Even when nurse practitioners (NPs) have good intentions, the services they deliver to trans people may still be tinged with discrimination and bias.
This is according to “Nurse Practitioner Knowledge, Attitudes, and Beliefs When Caring for Transgender People”, a study by Catherine Paradiso and Robin M. Lally, and published in Transgender Health.
Paradiso and Lally noted that discrimination toward trans people continues to be widespread. In the healthcare industry, discrimination and bias may not be intentional, and yet still “contributes to and supports the disparity in care.”
The study eyed to explore NP knowledge, attitudes and beliefs when working with trans people and to inform about practitioner education needs. To do this, the researchers used a qualitative descriptive design to explore NP experiences. Focused semistructured interviews were conducted in 2016 with 11 (N=11) NPs in the northeastern US who represent various years of experience and encounters with trans patients. These interviews explored NP knowledge attitudes and beliefs when caring for trans patients and described their overall experiences in rendering care in the clinical setting. These interviews were professionally transcribed and analyzed independently and jointly by two investigators using conventional content analysis.
For this study, four main themes and six subthemes were identified: personal and professional knowledge gaps, fear and uncertainty, caring with intention and pride, and creating an accepting environment.
The NPs in this study perceived gaps in their knowledge that threaten their ability to deliver quality, patient-centered care to trans patients, despite their best intentions.
According to the researchers, the findings show that “despite a desire to provide care, lack of experience with and education about trans healthcare limit NPs in their role, potentially causing them to be among the group of providers who unintentionally support existing disparities.”
Barriers to quality care include the following: (1) reluctance of trans patients to disclose gender identity when receiving medical care, (2) insufficient numbers of competent providers to care for LGBTQ issues, (3) insurance and policy barriers, (4) lack of culturally appropriate prevention services, and (5) discrimination.
Obviously, these findings have implications for changes in nursing practice, education, and research; in turn, the researchers stressed that these vital gaps need to be addressed in the healthcare provision for trans people.