Mental health practitioners' attitudes towards transgender people: A systematic review of the literature

ABSTRACT

Background: A systematic review was conducted to critically evaluate and synthesize literature investigating mental health practitioners' attitudes towards transgender people.

Objective: Three primary objectives were outlined; first, establish whether overall attitudes are positive or negative. Second, explore whether training, education or experience influences attitudes and finally, examine participant demographics in relation to attitude trends.

Method: A systematic electronic search was carried out in March 2017 using Medline, PsycINFO, PsycArticles, CINAHL, ASSIA, and Web of Science electronic databases. Manual citation and ancestral searches were conducted on identified papers. Qualitative, quantitative and mixed method studies were eligible for inclusion. A total of 13 papers of mixed quality were identified.

Results: Existing literature is limited to cross-sectional, quantitative data and fails to investigate differences between implicit and explicit attitudes. Small to moderate convenience samples reduce the generalizability of data. Overall attitudes were positive although negative attitudes were more frequent in male, Caucasian, heterosexual, religious, conservative mental health professionals.

Conclusions: Refined scales are needed to address the unique heterogeneity within transgender populations. Future research should focus on how attitudes impact care provided and employ longitudinal designs to explore the sustainability of targeted attitudinal training.

KEYWORDS:

• Attitudes
• mental health professional
• systematic review
• transgender

Declaration of conflict of interest/ethical approval

The authors declare that they have no conflict of interest. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Notes

³ Hegemonic masculinity is a concept proposed by Connell (1987) referring to gender order theory. This theory proposes males maintain their dominant position in society and justifies the subjugation of females and marginalization of males that do not conform to the dominant, binary, masculine view of male representation.

1. “Intense dislike of or prejudice against transsexual or transgender people.” (OED Online, 2013).

2. A societal ideological system that oppresses, denigrates, and stigmatizes any non-heterosexual form of identity, behaviour, relationship, or community (Herek, 1990).

3. Hegemonic masculinity is a concept proposed by Connell (1987) referring to gender order theory. This theory proposes males maintain their dominant position in society and justifies the subjugation of females and marginalization of males that do not conform to the dominant, binary, masculine view of male representation.