1
|
McMullan J, Thompson DR, Dixon A, Palumbo A, Dickinson T, Jourdain P, Monaghan C, Quinn B. Exploring perceptions of what increased gender diversity might bring to the nursing profession. J Adv Nurs 2024. [PMID: 39149919 DOI: 10.1111/jan.16246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 04/25/2024] [Accepted: 05/09/2024] [Indexed: 08/17/2024]
Abstract
AIMS To explore university nursing students and academic staff's perceptions of what increased gender diversity might bring to the nursing profession. DESIGN An exploratory study with students and academic staff from two university nursing schools. METHODS Students and staff in two university nursing schools were invited to participate in an anonymous online survey (October-November 2022). The survey focused on gender diversity within nursing and patient care, asking respondents about existing barriers to gender diversity and inviting ideas on increasing gender diversity within nursing. The survey findings helped inform questions, which were used to further explore views and thoughts of gender diversity within nursing through semi-structured one-to-one interviews (January-February 2023). RESULTS Nearly, two-thirds (64%, n = 69) of survey respondents strongly agreed/agreed that the lack of gender diversity in nursing negatively impacted delivering care to a gender-diverse society. Most (84%, n = 90) strongly agreed/agreed that increased gender diversity within the nursing workforce would positively contribute to nursing. Three-quarters (75%, n = 74) strongly agreed/agreed that working with a more gender-diverse nursing workforce would enrich their experience as a nurse. Three themes emerged from the interview data: shared stereotypes; improved care through knowledge, better relations and the presence of a gender-diverse workforce; a culture of welcome: suggested changes for the future. CONCLUSION Most of those who participated in the study believe there are benefits to be gained from greater gender diversity within nursing. This study provides insight into the lack of gender diversity in the nursing environment, highlights how this might impact patient care and suggests actions to make nursing a more inclusive profession. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Practical solutions were suggested, including the greater visibility of trans and non-binary persons in advertisement and recruitment campaigns to ensure nursing is viewed as a career choice for "all". Including a space for considered pronouns on university application forms, hospital documentation and name badges. Gender-neutral titles and uniforms should be considered for all nursing staff, and more gender-neutral toilets should be made available for staff and patients in university and hospital settings. IMPACT This study addressed the lack of gender diversity in nursing and explored what an increase in gender diversity might bring to the nursing profession. The main findings were: (i) Less than a tenth (9%, n = 12) of respondents described their team of colleagues as being "extremely gender diverse". (ii) Most (84%, n = 90) strongly agreed/agreed that increased gender diversity within the nursing workforce would be a positive attribute to nursing. (iii) Three-quarters 75% (n = 74) strongly agreed/agreed that working with a more gender-diverse nursing workforce would enrich their experience as a nurse. (iv) Many stereotypes still exist in nursing and tackling them is important to make the profession more inclusive. (v) A nurse's gender can impact the care they provide. (vi) A more gender-diverse workforce would better reflect the population it serves. (vii) This research will have an impact on the nursing profession globally. REPORTING METHOD The consolidated criteria for reporting qualitative studies (COREQ) was used as a guide throughout data collection and analysis. PATIENT OR PUBLIC CONTRIBUTION Every step of the study, including the survey and interview schedule, was co-constructed using an iterative approach with service users, students and staff who had personal experience of gender diversity and were a core part of the study team.
Collapse
Affiliation(s)
- Julie McMullan
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Alexx Dixon
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Alex Palumbo
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Tommy Dickinson
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Praise Jourdain
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Catherine Monaghan
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Barry Quinn
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| |
Collapse
|
2
|
Layton H, Tremayne P, Norton W. Supporting transgender patients with their personal hygiene. Nurs Stand 2023; 38:29-34. [PMID: 37599637 DOI: 10.7748/ns.2023.e12110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2023] [Indexed: 08/22/2023]
Abstract
Attending to one's personal hygiene is a private and ritualistic act that is linked to self-expression and is important for one's well-being and self-esteem. Providing effective support with personal hygiene to patients can demonstrate thoughtfulness and sensitivity to their individual needs. Nurses in all fields of nursing may encounter patients who identify as transgender, but many nurses have expressed concerns about their lack of knowledge and confidence in that area of care. This article discusses the use of gender-affirming language and the factors to consider when supporting transgender patients with their personal hygiene as part of personalised, equitable and inclusive nursing care.
Collapse
Affiliation(s)
- Helen Layton
- The Leicester School of Nursing and Midwifery, De Montfort University Leicester, Leicester, England
| | - Penny Tremayne
- The Leicester School of Nursing and Midwifery, De Montfort University Leicester, Leicester, England
| | - Wendy Norton
- Faculty of Health and Life Sciences, De Montfort University Leicester, Leicester, England
| |
Collapse
|
3
|
Hudak N. "Who's the Mom?": Heterosexism in Patient-Provider Interactions of Queer Pregnant Couples. HEALTH COMMUNICATION 2023; 38:114-123. [PMID: 34096428 DOI: 10.1080/10410236.2021.1936752] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Previous scholarship has discussed how queer individuals experience discrimination in healthcare settings. This study furthers this area of research by exploring how queer pregnant couples encountered heterosexism within patient-provider interactions. Heterosexism is being used as a framework for the study by looking at how healthcare acts as a power system to promote heterosexual identity. Through using a multiadic analysis, I interviewed 16 couples both together and separately, resulting in 46 total interviews. The analysis demonstrated that the couples experienced heterosexism by providers not understanding who the "mom" is, having to explain sexual identity to providers and providers reinforcing heterosexist expectations. The couples also provided advice for healthcare providers to improve their interactions with future queer pregnant couples.
Collapse
|
4
|
Gender identity and sexual behavior stigmas, severe psychological distress, and suicidality in an online sample of transgender women in the United States. Ann Epidemiol 2020; 52:15-22. [PMID: 32768521 DOI: 10.1016/j.annepidem.2020.07.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 07/10/2020] [Accepted: 07/28/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE The objective of this study is to (1) quantify burden of perceived, anticipated, and enacted gender identity (GI) and sexual behavior (SB) stigmas and (2) explore associations between GI and SB stigmas with key mental health factors among transgender women in the United States. METHODS We estimated associations between GI and SB stigmas with severe psychological distress, suicidal ideation, and suicide attempt using cross-sectional data from the Transgender Women's Internet Survey and Testing study from March to April, 2019. Modified Poisson regression produced prevalence ratios and 95% confidence intervals for severe psychological distress, suicidal ideation, and suicide attempt with GI and SB stigma items individually, as well as the GI and SB stigma items treated as two scales. RESULTS Of 381 transgender women, 52% experienced severe psychological distress in the past month, whereas 59.3% and 13.12% reported suicide ideation and attempt in the past year, respectively. In adjusted models, GI and SB stigma scales were significantly, positively associated with severe psychological distress, suicidal ideation, and suicide attempt. CONCLUSIONS Continued training for providers in trans-competent mental health care and the development of newer engagement and delivery strategies for stigma mitigation interventions are needed.
Collapse
|
5
|
Stryker SD, Pallerla H, Pickle S. Considerations on medical training for gender-affirming care: Motivations and perspectives. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2019; 21:79-88. [PMID: 33015661 PMCID: PMC7430477 DOI: 10.1080/15532739.2019.1689880] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Background: Many transgender individuals lack access to needed medical care, partially due to a lack of providers with experience in gender-affirming healthcare. Aims: The purpose of this study was to identify professional motivators for medical providers seeking out training in gender-affirming care and to define which training experiences were most beneficial to their career development. By identifying experienced providers' recommendations on which training modalities are most relevant to their practice, we aim to suggest future directions for medical education initiatives to effectively expand the transgender care workforce. Methods: A voluntary cross-sectional electronic survey was distributed through professional listservs and publicly-available referral lists to interdisciplinary providers who self-identified as having experience in providing care to transgender individuals. Results: One hundred and fifty-three (n = 153) physicians, physician assistants, or advance-practice nurses responded to the survey. The majority (96.7%) were located in the United States, representing 37 states. The two most common motivators for seeking out training in gender-affirming care were filling a need in the community (73.0%) and/or having met a transgender-identified person in a clinical setting who requested care (63.8%). While many providers gained skills independently (57.3%), the two most commonly-available training opportunities were professional conferences (57.3%) and mentorship (41.3%). Respondents were most likely to recommend that others in their field be trained via structured clinical experience (e.g., a rotation or longitudinal exposure during training), rather than additional didactic training. Discussion: This study identifies key high-yield training methodologies which could improve access to quality gender-affirming healthcare. Through integration of structured clinical experiences during training, direct clinical mentorship, and professional development at conferences on gender-affirming care, the workforce of welcoming and prepared healthcare providers for transgender patients will increase. This will lead to a tremendous improvement on access to gender-affirming care in our communities.
Collapse
Affiliation(s)
- Shanna Duffy Stryker
- Department of Family and Community Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Harini Pallerla
- Department of Family and Community Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Sarah Pickle
- Department of Family and Community Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| |
Collapse
|
6
|
Kcomt L. Profound health-care discrimination experienced by transgender people: rapid systematic review. SOCIAL WORK IN HEALTH CARE 2019; 58:201-219. [PMID: 30321122 DOI: 10.1080/00981389.2018.1532941] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 09/24/2018] [Accepted: 10/03/2018] [Indexed: 05/28/2023]
Abstract
Transgender people experience interpersonal and structural barriers which prevent them from accessing culturally and medically competent health care. This rapid systematic review examined the prevalence of health-care discrimination among transgender people in the U.S. and drew comparisons with sexual minority samples and the general U.S. population. Eight primary studies with 35 prevalence estimates were analyzed. Transgender populations experience profound rates of discrimination within the U.S. health-care system. Compared to sexual minorities, transgender participants appear to be more compromised in their access to health care. Service providers must change structural inequities which contribute to transgender people's invisibility.
Collapse
Affiliation(s)
- Luisa Kcomt
- a School of Social Work , University of Windsor , Windsor , Ontario , Canada
| |
Collapse
|
7
|
Abstract
Nearly fifteen years have passed since this author's publication which examined the depth of education and training for medical students and practicing physicians specific to clinical competence in the care of lesbian and gay patients in the United States. Since then, there has been an explosion of research gains which have shed a steady light on the needs and disparities of lesbian and gay healthcare. This rich literature base has expanded to include bisexual and transgender (LGBT) healthcare in peer-reviewed journals. Despite these research gains underscoring a call for action, there continues to be a dearth of cultural competency education and training for healthcare professionals focused on clinical assessment and treatment of LGBT patients. This article will focus exclusively on the current status of medical and nursing education and training specific to clinical competence for LGBT healthcare. We are long overdue in closing the clinical competency gap in medical and nursing education to reduce the healthcare disparities within the LGBT community.
Collapse
Affiliation(s)
- Kathleen A Bonvicini
- Institute for Healthcare Communication, 171 Orange Street, 2nd floor, New Haven, CT 06510-3153, United States.
| |
Collapse
|
8
|
|
9
|
Kellett P, Fitton C. Supporting transvisibility and gender diversity in nursing practice and education: embracing cultural safety. Nurs Inq 2016; 24. [DOI: 10.1111/nin.12146] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Peter Kellett
- Faculty of Health Sciences; University of Lethbridge; Lethbridge AB Canada
| | - Chantelle Fitton
- Faculty of Health Sciences; University of Lethbridge; Lethbridge AB Canada
| |
Collapse
|
10
|
Wylie K, Knudson G, Khan SI, Bonierbale M, Watanyusakul S, Baral S. Serving transgender people: clinical care considerations and service delivery models in transgender health. Lancet 2016; 388:401-411. [PMID: 27323926 DOI: 10.1016/s0140-6736(16)00682-6] [Citation(s) in RCA: 174] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The World Professional Association for Transgender Health (WPATH) standards of care for transsexual, transgender, and gender non-conforming people (version 7) represent international normative standards for clinical care for these populations. Standards for optimal individual clinical care are consistent around the world, although the implementation of services for transgender populations will depend on health system infrastructure and sociocultural contexts. Some clinical services for transgender people, including gender-affirming surgery, are best delivered in the context of more specialised facilities; however, the majority of health-care needs can be delivered by a primary care practitioner. Across high-income and low-income settings alike, there often remains a dearth of educational programming for health-care professionals in transgender health, although the best evidence supports introducing modules on transgender health early during clinical education of clinicians and allied health professionals. While these challenges remain, we review the increasing evidence and examples of the defined roles of the mental health professional in transgender health-care decisions, effective models of health service provision, and available surgical interventions for transgender people.
Collapse
Affiliation(s)
- Kevan Wylie
- University of Sheffield, Sheffield, UK; Porterbrook Clinic, Sheffield, UK.
| | - Gail Knudson
- Department of Psychiatry, University of British Columbia, BC, Canada
| | - Sharful Islam Khan
- Program for HIV and AIDS, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - Mireille Bonierbale
- Gender Dysphoria and Sexology Department, University Hospital La Conception, Marseille, France
| | - Suporn Watanyusakul
- Suporn Clinic, Division of Plastic Surgery, Aikchol Hospital, Chonburi, Thailand
| | - Stefan Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA
| |
Collapse
|
11
|
Review: Australian mental health nurses and transgender clients: Attitudes and knowledge. J Res Nurs 2016. [DOI: 10.1177/1744987115625008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
12
|
Walker CA, Cohen H, Jenkins D. An Older Transgender Woman's Quest for Identity. J Psychosoc Nurs Ment Health Serv 2016; 54:31-8. [PMID: 27648872 DOI: 10.3928/02793695-20160119-04] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 11/24/2015] [Indexed: 11/20/2022]
Abstract
Despite sensationalized media attention, transgender individuals are the most marginalized and misunderstood group in the lesbian, gay, bisexual, and transgender (LGBT) community. The current article presents a case study of one woman's quest for identity. Narrative inquiry was used to analyze data from interview transcripts and four themes emerged during analysis: (a) naming the ambiguity, (b) revealing-concealing the authentic self, (c) discovering the transgender community, and (d) embracing the "T" identity. Lifespan and empowerment theories were used to harvest meanings from these themes. Implications for nursing practice and research were examined based on study findings. Participatory action research offers an approach for future studies in which researchers advocate for transgender individuals and remove obstacles to their health care access. [Journal of Psychosocial Nursing and Mental Health Services, 54(2), 31-38.].
Collapse
|
13
|
Ciocca G, Capuano N, Tuziak B, Mollaioli D, Limoncin E, Valsecchi D, Carosa E, Gravina GL, Gianfrilli D, Lenzi A, Jannini EA. Italian Validation of Homophobia Scale (HS). Sex Med 2015; 3:213-8. [PMID: 26468384 PMCID: PMC4599558 DOI: 10.1002/sm2.68] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction The Homophobia Scale (HS) is a valid tool to assess homophobia. This test is self-reporting, composed of 25 items, which assesses a total score and three factors linked to homophobia: behavior/negative affect, affect/behavioral aggression, and negative cognition. Aim The aim of this study was to validate the HS in the Italian context. Methods An Italian translation of the HS was carried out by two bilingual people, after which an English native translated the test back into the English language. A psychologist and sexologist checked the translated items from a clinical point of view. We recruited 100 subjects aged18–65 for the Italian validation of the HS. The Pearson coefficient and Cronbach's α coefficient were performed to test the test–retest reliability and internal consistency. Main Outcome Measures A sociodemographic questionnaire including the main information as age, geographic distribution, partnership status, education, religious orientation, and sex orientation was administrated together with the translated version of HS. Results The analysis of the internal consistency showed an overall Cronbach's α coefficient of 0.92. In the four domains, the Cronbach's α coefficient was 0.90 in behavior/negative affect, 0.94 in affect/behavioral aggression, and 0.92 in negative cognition, whereas in the total score was 0.86. The test–retest reliability showed the following results: the HS total score was r = 0.93 (P < 0.0001), behavior/negative affect was r = 0.79 (P < 0.0001), affect/behavioral aggression was r = 0.81 (P < 0.0001), and negative cognition was r = 0.75 (P < 0.0001). Conclusions The Italian validation of the HS revealed the use of this self-report test to have good psychometric properties. This study offers a new tool to assess homophobia. In this regard, the HS can be introduced into the clinical praxis and into programs for the prevention of homophobic behavior.
Collapse
Affiliation(s)
- Giacomo Ciocca
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila L'Aquila, Italy
| | - Nicolina Capuano
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila L'Aquila, Italy
| | - Bogdan Tuziak
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila L'Aquila, Italy
| | - Daniele Mollaioli
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila L'Aquila, Italy
| | - Erika Limoncin
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila L'Aquila, Italy
| | - Diana Valsecchi
- Department of Experimental Medicine, Sapienza University of Rome Rome, Italy
| | - Eleonora Carosa
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila L'Aquila, Italy
| | - Giovanni L Gravina
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila L'Aquila, Italy
| | - Daniele Gianfrilli
- Department of Experimental Medicine, Sapienza University of Rome Rome, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine, Sapienza University of Rome Rome, Italy
| | | |
Collapse
|