Publication Date

Spring 2025

Degree Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Tamara H. McKinnon

Keywords

Transgender, Gender diverse, Implicit bias, Healthcare provider, Healthcare utilization avoidance

Abstract

Healthcare disparities disproportionately affect transgender and gender-diverse (TGD) individuals, often due to implicit biases among healthcare providers. This study examines the impact of an educational intervention designed to address these biases and improve care for TGD patients. Using the Biased Care Model as a guiding framework, the intervention targeted three critical phases of bias: pre-visit assumptions, in-visit interactions, and post-visit decisions. Conducted in the intensive care unit of a mid-sized hospital in Northern California, the study employed a pretest-posttest quasi-experimental design involving multidisciplinary healthcare workers. Participants completed a modified Jefferson Scale of Empathy survey to assess changes in cognitive and affective empathy levels before and after the training. The results of the educational intervention revealed significant improvements in healthcare providers' awareness of implicit biases and their ability to demonstrate empathy toward transgender and TGD patients. Participants reported increased confidence in addressing the unique needs of TGD individuals, with marked improvements in both cognitive and affective empathy as measured by the Jefferson Scale of Empathy. These findings suggest that targeted bias-reduction training can positively influence provider attitudes and behaviors, fostering a more inclusive and equitable healthcare environment. However, challenges such as institutional barriers and skepticism about the authenticity of allyship underscore the need for ongoing efforts to sustain these gains and ensure meaningful, lasting change in the care of TGD patients.

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