Analyzed data from the Harvard Implicit Association Test-; A widely accepted measure of a person’s attitudes toward people based on characteristics such as race, gender, and sexuality–researchers found that health care professionals, and nurses in particular, were more biased against transgender people. than those who are not healthcare professionals. A questionnaire administered before and after the experiment showed that health care professionals were less likely to know transgender people personally and nurses were more likely to identify with gender and gender identity. These results were reported in the journal Nov. 3 Hellion.
Implicit association tests work by asking participants to categorize words like “good” like “good” or “smile” and words like “bad” like “wicked” or “rotten.” Its results have been collected by a team of scientists as part of Project Implicit since 1998 and made available for use by the public and other researchers.
To specifically assess healthcare professionals’ attitudes toward transgender individuals, the researchers focused on a subset of respondents from 2020 to 2022, including 11,996 non-nursing healthcare professionals and 22,443 non-nursing healthcare professionals. These responses were compared with 177,810 responses from non-healthcare professionals.
A person’s bias is reported as their “D-score”, which can range from -2 to 2, with higher scores indicating more anti-transgender views. Standard classification of this test lists values greater than 0.15 as “slightly biased” and values greater than 0.35 and 0.65 as “moderately” and “strongly” biased, respectively.
Non-healthcare professionals reported an average D-score of 0.116, meaning they were considered to have little or no bias. However, healthcare professionals (non-nursing), reported an improved score of 0.149, which is on the verge of being considered “slightly biased”. The mean D-score of nursing healthcare professionals was 0.176, which clearly falls within the “slightly biased” range.
Participants’ D-score assessed their implicit biases–their true beliefs that they may be very reluctant to share–but their overt biases, or their self-reported opinions, were assessed by a questionnaire.
Nursing health care professionals are more likely than other health care professionals to agree with statements such as “I believe a person can never change their gender” or “I think there is something wrong with a person who says they are neither a man nor a woman.” was higher than other healthcare professionals and non-healthcare professionals.
“Our finding that nurses have high levels of implicit bias toward transgender people may be related to a tendency to conflate gender and gender identity, as shown by high levels of agreement with transphobic statements that combine these two distinct concepts,” author Daniel W. Derbyshire (@DWDerbyshire) of the University of Exeter and Tamsin Kay of Coventry University.
The questionnaire also asked participants about relationships with transgender people in their daily lives. Although healthcare professionals – including nurses and non-nurses – were more likely than non-healthcare professionals to have met a transgender person, they reported being less likely to have a transgender friend or family member.
“This suggests that healthcare professionals’ (both nurses and non-nurses) experiences of contact with transgender individuals may be largely limited to a work context,” the authors write.
The authors note that participants in this experiment were limited to those who visited the Project Implicit website and chose to complete the experiment. “As such, sample selection may be subject to bias given the demographics of sample participants and implicit association test (IAT) results,” the authors write. “However, it can be hypothesized that people with particularly negative attitudes toward transgender people will avoid taking the transgender IAT, and the results presented here may therefore underrepresent the extent of implicit bias toward transgender people.”
Derbyshire, DW, etc (2023) Nurses’ implicit and explicit attitudes toward transgender people and the need for trans-affirming care.. Hellion. doi.org/10.1016/j.heliyon.2023.e20762.