314
Views
0
CrossRef citations to date
0
Altmetric
Research Articles

A preliminary study of intensive transgender-specific cultural competency training: Implications for social workers and psychologists who work with rural transgender clients

ORCID Icon

References

  • Acker, G. M. (2017). Transphobia among students majoring in the helping professions. Journal of Homosexuality, 64(14), 2011–2029. https://doi.org/10.1080/00918369.2017.1293404
  • Almazan, A. N., Benyishay, M., Stott, B., Vedilago, V., Reisner, S. L., & Keuroghlian, A. S. (2023). Gender-affirming primary care access among rural transgender and gender diverse adults in five northeastern U.S. states. LGBT Health, 10(1), 86–92. https://doi.org/10.1089/lgbt.2021.0391
  • American Psychological Association. (2015). Guidelines for psychological practice with transgender and gender nonconforming people. American Psychologist, 70(9), 832–864. https://doi.org/10.1037/a0039906
  • American Psychological Association. (2017). Multicultural guidelines: An ecological approach to context, identity, and intersectionality. http://www.apa.org/about/policy/multicultural-guidelines.pdf.
  • Austin, A., Craig, S. L., Alessi, E. J., Wagaman, M. A., Paceley, M. S., Dziengel, L., Balestrery, J. E. (2016). Guidelines for transgender and gender nonconforming (TGNC) affirmative education: Enhancing the climate for TGNC students, staff and faculty in social work education. Council on Social Work Education. https://www.cswe.org/getmedia/e95d6dce-9e22-4c1f-a7af-374d398fd8de/Guidelines-for-Trasngender-and-Gender-Nonconforming-(TGNC)-Affirmative-Education-CSOGIE_WP2_TGNC_final_web.pdf.
  • Bidell, M. (2015). Using the sexual orientation counselor competency scale (SOCCS) in mental health and healthcare settings: An instructor’s guide. MedEdPORTAL, 11(10040). https://doi.org/10.15766/mep_2374-8265.10040
  • Bidell, M. P. (2014). Are multicultural courses addressing disparities? Exploring multicultural and affirmative lesbian, gay, and bisexual competencies of counseling and psychology students. Journal of Multicultural Counseling and Development, 42(3), 132–146. https://doi.org/10.1002/j.2161-1912.2014.00050.x
  • Bidell, M. P. (2005). The sexual orientation counselor competency scale: Assessing attitudes, skills, and knowledge of counselors working with lesbian, gay, and bisexual clients. Counselor Education and Supervision, 44(4), 267–279. https://doi.org/10.1002/j.1556-6978.2005.tb01755.x
  • Bishop, G. F. (2008). Item order randomization. In P. J. Lavrakas (Ed.), Encyclopedia of survey research methods (pp. 397–399). SAGE Publications.
  • Blodgett, N., Coughlan, R., & Khullar, N. (2017). Overcoming the barriers in transgender healthcare in rural Ontario: Discourses of personal agency, resilience, and empowerment. International Social Science Journal, 67(225–226), 83–95. https://doi.org/10.1111/issj.12162
  • Bragg, J. E., Nay, E. D., Miller-Cribbs, J., & Munoz, R. T. (2020). Implementing a graduate social work course concerning practice with sexual and gender minority populations. Journal of Gay & Lesbian Social Services, 32(1), 115–131. https://doi.org/10.1080/10538720.2019.1654425
  • Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa
  • Brown, S., Kucharska, J., & Marczak, M. (2018). Mental health practitioners’ attitudes towards transgender people: A systematic review of the literature. International Journal of Transgenderism, 19(1), 4–24. https://doi.org/10.1080/15532739.2017.1374227
  • Budge, S. L., Sinnard, M. T., & Hoyt, W. T. (2021). Longitudinal effects of psychotherapy with transgender and nonbinary clients: A randomized controlled pilot trial. Psychotherapy, 58(1), 1–11. https://doi.org/10.1037/pst0000310
  • Butler, R. M., Horenstein, A., Gitlin, M., Testa, R. J., Kaplan, S. C., Swee, M. B., & Heimberg, R. G. (2019). Social anxiety among transgender and gender nonconforming individuals: The role of gender-affirming medical interventions. Journal of Abnormal Psychology, 128(1), 25–31. https://doi.org/10.1037/abn0000399
  • Caldwell, J. T., Ford, C. L., Wallace, S. P., Wang, M. C., & Takahashi, L. M. (2016). Intersection of living in a rural versus urban area and race/Ethnicity in explaining access to health care in the United States. American Journal of Public Health, 106(8), 1463–1469. https://doi.org/10.2105/ajph.2016.303212
  • Chan, B., Skocylas, R., & Safer, J. D. (2016). Gaps in transgender medicine content identified among Canadian medical school curricula. Transgender Health, 1(1), 142–150. https://doi.org/10.1089/trgh.2016.0010
  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Academic Press.
  • Coleman, E., Radix, A. E., Bouman, W. P., Brown, G. R., de Vries, A. L. C., Deutsch, M. B., Ettner, R., Fraser, L., Goodman, M., Green, J., Hancock, A. B., Johnson, T. W., Karasic, D. H., Knudson, G. A., Leibowitz, S. F., Meyer-Bahlburg, H. F. L., Monstrey, S. J., Motmans, J., Nahata, L., … Arcelus, J. (2022). Standards of care for the health of transgender and gender diverse people, version 8. International Journal of Transgender Health, 23(Suppl 1), S1–S259. https://doi.org/10.1080/26895269.2022.2100644
  • Cor, D. N. (2016). Gender identity counselor competency Scale: A validation study [Doctoral dissertation]. ProQuest Dissertations and Theses Global.
  • Creswell, J. W., & Miller, D. L. (2000). Determining validity in qualitative inquiry. Theory into Practice, 39(3), 124–130. https://doi.org/10.1207/s15430421tip3903_2
  • Crisp, C. (2006). The gay affirmative practice scale (GAP): A new measure for assessing cultural competence with gay and lesbian clients. Social Work, 51(2), 115–126. https://doi.org/10.1093/sw/51.2.115
  • Crowne, D. P., & Marlowe, D. (1960). A new scale of social desirability independent of psychopathology. Journal of Consulting Psychology, 24(4), 349–354. https://doi.org/10.1037/h0047358
  • Cyr, M. E., Etchin, A. G., Guthrie, B. J., & Benneyan, J. C. (2019). Access to specialty healthcare in urban versus rural US populations: A systematic literature review. BMC Health Services Research, 19(1), 1–17. https://doi.org/10.1186/s12913-019-4815-5
  • Dancey, C. P., & Reidy, J. (2007). Statistics without maths for psychology (4th ed.). Pearson Education.
  • Dillon, F. R., Alessi, E. J., Craig, S., Ebersole, R. C., Kumar, S. M., & Spadola, C. (2015). Development of the lesbian, gay, and bisexual affirmative counseling self-efficacy inventory – Short form (LGB-CSI-SF). Psychology of Sexual Orientation and Gender Diversity, 2(1), 86–95. https://doi.org/10.1037/sgd0000087
  • Eberhardt, M. S., & Pamuk, E. R. (2004). The importance of place of residence: Examining health in rural and nonrural areas. American Journal of Public Health, 94(10), 1682–1686. https://doi.org/10.2105/ajph.94.10.1682
  • Fenway Institute. (2015). Ten things: Creating inclusive health care environments for LGBT people. http://www.lgbthealtheducation.org/wp-content/uploads/072315-Welcoming-Environment-Brief-WEB.pdf
  • Fernandez, T., Godwin, A., Doyle, J., Verdin, D., Boone, H., Kirn, A., Benson, L., & Potvin, G. (2016, June 26–29). More comprehensive and inclusive approaches to demographic data collection [Paper presentation]. ASEE Annual Conference & Exposition 2016, New Orleans, LA. https://doi.org/10.18260/p.25751
  • Fish, J. N., King-Marshall, E. C., Williams, N. D., Aparicio, E. M., Tralka, H. M., & Boekeloo, B. O. (2022). What motivates community mental and behavioral health organizations to participate in LGBTQ + cultural competency trainings? The American Journal of Orthopsychiatry, 92(6), 647–656. https://doi.org/10.1037/ort0000641
  • FitzGerald, C., & Hurst, S. (2017). Implicit bias in healthcare professionals: A systematic review. BMC Medical Ethics, 18(1), 1–18. https://doi.org/10.1186/s12910-017-0179-8
  • Gandy, M. E., Kidd, K. M., Weiss, J., Leitch, J., & Hersom, X. (2021). Trans*Forming access and care in rural areas: A community-engaged approach. International Journal of Environmental Research and Public Health, 18(23), 12700. https://doi.org/10.3390/ijerph182312700
  • Gerritse, K., Hartman, L. A., Bremmer, M. A., Kreukels, B. P., & Molewijk, B. C. (2021). Decision-making approaches in transgender healthcare: Conceptual analysis and ethical implications. Medicine, Health Care, and Philosophy, 24(4), 687–699. https://doi.org/10.1007/s11019-021-10023-6
  • Gottlieb, M. (2021). The case for a cultural humility framework in social work practice. Journal of Ethnic & Cultural Diversity in Social Work, 30(6), 463–481. https://doi.org/10.1080/15313204.2020.1753615
  • Green, E. R., & Mauer, L. (2015). The teaching transgender toolkit: A facilitator’s guide to increasing knowledge, reducing prejudice and building skills. Out for Health.
  • Grimstad, F. W., Satterwhite, C. L., & Wieneke, C. L. (2016). Assessing residency program approaches to the transgender health CREOG objective. Transgender Health, 1(1), 69–74. https://doi.org/10.1089/trgh.2015.0011
  • Grollman, E. A. (2014). Multiple disadvantaged statuses and health. Journal of Health and Social Behavior, 55(1), 3–19. https://doi.org/10.1177/0022146514521215
  • Holt, N. R., Eldridge-Smith, E. D., Griffin, J. A., Stepleman, L. M., Drescher, C. F., & Casanova, T. (2023, January–March 01). Differences in health care access, utilization, and experiences among LGBTQ + subgroups in the Southern United States. Family & Community Health, 46(1), 58–68. https://doi.org/10.1097/fch.0000000000000340
  • Holt, N. R., Hope, D. A., Mocarski, R., Meyer, H., King, R., & Woodruff, N. (2020). The provider perspective on behavioral health care for transgender and gender nonconforming individuals in the central Great Plains: A qualitative study of approaches and needs. The American Journal of Orthopsychiatry, 90(1), 136–146. https://doi.org/10.1037/ort0000406
  • Hope, D. A., Holt, N. R., Woodruff, N., Mocarski, R., Meyer, H. M., Puckett, J. A., Eyer, J., Craig, S., Feldman, J., Irwin, J., Pachankis, J., Rawson, K. J., Sevelius, J., & Butler, S. (2022). Bridging the gap between practice guidelines and the therapy room: Community-derived practice adaptations for psychological services with transgender and gender diverse adults in the central United States. Professional Psychology: Research and Practice, 53(4), 351–361. https://doi.org/10.1037/pro0000448
  • Horvath, K. J., Iantaffi, A., Swinburne-Romine, R., & Bockting, W. (2014). A comparison of mental health, substance use, and sexual risk behaviors between rural and non-rural transgender persons. Journal of Homosexuality, 61(8), 1117–1130. https://doi.org/10.1080/00918369.2014.872502
  • Israel, T., Willging, C. E., & Ley, D. (2016). Development and evaluation of training for rural LGBTQ mental health peer advocates. Journal of Rural Mental Health, 40(1), 40–62. https://doi.org/10.1037/rmh0000046
  • James, S. E., Herman, J. L., Rankin, S., Keisling, M., Mottet, L., Anafi, M. (2016). The report of the 2015 U.S. transgender survey. National Center for Transgender Equality. https://transequality.org/sites/default/files/docs/usts/USTS-Full-Report- Dec17.pdf.
  • James, C. V., Moonesinghe, R., Wilson-Frederick, S. M., Hall, J. E., Penman-Aguilar, A., & Bouye, K. (2017). Racial/Ethnic health disparities among rural adults—United States, 2012–2015. Morbidity and Mortality Weekly Report. Surveillance Summaries, 66(23), 1–9. https://doi.org/10.15585/mmwr.ss6623a1
  • Johnson, A. H., Hill, I., Beach-Ferrara, J., Rogers, B. A., & Bradford, A. (2020). Common barriers to healthcare for transgender people in the U.S. southeast. International Journal of Transgender Health, 21(1), 70–78. https://doi.org/10.1080/15532739.2019.1700203
  • Johnston, C. D., & Shearer, L. S. (2017). Internal medicine resident attitudes, prior education, comfort, and knowledge regarding delivering comprehensive primary care to transgender patients. Transgender Health, 2(1), 91–95. https://doi.org/10.1089/trgh.2017.0007
  • Jones, J. M. (2022, February 17). LGBT identification in U.S. ticks up to 7.1%. https://news.gallup.com/poll/389792/lgbt-identification-ticks-up.aspx.
  • Kattari, S. K., Walls, N. E., Speer, S. R., & Kattari, L. (2016). Exploring the relationship between transgender-inclusive providers and mental health outcomes among transgender/gender variant people. Social Work in Health Care, 55(8), 635–650. https://doi.org/10.1080/00981389.2016.1193099
  • Kenny, M. C., Helpingstine, C., Abreu, R. L., & Duberli, F. (2019). Understanding the needs of LGBTQ clients and their risk for commercial sexual exploitation: Training community mental health workers. Journal of Gay & Lesbian Social Services, 31(2), 166–181. https://doi.org/10.1080/10538720.2019.1568338
  • Knutson, D., Martyr, M. A., Mitchell, T. A., Arthur, T., & Koch, J. M. (2018). Recommendations from transgender healthcare consumers in rural areas. Transgender Health, 3(1), 109–117. https://doi.org/10.1089/trgh.2017.0052
  • Koch, J. M., & Knutson, D. (2016). Transgender clients in rural areas and small towns. Journal of Rural Mental Health, 40(3–4), 154–163. https://doi.org/10.1037/rmh0000056
  • Leitch, J., Gandy-Guedes, M., & Messinger, L. (2021). The psychometric properties of the competency assessment tool for lesbian, gay, bisexual, and transgender clients. Journal of Homosexuality, 68(11), 1785–1812. https://doi.org/10.1080/00918369.2020.1712138
  • Lelutiu-Weinberger, C., Clark, K. A., & Pachankis, J. E. (2022). Mental health provider training to improve LGBTQ competence and reduce implicit and explicit bias: A randomized controlled trial of online and in-person delivery. Psychology of Sexual Orientation and Gender Diversity, Advance online publication. https://doi.org/10.1037/sgd0000560
  • Matsuno, E., & Israel, T. (2018). Psychological interventions promoting resilience among transgender individuals: Transgender resilience intervention model (TRIM). The Counseling Psychologist, 46(5), 632–655. https://doi.org/10.1177/0011000018787261
  • McHugh, M. L. (2012). Interrater reliability: The kappa statistic. Biochemia Medica, 22(3), 276–282. https://doi.org/10.11613/BM.2012.031
  • Minturn, M. S., Martinez, E. I., Le, T., Nokoff, N., Fitch, L., Little, C. E., & Lee, R. S. (2021). Early intervention for LGBTQ health: A 10-Hour curriculum for preclinical health professions students. MedEdPORTAL, 17(11072), 1–9. https://doi.org/10.15766/mep_2374-8265.11072
  • Mizock, L., & Lundquist, C. (2016). Missteps in psychotherapy with transgender clients: Promoting gender sensitivity in counseling and psychological practice. Psychology of Sexual Orientation and Gender Diversity, 3(2), 148–155. https://doi.org/10.1037/sgd0000177
  • Morris, E. R., Lindley, L., & Galupo, M. P. (2020). “Better issues to focus on”: Transgender microaggressions as ethical violations in therapy. The Counseling Psychologist, 48(6), 883–915. https://doi.org/10.1177/0011000020924391
  • Movement Advancement Project. (2019a). Where we call home: Transgender people in rural America. www.lgbtmap.org/rural-trans
  • Movement Advancement Project. (2019b). Where we call home: LGBT people of color in rural America. http://www.lgbtmap.org/rural-lgbt-poc.
  • National Association of Social Work. (2015). Standards and indicators for cultural competence in social work practice. https://www.socialworkers.org/Practice/NASW-Practice-Standards-Guidelines/Standards-and-Indicators-for-Cultural-Competence-in-Social-Work-Practice.
  • Nelson, W., Greene, M. A., & West, A. (2010). Rural healthcare ethics: No longer the forgotten quarter. Cambridge Quarterly of Healthcare Ethics, 19(4), 510–517. https://doi.org/10.1017/s096318011000040x
  • Nowaskie, D. Z., Patel, A. U., & Fang, R. C. (2020). A multicenter, multidisciplinary evaluation of 1701 healthcare professional students’ LGBT cultural competency: Comparisons between dental, medical, occupational therapy, pharmacy, physical therapy, physician assistant, and social work students. PLOS One, 15(8), e0237670. https://doi.org/10.1371/journal.pone.0237670
  • Nowaskie, D. Z., & Patel, A. U. (2020). How much is needed? Patient exposure and curricular education on medical students’ LGBT cultural competency. BMC Medical Education, 20(1), 1–8. https://doi.org/10.1186/s12909-020-02381-1
  • Obasi, S. N., King, R. E., Holt, N. R., Mocarski, R., Hope, D. A., & Woodruff, N. (2023). Educational preparedness to care for transgender and gender diverse adults: Perspectives of mental health professionals. Journal of Gay & Lesbian Social Services, 35(2), 204–217. https://doi.org/10.1080/10538720.2022.2056782
  • Obedin-Maliver, J., Goldsmith, E. S., Stewart, L., White, W., Tran, E., Brenman, S., Wells, M., Fetterman, D. M., Garcia, G., & Lunn, M. R. (2011). Lesbian, gay, bisexual, and transgender–related content in undergraduate medical education. JAMA, 306(9), 971–977. https://doi.org/10.1001/jama.2011.1255
  • Patterson, J. G., Jabson Tree, J. M., & Kamen, C. (2019). Cultural competency and microaggressions in the provision of care to LGBT patients in rural and Appalachian Tennessee. Patient Education and Counseling, 102(11), 2081–2090. https://doi.org/10.1016/j.pec.2019.06.003
  • Poquiz, J., Moser, C. N., Grimstad, F., Boman, K., Sonneville, S. A., Turpin, A., & Egan, A. M. (2021). Gender-affirming care in the Midwest: Reaching rural populations. Journal of Rural Mental Health, 45(2), 121–128. https://doi.org/10.1037/rmh0000174
  • Preston, D. B., D'Augelli, A. R., Cain, R. E., & Schulze, F. W. (2002). Issues in the development of HIV-preventive interventions for men who have sex with men in rural areas. The Journal of Primary Prevention, 23(2), 199–214. https://doi.org/10.1023/A:1019968315959
  • Ralston, A. L., Holt, N. R., Andrews, A. R., Huit, T. Z., Puckett, J. A., Woodruff, N., Mocarski, R., & Hope, D. A. (2022). Mental health and marginalization stress in transgender and gender diverse adults: Differences between urban and non-urban experiences. Psychology of Sexual Orientation and Gender Diversity, Advance online publication. https://doi.org/10.1037/sgd0000595
  • Rosenkrantz, D. E., Black, W. W., Abreu, R. L., Aleshire, M. E., & Fallin-Bennett, K. (2017). Health and health care of rural sexual and gender minorities: A systematic review. Stigma and Health, 2(3), 229–243. https://doi.org/10.1037/sah0000055
  • Rowan, S. P., Lilly, C. L., Shapiro, R. E., Kidd, K. M., Elmo, R. M., Altobello, R. A., & Vallejo, M. C. (2019). Knowledge and attitudes of health care providers toward transgender patients within a rural tertiary care center. Transgender Health, 4(1), 24–34. https://doi.org/10.1089/trgh.2018.0050
  • Seelman, K. L., Colón-Diaz, M. J., LeCroix, R. H., Xavier-Brier, M., & Kattari, L. (2017). Transgender Noninclusive healthcare and delaying care because of fear: Connections to general health and mental health among transgender adults. Transgender Health, 2(1), 17–28. https://doi.org/10.1089/trgh.2016.0024
  • Sekoni, A. O., Gale, N. K., Manga-Atangana, B., Bhadhuri, A., & Jolly, K. (2017). The effects of educational curricula and training on LGBT-specific health issues for healthcare students and professionals: A mixed-method systematic review. Journal of the International AIDS Society, 20(1), 21624. https://doi.org/10.7448/ias.20.1.21624
  • Singh, A. A., & Dickey, L. M. (2017). Affirmative counseling and psychological practice with transgender and gender nonconforming clients. American Psychological Association.
  • Smith, A. J., Hallum-Montes, R., Nevin, K., Zenker, R., Sutherland, B., Reagor, S., Ortiz, M. E., Woods, C., Frost, M., Cochran, B. N., Oost, K. M., Gleason, H., & Brennan, J. M. (2018). Determinants of transgender individuals’ well-being, mental health, and suicidality in a rural state. Journal of Rural Mental Health, 42(2), 116–132. https://doi.org/10.1037/rmh0000089
  • Sodowsky, G. R., Taffe, R. C., Gutkin, T. B., & Wise, S. L. (1994). Development of the multicultural counseling inventory: A self-report measure of multicultural competencies. Journal of Counseling Psychology, 41(2), 137–148. https://doi.org/10.1037/0022-0167.41.2.137
  • Stewart, T., Lee, Y. A., & Damiano, E. A. (2020). Do transgender and gender diverse individuals receive adequate Gynecologic care? An analysis of a rural academic center. Transgender Health, 5(1), 50–58. https://doi.org/10.1089/trgh.2019.0037
  • Substance Abuse and Mental Health Services Administration. (2014). Improving cultural competence. Treatment Improvement Protocol (TIP) Series No. 59. HHS Publication No. (SMA) 14–4849. https://store.samhsa.gov/sites/default/files/d7/priv/sma14-4849.pdf
  • Sukhera, J., Watling, C. J., & Gonzalez, C. M. (2020). Implicit bias in health professions: From recognition to transformation. Academic Medicine , 95(5), 717–723. https://doi.org/10.1097/acm.0000000000003173
  • Sue, D. W., Sue, D., Neville, H. A., & Smith, L. (2019). Counseling the culturally diverse: Theory and practice (8th ed.). Wiley.
  • Syed, S. T., Gerber, B. S., & Sharp, L. K. (2013). Traveling towards disease: Transportation barriers to health care access. Journal of Community Health, 38(5), 976–993. https://doi.org/10.1007/s10900-013-9681-1
  • Thomas, D. D., & Safer, J. D. (2015). A simple intervention raised resident-physician willingness to assist transgender patients seeking hormone therapy. Endocrine Practice, 21(10), 1134–1142. https://doi.org/10.4158/ep15777.or
  • US Department of Agriculture. (2019, October 23). What is rural? USDA ERS. https://www.ers.usda.gov/topics/rural-economy-population/rural-classifications/what-is-rural/.
  • White Hughto, J. M., Reisner, S. L., & Pachankis, J. E. (2015). Transgender stigma and health: A critical review of stigma determinants, mechanisms, and interventions. Social Science & Medicine, 147, 222–231. https://doi.org/10.1016/j.socscimed.2015.11.010

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.