Transgender health for future nurses: Students' knowledge and beliefs before and after transgender curriculum integration

Despite recent calls to prioritize transgender health by the Institute of Medicine and the US Department of Health and Human Services, baccalaureate nursing curricula do not prepare nurses to care for transgender people. A lack of transgender specific curriculum content may contribute to poor health outcomes for transgender people: 19% of transgender people report being refused care and 50% report having to teach their provider about transgender care. Given the nationwide need for providers who are prepared to care for transgender patients and the failure of nursing programs to address this need, we developed transgender health content and integrated it into the baccalaureate curriculum at the Johns Hopkins University School of Nursing.

We evaluate these curricular additions using a non-experimental, one group pre-test post-test study.  Using results from the pre-test (n=80) and first post-test (n=43) we assessed the impact of a 20-minute introductory webinar on students’ knowledge and beliefs regarding transgender health.  We conducted two sample tests of proportions using aggregate survey data. We found moderate increases in knowledge and stability in beliefs: Students report a 19% increase in knowledge of external resources and referrals for transgender patients (p<.05) and no change in predicted comfort with transgender patients in clinical settings (Δ=-4.5%, p=.38).

These preliminary results build momentum for continued integration and evaluation of transgender health content at Johns Hopkins.  They also establish a framework for transgender health education for nurses that can be used at other schools of nursing and built into continuing education programs for practicing nurses.