RESULTS

This study examined how women with disabilities in Laos experienced and negotiated constraints on sport participation. In line with the aims of the study, the analysis focused on two related dimensions: first, the intrapersonal, interpersonal, and structural constraints shaping sport participation and how these constraints were influenced by the intersections of gender, disability, socioeconomic conditions, and place of residence; and second, how participants negotiated these intersecting constraints by drawing on supportive relationships, information, organizational resources, employment, and competitive opportunities to sustain their participation in sport. Reflexive thematic analysis of the interview data identified four overarching themes: intrapersonal constraints, interpersonal constraints, structural constraints, and negotiation strategies (Table 2).

Table 2 – Themes and Subthemes of Constraints and Negotiation Strategies in Sport Participation among Women with Disabilities in Laos

Intrapersonal Constraints at the Intersection of Gender, Disability, and Place

Fear of sport and diminished self-efficacy emerged as central intrapersonal constraints shaping participants’ sport participation. These constraints were not experienced solely as individual psychological responses but were shaped through the interaction of disability, gender, and place of residence. Many participants described growing up in rural areas where they had little access to information about sport. Limited opportunities for formal education and physical education meant that some participants had little knowledge of the sports available to them or whether participation was possible.

“Before I came to Vientiane and started playing basketball, I had only ever played pétanque in my hometown. I had never even thought about what kinds of sports were available, or what I could do.　Most people in my village have only ever lived in rural areas. They still don’t know what sport is. We move our bodies when we play, but in the countryside, people don’t really know about sport.” (Participant 1)

Within this context of limited sport literacy, participants reported repeatedly encountering messages from those around them that sport was “dangerous” for persons with disabilities and “dangerous” for women. Sport was commonly perceived as physically risky for people with impairments and as inappropriate for women, particularly in rural settings. These perceptions were expressed through protective attitudes within families and local communities, and participants described being exposed to such views in their everyday lives. As a result, even after becoming aware of sport and developing an interest, many participants experienced strong concerns related to health and safety and hesitated to participate.

“I was scared at first. I thought I would fall out of the wheelchair.　I saw the male players falling out of their chairs, and I felt like I wanted to try but also didn’t want to.” (Participant 7)

Furthermore, due to the limited availability of women’s teams, many participants were first introduced to sport in male-dominated environments. These settings were characterized by high levels of physical contact and competitiveness, which intensified feelings of psychological distance. Some participants questioned whether such environments were appropriate or suitable for them.

Taken together, these findings show that fear of sport and low self-efficacy were formed through the combined effects of limited sport knowledge, disability-based perceptions of danger, and gendered perceptions of risk. These intersecting conditions operated simultaneously in shaping participants’ intrapersonal constraints toward sport participation.

Interpersonal Constraints within Gendered and Disability-Based Social Relations

Participants described interpersonal constraints arising from the interaction of disability-related family concerns, gendered restrictions on girls’ activities outside the home, limited household resources, and expectations that women prioritize domestic and caregiving responsibilities. Participants frequently reported that family members expressed strong concern due to their disability, particularly regarding the risk of injury or further impairment. As a result, outdoor activities and sport participation were often discouraged or restricted.

“When I was small, my family saw me fall from my wheelchair and didn’t want me going out to play. I already had a disability, and they didn’t want me to be hurt again.” (Participant 7)

These protective attitudes were closely linked to gender norms prevalent in rural communities. Participants described contexts in which girls’ activities outside the home were viewed negatively, and their behavior was more tightly controlled. In addition, limited knowledge about sport within families contributed to perceptions of sport as inherently dangerous. Participant 3 reported spending long periods alone at home while family members worked in the fields, with few opportunities to engage in activities outside the household.

“I used to stay at home alone. My parents were working in the fields, and I had nothing to do during that time. It was painful and very hard.” (Participant 3)

Participant 4 further explained that caregiving responsibilities within the family were prioritized to such an extent that even schooling was not regarded as necessary, and sport participation was explicitly discouraged.

“Taking care of parents and children was considered the top priority, so my family believed that even going to school was unnecessary. Needless to say, participating in sport was not welcomed at all.” (Participant 4)

These conditions overlapped with expectations placed on women to fulfill domestic and caregiving roles. Participant 4 noted that although she currently participated in sport in the capital, returning to her family home meant being expected to prioritize family care, making continued participation difficult. Sport was perceived as potentially interfering with work and household responsibilities.

“I now participate in sport in the capital, but when I return home, I am expected to care for my family and cannot continue participating. My family supports me because I compete in tournaments, but they are still worried that sport may interfere with my job or household duties.” (Participant 4)

Under these intersecting conditions—disability-based protective attitudes, negative views of girls’ outdoor activities, socioeconomic prioritization of household survival, and gendered caregiving expectations—participants described difficulty entering sport spaces alone.

Structural Constraints across Disability, Location, and Socioeconomic Status

Participants described structural constraints related to inaccessible sport facilities and public transportation, limited availability of suitable facilities outside Vientiane, and the failure of public infrastructure to accommodate their individual access needs. These constraints were shaped by the interaction of impairment-related needs, place of residence, and limited economic resources, restricting when, where, and for how long participants could engage in sport.

Participants reported that many sport facilities and public spaces were not designed with persons with disabilities in mind. Basic features such as ramps, handrails, sufficient corridor width, and wheelchair-accessible toilets were often absent, making safe use of facilities difficult. Under these conditions, reaching and remaining at sport venues constituted a barrier prior to participation itself.

“There are already very few sport facilities in Laos, and even fewer where persons with disabilities can participate safely.” (Participant 2)

While a sport facility with basic barrier-free design exists at the National Rehabilitation Centre in Vientiane, similar facilities were described as extremely limited at the national level. As a result, access to suitable environments differed substantially depending on place of residence.

Public transportation was also described as a significant structural constraint. In Laos, public transport relies primarily on buses, which are not designed for independent use by persons with disabilities. Participants who did not own a private vehicle or motorbike depended on family members or acquaintances for transport, which restricted the times and locations at which participation was possible.

“Even now, it’s hard to go out by myself. I can only go to places where I can do sport if someone goes with me.” (Participant 3)

Several participants described concrete difficulties related to the design of toilets in sport facilities and public spaces, noting that these designs did not accommodate their individual bodily and mobility-related needs. Participants reported that steps leading to toilets were too high, that the height and size of toilet fixtures were unsuitable for them, and that the facilities were difficult to use independently. Squat toilets were described as unusable, and even Western-style toilets were sometimes too high to use safely.

“Sometimes the steps to the toilet are too high. My body is smaller than that of women without disabilities, so the facilities don’t fit me.” (Participant 7)

“I can’t use squat toilets. I also can’t use high toilets because of my leg condition.” (Participant 5)

These toilet-related difficulties reflected a mismatch between standardized facility design and participants’ diverse bodily, mobility, and support needs. As a result, some participants limited the amount of time they spent at sport venues or refrained from participation because of concerns about toilet use.

Negotiating Sport Participation under Intersecting Constraints

The findings also showed that sport participation was not entirely blocked even under conditions in which the constraints discussed above persisted. Many participants began engaging in sport only after relocating from rural areas to the capital city, Vientiane. This relocation was not undertaken for the purpose of sport participation itself, but rather to address everyday needs such as prosthetic fitting, rehabilitation, vocational training, and employment. Nevertheless, moving to an urban setting placed participants in environments where disability support facilities and related organizations were concentrated, thereby enabling access to information about sport and contact with people involved in disability sport.

“When I started working in the capital, there was someone at my workplace who was involved in sport. That person said to me, ‘There is this kind of sport—why don’t you try it?’ Until then, I had never had the opportunity to participate in sport and had never looked for it myself, but hearing directly from someone close to me made me realize that there was actually a place where I could participate.” (Participant 3)

“When I was attending a vocational training school, a teacher introduced me to sport activities. The teacher explained that there was a sport like this and that people were practicing it, and I started attending boccia training. As I continued, the teacher told me, ‘You can continue within your own limits,’ and I kept participating.” (Participant 6)

“I saw other people with the same disability playing sport, and I was invited to try a sport that suited me. After coming to the capital, I saw people with more severe disabilities playing even more powerfully than I was, and that made me want to challenge myself.” (Participant 5)

These social relationships provided conditions that enabled participants to continue engaging in sport. In particular, through relocation from rural to urban areas and encounters with other women with disabilities or supporters who were knowledgeable about disability sport, participants gradually assembled the conditions necessary for sport participation. As this process unfolded, feelings of anxiety and hesitation toward sport diminished, and participants increasingly came to think that they wanted to continue and challenge themselves further.

Against this background, several participants proactively chose to participate in domestic and international competitions and accumulated experience through these opportunities. In the context of a late-developing, low-income country such as Laos, participation in the Paralympic Games entails substantial institutional and competitive barriers and is therefore not easily perceived as a realistic or immediate goal. Instead, semi-regional international competitions such as the ASEAN Para Games were positioned as attainable and meaningful international stages for participants. Participation in these competitions not only created opportunities to sustain sport involvement but also functioned as a means of demonstrating the legitimacy and safety of their sport participation in response to negative or skeptical reactions from family members and local communities. Drawing on the participation conditions that had been gradually established, participants sought to gain understanding and support from others through visible achievements such as participation in the ASEAN Para Games.

“I really enjoyed sport and felt that I had changed since I started. Some family members and people around me told me to stop, so at first I continued without telling them. They were angry at first, but after I started competing and travelling by plane to tournaments [such as the ASEAN Para Games], the criticism gradually decreased and it became easier to continue. Now my family supports me. I am the only person in my family who has travelled abroad. When they saw me win a medal at an international competition [the ASEAN Para Games], they stopped being angry and began cheering for me.” (Participant 1)

“I try to be careful not to get injured so that people around me do not worry. I explain to concerned family members and friends that I can manage myself as an athlete, and sometimes I invite them to come with me to competitions [including the ASEAN Para Games]. Over time, they began to accept what I do.” (Participant 3)

“After competing in the ASEAN Para Games, it felt as if I had returned from overseas. A neighbor said, ‘Even ordinary people rarely get to travel abroad, but you went for a competition.’” (Participant 7)

These competitive experiences provided participants with visible evidence that they could engage in sport safely and successfully. They used their participation in competitions, international travel, and athletic achievements to reassure family members and challenge concerns about the risks and appropriateness of their sport participation. Participants also emphasized that stable employment and a secure living situation were important for sustaining sport participation. Several participants actively sought workplaces and support organizations that enabled them to combine employment with continued involvement in sport.

“After graduating from high school, I was looking for a job in fashion design. As a person with a disability, I was searching for a place where I could work, and I found a job advertisement from a support organization on Facebook. When I started working there, I was asked, ‘Are you interested in sport?’ and was told, ‘We can support both your work and your sport.’ I had been looking for an environment where I could continue working while participating in sport, so I was very happy to know that I could do both.” (Participant 6)

“Previously, I worked at another disability center for five years, but I did not have enough time or money to play sport. In 2018, I joined a wheelchair basketball tournament and met staff from a support organization. They told me that I could continue my sport career while working, so I changed jobs. Once my employment became stable, I had more opportunities to represent Laos at the ASEAN Para Games and the Asian Para Games.” (Participant 1)

Maintaining employment provided participants not only with financial stability but also with time, organizational support, and access to institutional networks that facilitated continued sport participation. More broadly, participants sustained their involvement in sport by gradually gaining access to peer relationships, support organizations, suitable employment, and competitive opportunities. These resources did not eliminate the constraints they faced, but they enabled participants to manage them, explain the value of sport participation to family and community members, and continue participating over time. Negotiation therefore emerged as a cumulative process shaped by access to multiple forms of relational, organizational, and material support.