The United States Department of Health and Human Services stated that one of the goals of its Healthy People 2020 initiative was to “improve the health, safety, and well-being of LBGT individuals” (2014, para 1). Evidence suggests that gender-nonconforming individuals are becoming more visible in local primary care settings in both rural and urban environments. Nurses have challenging roles in transforming evidenced-based care and intervention into practice to provide culturally sensitive patient care for transgender people. Emerging evidence suggests that content related to LGB and transgender health disparities in the nursing curriculum is suboptimal (Lim, Brown & Jones, 2013).
Recent social gains made by LGB and transgender communities indicate a need for a national LGBT health care agenda and illustrate the need for nurses to address health parity for LGB and transgender individuals. Halloran (2015) states that few practitioners have received formal education on the evolving needs of transgender patients. Undeniably, the nursing profession has consistently provided care for vulnerable diverse populations. However, like other health care providers, nursing is influenced by sociopolitical values and society's expectations for health care delivery systems. This may result in gaps in practicing nurses’ knowledge and skills, which may, in turn, adversely affect LGB and transgender patients’ health care (Carabez et al., 2015; Chinn, 2013; Sirota, 2013).
Makadon, Goldhammer, and Davis (2015), assert that “there is no question that the actions and inactions of health professionals have had a significant effect on the health of LGBT people” (p. 6). Chinn (2013)—a pioneer nurse educator and LGBT advocate—stated that LGBT content has been missing from the nursing curricula for too long, and has encouraged nursing faculty to integrate LGBT issues into their curricula. Chinn (2013) identified four common barriers faculty experience related to the integration of LGBT-related curriculum content: sexual identity, lack of sufficient time, issues regarding religious beliefs, and fear of negative student evaluations. Levesque (2015) asserted that the increasing visibility of transgender students in academia requires nurse educators to build a culturally congruent curriculum wherein the next generation of nurses can feel safe and free from harm and prejudices, including the threat of bullying (Zou, Andersen, & Blosnich, 2016).
Understanding the transgender experience as these individuals transition to an appropriate gender expression will have a positive impact on nursing knowledge and professional collaborative nursing practice. Although research related to this vulnerable population has been conducted, little is known about the transition experience of transgender people. A phenomenological study was conducted to explore the lived experience of 11 individuals who have undergone gender transitions. The secondary aims of the study were to better address the health disparities of transgender individuals and guide faculty in implementing curricula to meet health disparities of transgender individuals.
After data analysis from in-depth interviews was completed, four major themes emerged and were threaded through the participants’ experiences: a) it’s gravity; b) shedding your skin; c) navigating the way; and d) a turning point. Participants shared the unrelenting recognition of their biological gender not matching their emotional gender. Most participants experienced a turning point in their gender identification journey. Many experienced thoughts of suicide and recurring depression before their gender transitions. Locating high quality healthcare resources was a common theme. They identified word of mouth and transgender groups as their primary sources of information. Participants shared their desire to make meaning from their experience in order to help and advocate for others. Understanding these commonalities of the lived experience of transgendered people is a fundamental objective for healthcare providers and educators so that quality care is given to improve patient outcomes in this vulnerable population.