Out of the Closet: Nurse Practitioner Faculty Knowledge, Comfort and Willingness to Incorporate LGBTQ2SA Content into the Curriculum.

BACKGROUND: To improve the health of LGBTQ2SA individuals, nurse practitioners need to increase their knowledge related to the health needs of sexual and gender minorities. However, nurse practitioners often feel unprepared as a result of a lack of content in their educational training. In order to better understand the current state of nurse practitioner education around sexual and gender minorities, it is critical to assess educational preparedness and faculty knowledge teaching the content.Purpose: The purpose of this study was to assess the knowledge and experience of nurse practitioner faculty in Ontario around LGBTQ2SA health and their comfort level teaching this material in the nurse practitioner program. METHODS: This quantitative descriptive study used purposeful sampling to recruit faculty from the Ontario Primary Health Care Nurse Practitioner Program. Data was collected using a modified survey administered on the Opinio platform. RESULTS: Twenty-three individuals completed the study. Most participants felt that LGBTQ2SA health content was important, but rarely or never taught. The most frequently identified strategies to promote faculty readiness to integration of LGBTQ2SA health topics into the curriculum included faculty development seminars, reviewing curriculum to identify gaps and partnering and utilizing LGBTQ2SA specific agencies as clinical sites. CONCLUSIONS: Results indicate that barriers exist at the faculty level which may limit the extent to which LGBTQ2SA health topics are incorporated into the curriculum. Supporting faculty to develop their knowledge and comfort with this topic will allow them to better educate students to care for LGBTQ2SA clients.

A Critical Review of Clinical Practice Guidelines for Care of Transgender and Gender Diverse Children and Youth for Use by Primary Care Practitioners.

Purpose: To examine and critique international clinical practice guidelines (CPGs) related to transgender and gender diverse children and youth and to assess the applicability of the guidelines to ethical and affirming primary care practice. Methods: A review was conducted to obtain English language clinical guidelines. Guidelines were obtained from electronic databases, medical associations, government agencies, and community organizations. Guidelines were critiqued by all authors using the AGREE II instrument. Results: Nine documents were reviewed. Overall, there was agreement among reviewers that the scope, purpose, and clarity of presentation of the guidelines was carried out well. Areas identified for improvement in all guidelines included clarity/rigor of methodologic development, inclusion of community stakeholders, and transparency of editorial independence. The Endocrine Society Clinical Practice Guideline scored highest overall. Despite lower overall scores, other guidelines were identified as having strengths of practical utility within primary care and/or in the discussion of specific social, ethical, and cultural considerations of transgender care in differing contexts worldwide. Conclusion: The use of specific, high-quality CPGs can support primary care practitioners to provide gender-affirming care to children and youth. Methodologic improvement in the development of these CPGs is needed to ensure the best possible quality of care is being outlined.

Review and Analysis of International Transgender Adult Primary Care Guidelines.

Purpose: To examine and critique current international clinical practice guidelines (CPGs) related to providing primary care to transgender adults and to assess their applicability to practice. Methods: A review was conducted to obtain English language clinical guidelines. Guidelines included in this review were obtained from published journals and gray literature. Guidelines were critiqued using the AGREE II instrument. Results: Seventeen documents were included in the final review. Eleven were specifically designed for primary care practitioners, whereas the remaining six were deemed applicable to primary care. Overall, across the CPGs, the scope, purpose, and clarity of presentation were done well. However, the overall methodological rigor in guideline development was poor. Many CPGs included useful tools that could be helpful for the primary care practitioner. Conclusions: CPGs can be an important support for primary care providers' clinical practice with transgender people, particularly after having received limited formal education in transgender care. Improvements in transgender health CPG rigor and transparency are needed. Future CPGs would benefit from recommendations on the nuanced discussion of gender concepts and interpersonal communication that can create conflict in health care interactions.