Transgender-specific factors related to healthcare professional students’ engagement in affirmative practice with LGBTQ+ clients

ABSTRACT

Transgender individuals face many barriers to healthcare access, including providers’ lack of knowledge on transgender-specific healthcare needs. Physicians and medical students report a lack of training on and low confidence with transgender-related healthcare. Previous research has demonstrated the importance of self-efficacy and beliefs regarding affirmative practice for counsellors’ engagement in affirmative practice with LGBTQ+ clients. The present study investigated healthcare professional students’ attitudes towards transgender individuals, as well as the influence of students’ skills in working with transgender clients and their confidence understanding transgender healthcare terms on their beliefs about, self-efficacy regarding, and actual engagement in affirmative practice. Sixty-one Canadian healthcare professional students participated in an online survey. Participants reported positive attitudes towards transgender individuals, and positive beliefs about the importance of affirmative practice with LGBTQ+ clients. In a multiple mediation model, confidence with understanding transgender healthcare terms and practical skills with working with transgender clients each related to self-efficacy regarding affirmative practice; self-efficacy in turn related to engagement in affirmative practice. Healthcare professional students’ positive attitudes and beliefs are promising; additional training that builds practical skills and confidence in using correct language is important for students’ self-efficacy and engagement in affirmative practice.

KEYWORDS:

• Healthcare education
• transgender healthcare
• affirmative practice

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. We use the term ‘client’ throughout this paper to emphasise the active and collaborative role that individuals take in their healthcare.

2. The term ‘healthcare’ as used in this paper refers to both physical and mental healthcare services, which may be provided by professionals such as medical doctors, nurses, therapists, and counsellors.

3. We use + at the end of the LGBTQ acronym in order to be inclusive of other sexual orientations and gender identities.

Additional information

Funding

This work was supported by an Ontario Graduate Scholarship awarded to Meghan McInnis, and an Ontario Women’s Health Scholar Award awarded to Stéphanie Gauvin. The Ontario Women’s Health Scholars Award is funded by the Ontario Ministry of Health and Long-Term Care. The views expressed in the publication are the views of the author(s) and do not necessarily reflect those of the Ministry of Health and Long-Term Care.

Notes on contributors

Meghan K. McInnis

Meghan McInnis is a Clinical Psychology doctoral student working under the supervision of Dr. Caroline Pukall in the Sexual Health Research Laboratory (SexLab) at Queen’s University. Her research interests are varied, with a focus on sexual and gender diversity. Her doctoral research is an investigation of the concept of virginity in adulthood. She is a co-founder of QueeringCancer.ca, an online resource for LGBTQ+ individuals living with cancer.

Stéphanie E. M. Gauvin

Stéphanie Gauvin is a Clinical Psychology doctoral student under the supervision of Dr. Caroline Pukall in the Sexual Health Research Laboratory (SexLab) at Queen’s University. Stéphanie is a co-editor of the comic anthology Rainbow Reflections: Body Image Comics for Queer Men which mobilizes knowledge on gay, bisexual, queer, and trans men’s body image. Her doctoral research focuses on how individuals in relationships negotiate and navigate sexual challenges, with a focus on how sexual script flexibility is related to sexual well-being after treatments for breast cancer.

Caroline F. Pukall

Dr. Caroline Pukall received her Ph.D. in Clinical Psychology from McGill University. She is currently Full Professor in the Department of Psychology and the Director of the Sex Therapy Service at the Psychology Clinic at Queen’s University. The students in Caroline’s research lab—the Sexual Health Research Laboratory—work on research projects examining various aspects of sexuality, including: vulvodynia, sexual difficulties, male and female sexual arousal, women’s health issues, male circumcision, and various relationship constellations. She has investigated numerous aspects of sexuality using brain imaging, psychophysics, psychophysiology, and blood flow imaging, all the while relating the findings of these methods to a variety of self-report measures. Caroline’s research has been funded by several organizations including the Canadian Institutes of Health Research and the National Vulvodynia Association. Caroline is Associate Editor for Sexual Medicine Reviews and is on the editorial board of several journals, including The Archives of Sexual Behavior, The Journal of Sex and Marital Therapy, and The Canadian Journal of Human Sexuality. Recently, she was co-chair of the Women’s Sexual Pain Disorders Committee of the International Consultation of Sexual Medicine.