Project Summary:
The Human Rights Campaign just declared a national state of emergency for lesbian, gay, bisexual,
transgender, and queer (LGBTQ+) Americans in response to over 75 bills being signed into law that restrict the
rights of this population, including bans to gender affirming healthcare. Denial of healthcare due to
discrimination and lack of provider knowledge of transgender and gender diverse (TGD) health remain high in
healthcare settings. To reduce such barriers to healthcare and known health disparities affecting TGD people,
it is imperative to provide up-to-date knowledge on TGD-affirming care according to the World Professional
Association of Transgender Health (WPATH) Standards of Care Version 8 (SOC-8). Nurses are uniquely
suited to provide TGD-affirming care to patients as they are the largest healthcare profession. Currently,
nursing programs and faculty are woefully underprepared to provide students training on TGD-affirming
healthcare practices. To address these educational deficits, our aims are to 1) Create Trans*forming Care: A
7-Module Program Experience, which is a multi-pronged online learning curriculum for nursing students based
on essential components of TGD healthcare utilizing the WPATH SOC-8, community partner relationships,
empirical research, and subject matter experts; 2) Establish the validity of the online learning curriculum in
addressing healthcare needs of TGD as identified by community partners, subject matter experts, and WPATH
SOC-8; 3) Evaluate the short-term impact of the curriculum on nursing student knowledge, skills, attitudes and
connections within TGD healthcare. This multi-phase study will leverage multi-method data to create and
evaluate the Trans*forming Care Program. The Trans*forming Care program will be created through focus
groups and expert validity, as well as utilize an innovative platform to improve nursing students’ knowledge,
skills, attitudes, and connections of TGD patients. Specifically, we will establish face and content validity
through qualitative methods working closely with our subject matter experts (Phase 1) – followed by a
quantitative evaluation of nursing students' knowledge, skills, attitudes, and connections to TGD patients both
pre and post completion of the Trans*forming Care program. The Trans*forming Care program supports the
strategic plan and research lenses of the National Institute of Nursing Research (NINR). These five areas
include 1) health equity, 2) social determinants of health, 3) prevention and health promotion, 4) systems and
models of care, and 5) population and community health. Additionally, this project is ideally suited for this R25
as it will enhance the knowledge of health professionals on influences to health and disease that are present
for TGD individuals. We anticipate this open-source continuing education program to become a model for
TGD-affirming healthcare in nursing schools across the country, leading to improved health outcomes for TGD
people.
