Loyola Nursing receives grant to improve nursing education on transgender health care

The Marcella Niehoff School of Nursing has received a $646,000 federal grant to develop an online curriculum to educate nursing students on how to best provide health care to transgender and gender nonconforming patients.

The National Institutes of Health (NIH) grant, awarded in summer 2024, will fund research behind the school’s “Trans*forming Care” program, which will be available through a phone app.

The app, which will be developed over the next four years, will provide future nurses with basic knowledge and skills for treating transgender patients, who face challenges to wellbeing including higher-than-average rates of chronic illnesses and an increased likelihood of physical or sexual assault.

By providing an interactive, game-like experience, Loyola Nursing hopes to engage more users and provide nursing schools with a tool to supplement their instruction on gender-affirming care.

“We believe this will become a model for transgender-affirming health care in nursing schools across the country,” said Associate Professor Dian Squire, associate dean of inclusive excellence and co-lead of the project with Associate Professor Lindsey Garfield.

The project’s goal is to enhance health care quality for transgender and gender nonconforming patients. Squire said many nursing schools provide little classroom instruction on working with LGBTQ+ patients, and “we want to help change that.”

Garfield said Trans*forming Care “will make our students better prepared for real-world circumstances with transgender populations. It gives nursing students an opportunity to say, ‘I have patients who aren’t like me, might not have values that I understand, but I still need to provide them with quality health care.”

The platform will be available for free for users worldwide—including practicing nurses, who may not have received instruction on caring for transgender patients during their education—for five years after its completion.

A research focus

Trans*forming Care is one of the latest Loyola Nursing research projects to receive competitive federal funding. Dean Lorna Finnegan said the program reflects the school’s emphasis on equity and inclusion and will make an important contribution to nursing education.

“We’re providing evidence-based instruction to help nurses learn how to address the needs of a population that has long been overlooked by our health care system,” she said. “Our work is unique because we’re incorporating the real-life experiences and perspectives of transgender and gender nonconforming individuals.”

Research on the health needs of those populations is increasing but remains relatively understudied. That means health care providers face a lack of clarity about their health care needs across the lifespan, such as care for transgender patients during menopause.

The Trans*forming Care grant was awarded under NIH’s Galvanizing Health Equity Through Novel and Diverse Educational Resources (GENDER) program, which supports new educational strategies and methods that integrate knowledge of sex and gender influences into health-related training.

Squire noted that “being able to take an idea and innovate it is a core component of getting this grant, and the gamification element of the app was significant to making us competitive for this.”

Gamification—adding elements like point scoring or graphics to a task to increase engagement—has grown in popularity in recent years as an educational strategy, particularly among younger generations that grew up with smartphones and the internet.

The app’s seven modules will address scenarios nurses might face on the job, from using appropriate pronouns with transgender patients to understanding potential interactions between hormone therapies and other drugs.

Even though Trans*forming Care will be packaged as a game, project leaders say the app is a serious, research-based endeavor. Focus groups will collect firsthand experiences from transgender individuals and those who provide health care to that population, and their accounts will become part of the Trans*forming Care curriculum. The findings will be reviewed by other organizations that provide gender-affirming care.

The final leg of research will involve testing the app with nursing students and assessing how their attitudes and skills change after using it—something that “could have big implications for the classroom and how we teach gender-affirming care,” Squire said.

An interdisciplinary approach

Squire noted that transgender and gender nonconforming populations tend to be underserved in health care settings and their quality of care may depend on where they live.

According to the Center for American Progress (CAP), nearly half of transgender patients have encountered discrimination or mistreatment from health care providers, including refusal of care, misgendering, and outright abuse. Among transgender patients of color, CAP said 68 percent reported such experiences.

The app’s modules will cover gender definitions and health and societal barriers faced by those communities.

“We’re bringing in so many different disciplines,” said Garfield, a nurse scientist who studies mindfulness and stress reduction among Black mothers. “We have a whole tech component, mental health professionals, lawyers, doctors, and nurses. It is the most interdisciplinary work I’ve ever done.”

The app will educate nurses on best approaches to help patients navigate polices or laws that restrict gender inclusive care. While those legal challenges “aren’t necessarily related to health care, they are part of the life of your patient,” she said.

The app is also a tool for reflection, a guiding value of Jesuit education.

“When we talk about our cura personalis, when we talk about underserved communities, this fits right into Loyola’s mission and values,” Garfield said. “When you look at the heart and the core of Loyola’s mission and values, this is what we’re about.”

Read more stories from the Marcella Niehoff School of Nursing.