Introduction

According to the World Health Organization (WHO), approximately 2.5 billion people worldwide are expected to experience some degree of hearing loss by 2050, and more than 700 million of them will have disabling hearing loss [ 1 ]. Individuals with hearing impairment (HI) may have difficulty hearing sounds below the normal threshold of 20 dB [ 2 ]. People who are hard of hearing typically have mild to moderate hearing impairment and can often communicate through spoken language, with or without hearing aids or cochlear implants. In contrast, deafness refers to severe or profound hearing impairment, and individuals in this group often rely on speech reading, writing, or pointing to communicate. One of the most effective means of communication for this population is sign language (SL), which continues to evolve and expand [ 3 ].

Sign language is a complex and expressive language that enables individuals with hearing impairments to communicate effectively [ 4 ]. As sign language interpreting (SLI) became professionalized in the 1970s, research on this field began to expand [ 5 ]. Brentari (2010) suggested that SLI is a valuable service because it facilitates communication and promotes mutual understanding between individuals with hearing impairments and those who have difficulty communicating with them [ 6 ]. Despite its many benefits, sign language interpreting (SLI) worldwide faces numerous occupational challenges that may compromise the quality of the services it provides.

Failure to provide and facilitate adequate sign language interpreting services may result in violations of the human rights of sign language users. In the Middle East and North Africa (MENA) region, there is a substantial shortage of qualified sign language interpreters, as well as limited recognition of the profession and insufficient training programs [ 7 ].

However, in many countries, sign language interpreting is performed primarily voluntarily. Both volunteer and paid sign language interpreters (SLIs) may encounter a variety of occupational challenges, including physical and emotional demands. According to Adigun (2019), the number of qualified SLIs is often insufficient to meet service demands, and the resulting heavy workload may contribute to physical strain [ 8 ]. Furthermore, Humphrey (2015) reported that SLIs commonly experience musculoskeletal problems, including neck, shoulder, hand, and wrist pain [ 9 ].

Emotional challenges may also place SLIs at increased risk of mental health problems, such as anxiety and depression, due to the demands of working with individuals with disabilities and the high level of occupational stress. Prolonged exposure to these stressors may ultimately lead to burnout [ 10 ]. In some cases, SLIs may also be exposed to traumatic experiences recounted or relived by their clients, increasing the risk of compassion fatigue [ 11 ]. These challenges may be even greater for volunteer interpreters, many of whom acquire sign language through personal interest rather than formal academic training [ 10 ].

In this study, we explored the occupational challenges faced by sign language interpreters (SLIs) in Iran from the perspectives of both Iranian SLIs and their clients. In Iran, national programs for individuals with hearing impairments primarily focus on primary prevention [ 12 ], and the national hearing screening guidelines do not address sign language services. Although cochlear implants and hearing aids are available, cochlear implantation remains costly, despite insurance coverage and government subsidies for eligible patients. Sign language is recognized as a means of communication for individuals who cannot benefit from hearing aids or cochlear implants; however, there is no official registry or reported number of practicing SLIs in the country. Despite the high demand for sign language interpreting services and the limited number of qualified interpreters, research on the occupational experiences of Iranian SLIs is scarce. Therefore, the primary aim of this study was to explore the occupational experiences of Iranian sign language interpreters.

Methods

A reflexive thematic analysis, as described by Braun and Clarke [ 13 ], was employed to analyze the data. Reflexive thematic analysis is a qualitative approach that actively engages with the data to identify and interpret underlying concepts and patterns in participants' narratives, while emphasizing the researcher's reflective role throughout the analytical process. This approach acknowledges that the researcher's perspectives and interpretations influence the development of themes during data analysis [ 14 ].

Procedures

The study was conducted in Isfahan, Iran. Participants were recruited using snowball sampling through associations and non-governmental organizations (NGOs) serving the deaf community. Recruitment continued until data saturation was achieved to ensure a comprehensive representation of participants' perspectives. Data saturation was considered reached when no new themes, insights, or relevant information emerged from the interviews.

Participant Recruitment and Inclusion Criteria

A total of 54 participants, including 34 sign language interpreters (SLIs) and 20 individuals with hearing impairments (HIs), were enrolled in the study (Tables 1 and 2). Participants were eligible if they were at least 18 years of age and either members of the deaf community or actively working as sign language interpreters.

Development of Interview Guides

Semi-structured interview guides were developed based on a review of the relevant literature and consultation with experts in the field. The guides consisted of open-ended questions designed to explore participants' pathways to sign language, the challenges associated with interpreting services for sign language, and the specific needs and difficulties experienced by individuals with hearing impairments.

Interview Process

Written informed consent was obtained from all participants before the interviews. Interviews with both sign language interpreters (SLIs) and individuals with hearing impairments (HIs) were conducted face-to-face in private settings to ensure confidentiality and participant comfort. The interviews lasted approximately 60 minutes for SLIs and 80 minutes for HIs.

All interviews followed a semi-structured format, allowing the interviewer to explore emerging topics while maintaining consistency across participants. An interview protocol, consisting of core questions and follow-up prompts, was used to guide each session. The interviews focused on participants' pathways to sign language, workplace challenges, and the needs related to interpreting services.

With participants' permission, interviews with SLIs were audio-recorded using digital recorders and subsequently transcribed verbatim for analysis. Interviews with participants with hearing impairments were documented through detailed handwritten notes taken during the interviews, supplemented by the interviewer's field notes and reflections immediately afterward. This approach was adopted to accommodate participants' preferences and logistical considerations.

Data Analysis

All interview transcripts and field notes were analyzed using thematic analysis to identify key patterns and insights related to the experiences of sign language interpreters (SLIs) and individuals with hearing impairments (HIs). The analysis followed the six-phase reflexive thematic analysis approach described by Braun and Clarke [ 13 ]. The authors independently coded the interview transcripts, discussed the initial codes to reach consensus, and organized them into subthemes and overarching themes. A thematic map was subsequently developed to illustrate the relationships among the themes.

To enhance the trustworthiness of the findings, an external expert reviewed selected themes, and an audit trail was maintained throughout the analytical process. In addition, participants were invited to review the codes and themes to confirm that they accurately reflected their experiences, thereby enhancing the credibility of the findings [ 15 ].

Results

According to our findings, fewer than 20 sign language interpreters (SLIs) serve approximately 13,000 individuals with hearing impairments in Isfahan Province, and most of these interpreters work voluntarily. Four main themes and ten categories emerged from the data (Table 3).

The four main themes identified were SLI as a blessing, necessities, challenges, and needs. The theme necessities comprised three subthemes: social, psychological, and educational. The theme challenges included five subthemes: lack of formal recognition, lack of or insufficient financial benefits, limited acceptance of SLIs by the deaf community, high workload, and burnout. Finally, the theme needs consisted of three subthemes: educational, structural, and advocacy. These themes and subthemes are described in detail below.

Theme 1: SLI as a Blessing

For most participants, sign language interpreting (SLI) was first and foremost perceived as a blessing. Because SLI is not officially recognized as a profession in Iran, many participants did not initially view it as a formal career. Instead, they reported becoming interpreters out of personal interest or life experience. Their motivations included being a child of a deaf adult (CODA), aspiring to become an interpreter, or having a general desire to support individuals with disabilities. “It is a very pleasant experience for me to be able to learn a language beyond my first language and to help a person who has a deficit in one of his/her senses” (SLI 1).

Theme 2: Necessities

Almost all participants believed that the presence of sign language interpreters (SLIs) is a social, psychological, and educational necessity for many individuals with hearing impairments.

2-1 Social Necessity. From a social perspective, both interpreters and participants with hearing impairments emphasized that SLIs are essential because interpreters serve as a bridge for communication between deaf and hard-of-hearing individuals and the hearing community. Many SLIs regarded their work as a social responsibility that promotes the inclusion of individuals with hearing impairments in society. As one participant stated: “Deaf and hard of hearing people have the right to have human relationships and a normal life”. (SLI 18)

2-2 Psychological Necessity: From a psychological perspective, participants noted that, without the support of an interpreter, some individuals with hearing impairments may be unable to manage everyday activities independently outside the home, which can lead to feelings of embarrassment. The presence of a trusted SLI was perceived as reducing feelings of embarrassment, loneliness, and insecurity and was highly valued by participants with hearing impairments. As one participant explained: “It's a good feeling to be with them…It's very relaxing to communicate with others” (PHI 24).

2-3 Educational Necessity. Education was identified as one of the areas in greatest need of sign language interpreting services. Without access to qualified interpreters, students with hearing impairments may struggle to succeed academically in mainstream schools and universities. Participants also noted that SLI services are not consistently available across educational institutions, and communication barriers may contribute to academic failure or school dropout. As one interpreter stated: “Deaf people must have an interpreter at every stage of their education”. (SLI 25)

Theme 3: Challenges

Although access to sign language interpreters is essential for individuals with hearing impairments, participants described the occupation of sign language interpretingashighlychallenging.Themajor challengesidentifiedincludedlackofformal recognition, limited financial benefits, low acceptance within the deaf community, and high levels of burnout.

3-1 Lack of Formal Recognition. From the participants' perspective, the success and sustainability of a profession depend on its official recognition and social acceptance. Many participants believed that sign language interpreting is not yet fully recognized as a formal profession in Iran. As one interpreter explained: “In many places, SLI is still not well understood, and some organizations do not allow the interpreter to be present”. (SLI 28)

3-2 Lack of or Insufficient Financial Benefits. Almost all participants believed that sign language interpreting in Iran offers very limited job security because it is rarely recognized as a formal profession. The majority of Iranian sign language interpreters (SLIs) work voluntarily and receive either no financial compensation or only minimal financial incentives, with no insurance coverage. Participants believed that inadequate financial support has contributed to a decline in the number of SLIs across the country. “The number of interpreters has decreased, and the ratio of deaf people to interpreters is not balanced. The main reason is financial issues, because tariffs, salaries, and benefits have not been defined for them” (SLI 31).

3-3 Limited Acceptance of SLI Within the Deaf Community. Surprisingly, some individuals with hearing impairments (HIs), the primary users of sign language interpreting services, showed limited interest in using these services for several reasons. Some individuals with HIs do not use the official form of sign language, making it more difficult for them to recognize sign language interpreting as a profession. Others rely heavily on family members or close friends for communication and therefore do not perceive a need for a sign language interpreter. The cost of interpreting services was another controversial issue among participants with HIs. In addition, trust was identified as an important factor influencing the use of interpreting services. As one interpreter stated: “The lack of enthusiasm among deaf people to express their need for SLIs has prevented this profession from being accepted and recognized”. (SLI 18)

3-4 High Burnout. Sign language interpreting (SLI) places a considerable physical and emotional burden on interpreters, which may lead to occupational burnout. The most commonly reported physical problems associated with repetitive upper-limb movements included joint disorders, arthritis, and pain, particularly in the hands and shoulders. As one interpreter stated: “We endure a great deal of work pressure during various events because the number of interpreters is low, and we may have to work continuously for several hours”. (SLI 16)

In addition, sign language interpreters are often required to convey the emotions of individuals with hearing impairments who have experienced significant life difficulties or traumatic events. During these emotionally demanding situations, interpreters may receive little or no psychological support. As one participant explained: “Most deaf people live in poverty because they do not have a source of income. Working with these people is psychologically difficult, especially when they have experienced traumatic events” (SLI 27).

Theme 4: Needs

Many participants believed that several important needs remain unmet within the sign language interpreting profession. These needs were grouped into three subthemes: educational, structural, and advocacy.

4-1 Educational Needs. Many individuals interested in becoming sign language interpreters learn sign language through family members, friends, online courses, or deaf associations. Consequently, many enter the profession without adequate preparation for its physical and emotional demands and are often unawareofhowtomanagethesechallenges effectively. As one participant stated: “Interpreters who, like me, come from a hearing family and choose this path should know that communicating with deaf people requires attention and care.” (PHI 4).

4-2 Structural Needs. Participants believed that, for sign language interpreting to be recognized as a profession, it must first receive formal recognition from the government. They emphasized the need for structured education and training programs, formal employment opportunities, health insurance, and retirement benefits. As one interpreter stated: “If sign language interpreting is officially recognized, we, as interpreters, will be better known and our work will be valued as a profession” (SLI 14).

4-3 Advocacy Needs. Most participants emphasized the importance of advocacy in promoting the recognition of sign language interpreting. They believed that both individuals with hearing impairments and sign language interpreters should play leading roles in raising public awareness about the value of SLI. Participants noted that interpreters are needed in many settings, including public events, the media, emergencies, and healthcare services. However, because of limited advocacy efforts, the presence of SLIs in these settings remains uncommon; the profession continues to be undervalued, and public awareness of its essential role remains limited.

Discussion

This study explored the occupational experiences of sign language interpreters (SLIs) in Iran. Interviews were conducted with two groups—Persons with hearing impairments (PHIs) and sign language interpreters (SLIs). Four main themes emerged from the data: SLI as a blessing, necessities, challenges, and needs.

Almost all SLIs described their work as a blessing and indicated that they would continue to serve as interpreters regardless of financial compensation. Consistent with previous studies [ 6 , 16 ], our findings highlight the importance of sign language interpreting for both interpreters and service users. Similarly, McCartney [ 17 ] reported that most interpreters initially choose this profession because of intrinsic motivation. They perceive interpreting as a meaningful and rewarding service, which contributes to greater job satisfaction.

The findings showed that without the assistance of a sign language interpreter (SLI), individuals with hearing impairments may experience social isolation and have their emotional well-being adversely affected. Burhani and Prasetyo [ 18 ] similarly reported that SLIs provide important psychological support for individuals with hearing impairments. As emphasized by nearly all participants in the present study, the presence of SLIs is essential in many organizations; however, their importance has not yet been fully recognized in Iran.

Several important challenges affecting sign language interpreting in Iran were identified. The first and perhaps most significant challenge is that sign language is not officially recognized as a language in Iran. Consequently, sign language interpreting has not achieved a stable professional status within mainstream society or among policymakers, according to Choubsaz et al. [ 19 ]. Although the Baghcheban method, an important phonetic alphabet, is widely used in Iranian schools for deaf students, sign language users may communicate using a combination of the Baghcheban alphabet, sign language, lip-reading, fingerspelling, and mouthing. As a result, sign language is not only absent from official language policies but is also not uniformly adopted by its primary users, individuals with hearing impairments.

Another major challenge identified by participants was the lack of financial support. Most SLIs in the present study worked voluntarily and rarely received financial compensation for their services. Consequently, many participants did not regard sign language interpreting as a recognized profession in Iran.

Sign language interpreting (SLI) can be physically and emotionally demanding. However, because many SLIs have not received formal training or professional supervision, they often lack the knowledge and skills needed to prevent or manage the physical and emotional challenges associated with their work. In addition, despite the demands of the profession, the absence of stable financial compensation led many participants to reduce or discontinue their interpreting activities after experiencing adverse physical or emotional consequences. Consistent with our findings, Shin and Jung [ 20 ] reported that the challenging working conditions faced by SLIs may contribute to job dissatisfaction.

Although the Convention on the Rights of Persons with Disabilities [ 21 ] states that “States parties shall take appropriate measures to ensure persons with disabilities access, on an equal basis with others, to the physical environment, transportation, information, and communications”, Iran still has a long way to go to achieve equal access to information and communication for individuals with hearing impairments and their interpreters.

Addressing the physical and emotional challenges of sign language interpreting requires formal training, professional supervision, and education on the ethical and cultural considerations involved in providing interpreting services. These competencies should be incorporated into academic training programs. Burke [ 22 ] argued that the provision of sign language interpreting is inherently a political issue. Therefore, the importance of sign language interpreting should first be formally recognized in disability legislation and public policy. This remains an important gap in Iran that requires special attention.

One limitation of this study is the participants' age range. Only adults with hearing impairments were interviewed. Including children with hearing impairments and their parents in future studies may provide additional perspectives and generate different findings.

Conclusion

In conclusion, sign language interpreting is a physically and emotionally demanding activity that can also provide a strong sense of satisfaction and personal fulfillment. However, the profession offers little or no financial compensation, and most participants believed that sign language interpreting is not formally recognized as a profession in Iran. Instead, it is largely viewed as a voluntary activity with limited opportunities for formal education and professional supervision. Moreover, the number of sign language interpreters is insufficient to meet the needs of individuals with hearing impairments. To promote equal rights and access to communication for persons with hearing impairments, Iran should implement policies that formally recognize sign language interpreting as a profession and expand university- based education and training programs in this field.

Acknowledgments

The authors thank all participants for generously sharing their experiences. They also acknowledge Ms. Sama Zamani for her assistance with the interviews involving participants with hearing impairments.

Authors’ Contributions

All authors contributed to the study conception and design, data analysis, and manuscript preparation, and approved the final version of the manuscript.

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