Provider cultural competence and humility in healthcare interactions with transgender and nonbinary young adults

Abstract

PurposeTransgender and nonbinary (TGNB) patients experience many barriers when seeking quality healthcare services, including ineffective communication and negative relationships with their providers as well as a lack of provider competence (including knowledge, training, and experience) and humility (engagement in the process of self‐reflection and self‐critique) in treating TGNB individuals. The purpose of this qualitative study was to identify factors associated with cultural competence and humility that facilitate and impede effective relationships between TGNB young adults and their healthcare providers.MethodsData came from individual interviews with 60 young adults aged 18 to 24 from Florida who self‐identified as transgender or nonbinary. We analyzed the data using inductive thematic approaches, and a feminist perspective, to identify themes associated with patient‐provider relationships.ConclusionsWe identified 4 themes related to patient‐provider relationships: (1) Participants indicated effective patient‐provider communication and relationships are facilitated by providers requesting and utilizing TGNB patients' correct names and personal pronouns. (2) Participant narratives conveyed their preferences that providers “follow their lead” in terms of how they described their own anatomy, reinforcing the utility of cultural humility as an approach for interactions with TGNB patients (3) Participants discussed the detrimental effects of TGNB patients having to educate their own providers about their identities and needs, suggesting clinicians' competence regarding gender diversity is paramount to fostering and maintaining patient comfort. (4) Finally, participants' responses indicated concerns regarding the confidentiality and privacy of the information they provided to their providers, suggesting a lack of trust detrimental to the process of building rapport between patients and their providers.Clinical RelevanceOur findings indicate balancing the use of cultural humility and cultural competence during clinical encounters with TGNB young adults can enhance patients' experiences seeking healthcare. Nursing education is often devoid of focus on caring for transgender and nonbinary persons. Additional provider training and education on approaching clinical encounters with TGNB patients with cultural humility and competence should improve patient‐provider communication and relationships, leading to a higher quality of patient care.

Cultural humility, counseling alliance, and counseling outcome among LGBTQ+ clients

“…Additionally, the results also indicated the need for a service that promotes equity, inclusion, and respect for diversity. These findings both highlight the importance of LGBTQ+ cultural competence and cultural humility to counselors continually updating their knowledge and skills as well as avoiding potential negative counseling experiences of LGBTQ+ clients (Reeves et al., 2023; Rosati et al., 2022).…”

“…Cultural humility helps counselors to continually update their LGBTQ+CC and focus on what is most relevant to diverse LGBTQ+ clients (Reeves et al., 2023; Zhu et al., 2023b). Because the terminologies, trends, needs, and perspectives of people in the LGBTQ+ community are fast evolving (Bitterman & Hess, 2021), and because legislation is changing rapidly, especially on issues relevant to transgender people (Wittlin et al., 2023), LGBTQ+CC may need constant update and revision to be currently relevant.…”