and lived-experience expertise. Such approaches are consistent with inclusive organisational models that recognise disabled people as active contributors to the design and delivery of sporting opportunities rather than passive recipients of support [37]. The T1D initiatives drew together people living with diabetes, clinical expertise and sporting organisations, while Deaf Sport initiatives were developed through Deaf communities, Deaf athletes and organisations with specific cultural and linguistic knowledge. Such approaches shift inclusion from something determined for athletes towards something developed with and by them. The objective is therefore not to create a single model of inclusion for hidden impairments, but to develop sport-specific and community-informed approaches that translate formal rights into meaningful opportunities to participate.

4.2. From Individual Adaptation to Anticipatory Inclusion

A further opportunity is to move from approaches that require individuals to adapt to existing sporting systems towards anticipatory inclusion, whereby potential barriers are considered as part of the organisation and delivery of sport rather than addressed only after an athlete identifies a problem. For people with hidden impairments, this distinction is particularly important. Where adjustments depend upon disclosure or individual requests that may be denied, athletes may have to explain their impairment, negotiate their participation and educate those around them before support is provided. Anticipatory inclusion instead requires sporting environments to orient towards access in which difference is expected as a norm rather than an anomaly. This reflects principles of inclusive design that advocate embedding accessibility within services, environments and sporting experiences from the outset rather than responding retrospectively to identified barriers (e.g., [46]), and shifts responsibility for inclusion or advocacy away from individuals and towards the transformation of environments, practices, cultures and organisational systems.

This idea can be developed through Mingus’s [47] concept of access intimacy, which offers a relational understanding of what meaningful access can feel like. Access intimacy describes the knowledge and connection that develops when access needs are understood, anticipated and respected without the individual having to repeatedly explain or justify them. This is particularly relevant to sport, where access is often treated as an individual accommodation or logistical problem, placing responsibility on athletes to disclose, negotiate and advocate for their participation. For Deaf and T1D athletes, therefore, meaningful inclusion is not only about whether an adjustment is technically available, but whether the sporting environment is one in which communicating a need is understood as an ordinary part of participation rather than an interruption requiring justification.

Of note, anticipatory inclusion does not mean attempting to predict every individual’s needs or developing a universal set of adjustments for everyone with a particular impairment. Rather, it involves building sufficient flexibility into sporting environments to accommodate variation while retaining opportunities for individual needs and preferences to be recognised. For Deaf athletes, this might involve routinely incorporating visual communication, learning sign commonly used in the sport, using alternative cues in coaching and competition, or ensuring the coach stands directly in front of a Deaf athlete in a group for easier lip reading. For athletes with T1D, it might involve rules and practices that allow sufficient time to monitor glucose, having coaches or umpires carry glucose tablets that can be used during matches, clean spaces assigned for athletes to inject insulin, learning the meaning of glucose readings to better support athletes, and to be aware of what to do if someone with T1D is dangerously low or high.

This reframes anticipatory inclusion from a checklist of adjustments to a culture of access. In this sense, anticipatory inclusion and access intimacy complement one another; the former provides an organisational orientation towards anticipating diversity, while the latter draws attention to the relational experience of having one’s access needs understood, respected and shared. Together, they offer a move from accommodation towards collective responsibility for access [7].

4.3. From Access to Belonging

Access to sport is an important starting point for inclusion, but it does not necessarily produce a sense of belonging, acceptance or value. This distinction reflects longstanding arguments that inclusion should extend beyond physical access to encompass meaningful participation, engagement and community membership [17]. Haegele and Maher [16] argued that understandings of inclusion in sport have too often centred on access to physical and social spaces, rather than the experiences of disabled people within those spaces. This perspective is particularly relevant to communities with hidden impairments, where an athlete may be physically present within a sporting environment while remaining socially or culturally peripheral to it. Meaningful inclusion therefore requires attention not only to whether people can participate, but whether they experience themselves as valued members of the sporting community [15].

This distinction is particularly evident within Deaf sport. Deaf sport can provide opportunities to develop Deaf identity, experience belonging and become part of a community in which participants felt understood and accepted [41]. These experiences in community-specific sporting spaces provide forms of communication, cultural connection, peer support and identity that may be difficult to achieve within mainstream provision. Specialist sport should therefore not automatically be understood as a lesser or segregated form of provision, but constitute an important site of inclusion in its own right. The issue is instead whether athletes have meaningful choices between pathways and whether different forms of provision are adequately resourced and valued.

Representation is an important part of creating this sense of possibility and belonging. The absence of Deaf people from visible sporting roles can reinforce perceptions that they are peripheral to sport. Deaf sporting communities have described a lack of Deaf role models and limited awareness of Deaf sporting history and culture [48]. This connects with wider evidence that relatively few people with hearing impairments report seeing people like themselves participating in sport or working and volunteering within sporting environments [49]. Representation therefore matters not simply because people want to see themselves reflected, but because it can shape whether participation, progression and leadership appear possible and legitimate.

Belonging also requires equitable opportunities to progress. The experiences of Deaf athletes demonstrate that access to participation can coexist with exclusion from the resources required to pursue sporting excellence. Participants have described elite Deaf athletes relying on personal savings, fundraising and voluntary support to compete internationally, with institutional support diminishing at the point where elite development should begin [42]. This highlights an important distinction between inclusion and equity; being able to enter a sporting system does not necessarily mean having an equitable opportunity to progress within it. Sporting systems therefore need to consider development pathways, coaching, leadership, funding and recognition alongside participation itself. Otherwise, inclusion risks becoming concentrated at the point of entry while inequalities persist throughout athletes’ sporting journeys.

The T1D experience similarly demonstrates the importance of belonging and peer connection. The Diabetes Football Community provides a space in which people with T1D can participate alongside others who understand the practical and emotional realities of managing the condition within sport [50]. Such communities can create forms of sporting belonging that are difficult to measure through conventional participation indicators, but which may be important in sustaining engagement and developing sporting identity. Rather than positioning community-specific opportunities as an alternative to mainstream sport, they can provide an additional pathway through which athletes develop confidence, knowledge and connections while also participating within mainstream sporting environments.

Taken together, these perspectives suggest that inclusion should be understood not simply as access to sporting spaces, but as access to sporting communities, identities and futures. Haegele and Maher’s [16] emphasis on belonging, acceptance and value provides an important conceptual shift; the question is not only whether an athlete is permitted to participate, but whether they are recognised as someone who belongs and whose presence and contribution are valued. For Deaf and T1D communities, this means creating opportunities to see people with similar experiences represented, develop relationships with others who understand those experiences, and progress through sporting pathways on equitable terms. Championing inclusion therefore requires sporting systems not simply to accommodate difference, but to value the people and communities that difference brings into sport.

4.4. Lessons from Other Inclusion Research

Research involving other communities has offered valuable insights into how difference could be accommodated and people valued within sporting environments. Although these experiences are not directly equivalent to those of Deaf and T1D communities, studies examining participation among people with mental health conditions, neurodivergent people and people with learning difficulties identified both shared barriers and approaches that supported more inclusive participation. For example, research involving children and young people with psychiatric disorders highlighted the value of peer support and engagement, supportive parental involvement and inclusive programming in addressing barriers such as social isolation, low self-efficacy and limited staff understanding [51]. Similarly, research with Autistic people identified the importance of sensory accommodations, predictable activities, personalised coaching and improved staff awareness in creating more accessible and supportive sporting experiences [52]. Research involving people with learning difficulties also demonstrated the value of offering choice, tailoring activities to individual capabilities, developing positive relationships and ensuring appropriate support from coaches and caregivers [53].

Taken together, these studies suggest that meaningful inclusion could not be achieved through access or individual accommodation alone. Rather, they highlight the importance of sporting environments that are responsive, flexible and supportive, where coaches and organisations actively consider how activities, communication, relationships and support can be adapted to enable meaningful participation. This resonated with Valet’s [15] argument that inclusive participation involves more than being physically present or taking part alongside others, but requires participants to be recognised and valued within the shared sporting experience. Distinctions between being ‘among others’, ‘doing with others’ and ‘being valued by others’ are particularly useful in understanding the relationship between access, participation and belonging. These insights reinforce the need to move beyond approaches that expect individuals to adapt to established sporting norms, towards sporting cultures and practices that anticipated and valued human difference.

5. Conclusions

The experiences of Deaf and T1D communities demonstrate how sporting environments can remain exclusionary when impairment is not immediately visible, when support needs depend upon disclosure, or when disability does not align neatly with individual identity. Legal protection under the Equality Act 2010 is therefore necessary, but insufficient to ensure meaningful inclusion in everyday sporting practice. We have proposed three shifts to address this gap; (1) from policy to practice, (2) from individual adaptation to anticipatory inclusion, and (3) from access to belonging. Together, these shifts reposition inclusion as a collective responsibility. Rather than requiring individuals to disclose, explain and negotiate their needs, sporting organisations should anticipate difference, embed flexibility within everyday practice and work alongside disabled people and their communities to develop appropriate forms of support. Crucially, this should not mean imposing a universal model of inclusion; meaningful inclusion requires responsiveness to the diverse identities, preferences and experiences within communities such as Deaf and T1D populations. Ultimately, the challenge is not to make hidden impairments more visible, but to make sporting environments more responsive to difference. Inclusive sport should be a space where people do not have to disclose, justify or conceal who they are in order to participate, belong and progress. Championing inclusion therefore means moving beyond access and accommodation towards sporting cultures in which difference is anticipated, identities are valued and all athletes are recognised as legitimate members of the sporting community.