Improving Transgender/Gender Non-Binary Knowledge and Self-Efficacy in an Outpatient Clinic

Transgender/gender non-binary (TGNB) individuals experience health disparities such as gaps in knowledge amongst providers and health care organizations.

To understand the level of knowledge and self-efficacy at an organizational level when providing health care related services to the TGNB population within Eastern Riverside County, an evidence-based practice (EBP) project was created using Brown and Ecoff’s EBP Institute Model. The study was a prospective cohort study that recruited a sample of 150 employees and community partners to participate in a two-hour TGNB intervention. The participants that were recruited consisted of various socio-demographic such as age, sex, sexual orientation, and gender identity backgrounds.

The data was collected using a pre-test and post-test instrument that captured information assessing the overall knowledge and level of self-efficacy of the individuals participating in the intervention. Questions consisted of: 1) how confident are you with working with the transgender/gender non-binary community, 2) how confident are you in applying your knowledge into your daily practice? Rate your knowledge in best-practices when working with the transgender community.

Data was analyzed using SPSS version 25, and responses were compared using a non-parametric Wilcox-Sign Ranks Test. Based on the findings, there is an increase in knowledge and self-efficacy after the intervention was conducted. When comparing the results on “how knowledgeable are you of the transgender community,” 28% responded very little knowledge for the pre-test while 63% responded knowledgeable/very knowledgeable on the post-test. When comparing “how confident are you working with the TGNB community,” 46% responded that they had very little confidence/somewhat confident on the pre-test, whereas 83% responded confident/very confident on the post-test. In addition, questions such as “please rate your knowledge of the transgender community, please rate your knowledge of the gender non-binary community, best practices involving the transgender community, confidence in working with the TGNB community, and confidence in applying your knowledge into your daily practice” illustrated normal distribution with (P=0.02) making the intervention significant.

As a result of the intervention and the preparation leading up to it, it was identified that the employees and community partners in attendance were receptive in more education towards culturally competent care for TGNB individuals. In addition, a shift in knowledge and self-efficacy can have a positive impact in patient care delivery at all levels of the organization. Based on the findings, the organization will implement a condensed 30-minute presentation from a subject matter expert that will cover best practices when working with the TGNB patients and/or community. Furthermore, the data that was collected will be utilized to develop and/or update future organizational health policies, program development, and additional resources needed to better improve care delivery. Overall, the findings from the intervention were beneficial and similar interventions could be applied for continuous development of trainings to address health disparities in other marginalized communities.