A preliminary scoping review on gender-affirming care in Canadian undergraduate nursing education

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Date
2023-05-29
Authors
Crawford, Jess
Schultz, Annette
Linton, Janice
Kramer, Marnie
Ristock, Janice
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Abstract

Nurses have an ethical responsibility to address the accessibility of healthcare for trans* people. Gender-affirming care (GAC) is the provision of culturally safe and humble care for trans* people, where the provider values one’s gender identity and actively supports gender affirmation or transition goals. Integration of GAC into nursing practice makes a significant difference in the lives and health of trans* people. Enhancing nursing’s collective capacity to deliver GAC could be achieved by strategically incorporating GAC principles and practices in undergraduate nursing education. However, little is known about how (or if) GAC is addressed in Canadian nursing curriculums. We designed a preliminary, iterative scoping review to map how GAC is included in the formal, informal, and hidden curricula in undergraduate nursing in Canada. Drawing on methods by Arksey and O’Malley and Levac and Colquhoun, we conducted a review of medical and nursing databases, and grey literature in October 2022. Our preliminary search resulted in 679 unique articles, of which 9 were deemed eligible for our review. One source from the Canadian Nursing Students Association had 5 position papers, as such, our review included 13 unique sources. Our preliminary review revealed one formal curriculum strategy used to teach GAC in one undergraduate nursing course in Canada. Three additional sources discussed trans* health in the hidden and informal curricula, while another three included a sentence on trans* health. Overall, the sources focused more broadly on “LGBTQ+” curricular inclusion. Collaborating with trans* community members and organizations can strategically advance GAC in undergraduate nursing curricula. This collaboration provides opportunities for faculty professional development and helps incorporate GAC into formal curricula settings such as lectures, simulation, and clinical. Additionally, trans* allyship needs to be prioritized at the faculty level (i.e., neutralizing language) and within nursing schools (i.e., diverse hiring, and safe, inclusive spaces). When there are intentional efforts to improve the informal (faculty-student relationships) and hidden curricula (the environment), then the safety and inclusivity of trans* students and faculty become a priority and GAC practices and principles become a reality. Finally, nursing schools should advocate for GAC requirements in CASN accreditation, NCLEX-RN testing, and professional competencies. This preliminary review has informed the development of our scoping review, which will expand its scope to map how North American undergraduate nursing curricula are integrating GAC.

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Keywords
gender identity, gender-affirming care, nursing education
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