Date of Award

January 2025

Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Yale University School of Nursing

First Advisor

Ron Yolo

Abstract

Transgender and Gender Diverse People – Inclusive Healthcare System AccessPurpose: This DNP project implemented a dual strategy to increase system-wide access to care and awareness of the needs of transgender and gender diverse people. Background: The 2015 U.S. Transgender Survey is the most recent and largest survey of its kind in the United States comprising a total of 27,715 responses. (National Center for Transgender Equality, 2015, U.S. Transgender Survey). The results of this survey are as follows: 1) 26% of the total national respondents experienced insurance issues for gender affirming healthcare or being denied coverage for routine care; 2) 32% reported a negative experience in a healthcare setting; 3) 27% reported not seeing a doctor for fear of healthcare mistreatment; 4) 28% did not seek medical help because of financial limitations; and 5) 13% reported a healthcare professional or religious advisor attempted to stop them from being transgender. As evidenced in these findings, almost 60% of the respondents directly reported having a negative experience or fearing mistreatment in healthcare settings. This particular finding, along with the other concerning results of this survey, validate the prevalence of healthcare avoidance within the TGD population. Methods: 16 nurse leaders participated in a 60 minute interactive didactic seminar sessions, focused on understanding the significance of inclusive language (gender, pronouns, and name) and standardized communication. The seminars had a foundation of evidence from WPATH SOC 8, which is the global evidenced based standard for TGD health. Results: Descriptive and bivariate statistics were utilized for the data analysis. The pre / post test surveys were compared via paired t-tests. The program evaluations were analyzed descriptively with the results pooled for a total score for comparative purposes. Conclusion: The need for the sustainability and scalability of this project is exemplified in the data analysis and correlating seminar discussions

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This is an Open Access Thesis.

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