Nursing Students' Perceptions, Knowledge, and Experience in Providing Care to Transgender and Gender-Nonconforming Persons: A Qualitative Study.

Transgender and gender-nonconforming individuals need access to diverse health services in welcoming, affirming, clinically appropriate, and culturally sensitive environments. Nursing students often feel underprepared due to limited knowledge and attitudes about transgender and gender nonconforming issues, and despite growing interest, research on their care remains limited. This study explores the perspectives of nursing students nearing graduation on providing care to transgender and gender-nonconforming persons. We conducted a qualitative descriptive exploratory study at the Fondazione IRCCS Istituto Nazionale dei Tumori, part of the University of Milan's Bachelor's School of Nursing. Individual semi-structured interviews were transcribed and analyzed using NVivo Version 14.23.2. Thematic analysis by Braun and Clarke was employed to derive themes from the data. Nineteen interviews were conducted, uncovering three main themes and eight subthemes related to students' knowledge, perspectives, and experiences on transgender and gender-nonconforming care. The findings indicated that the current curriculum often neglects transgender and gender-nonconforming specific issues, leading to insufficient practical experience and contributing to students' feelings of inadequacy. The participants highlighted the significant impact of societal attitudes and cisnormativity of the health care system on transgender and gender-nonconforming care. Furthermore, a generational gap was observed in attitudes toward transgender and gender-nonconforming individuals, with older health care providers often lacking sensitivity and knowledge compared with their younger counterparts. This study underscored the urgent need for educational reforms and ongoing professional development to address transgender and gender-nonconforming health issues, improve nursing education, and bridge generational gaps, thus fostering a more inclusive and equitable health care system to effectively address the unique needs of this population.