It’s complicated: Improving undergraduate nursing students’ understanding and care of LGBTQ older adults

By Nadine Henriquez
January 2019
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What you need to know

This project introduced an unfolding family case model  of a transgender woman and her partner to undergraduate nursing students. This model provided a forum for exploration of personal biases, and an opportunity to practice gender-affirming techniques while addressing the challenges of aging for a transgender woman and her lesbian partner within the broader context of societal stigma and discrimination. Students gained critical knowledge regarding the shift in the structure of families within society and developed a better understanding of the nurses’ role as advocates for vulnerable populations and how factors such as discrimination and the complexities of aging intersect. Students also learned how to address specific health concerns and facilitate a more equitable access to healthcare for transgender older adults.

Why this research is important

Research has shown that health inequities for the Lesbian, Gay, Bisexual, Transgender and Queer/Questioning (LGBTQ) community are related to differences in access to health services, unhealthy or risk-associated behaviours, and the overall negative impact of experiences of discrimination. While LGBTQ older adults experience challenges similar to other older adults, many face unique barriers that can decrease the quality of life in later years. Nursing educational content regarding LGBTQ issues, risk factors, and health disparities has been historically limited, resulting in nurses entering practice with potentially limited knowledge. This family case model sought to normalize sexual and gender diversity within the curriculum, and provide a foundation for inclusive and equitable care for LGBTQ persons. The case study methodology helped students to understand older adult transgender family structures, family dynamics, and their unique health and social issues. Nursing students have the potential to influence the lives of thousands of patients, families, co-workers, and community members during their career. Well-developed knowledge and skills for providing holistic, culturally sensitive care to LGBTQ older adults and their families will positively impact the health and well-being of the LGBTQ community.

How the research was conducted

This project introduced an older adult transgender family case model using a method that unfolds or evolves over time to undergraduate nursing students. Students provided narrative feedback and quantitative numerical ratings prior to and after the educational interventions. Surveys focused on examining students’ abilities to identify and discuss health disparities and comfort levels in providing nursing care for patients from the LGBTQ community.

What the researcher found

Students reported increased knowledge on LGBTQ culture and transgender older adults and increased empathy and insight into patient perspectives for transgender families. Students also described significant increases in abilities to describe LGBTQ health disparities, demographics, strategies for creating welcoming environments and self-perceived effectiveness of being able to communicate with LGBTQ people sensitively. The most notable finding was a significant increase in students’ reported comfort levels in providing nursing care to the LGBTQ community following the implementation of the case model.

How this research can be used

By including LGBTQ families in the curriculum, faculty can foster the development of inclusive and nonjudgmental practices in a safe, supportive, educational setting. This approach allows students to examine their biases and to practice gender-affirming communication techniques and helps to prepare students for future challenges working across cultures in diverse communities. Students will have an opportunity to understand older adult transgendered family structures, family dynamics, and their unique health and social issues, and overall improving students’ knowledge and comprehension of transgender family’s needs. This model provides an opportunity to normalize sexual and gender diversity in the nursing curriculum, and helps to provide students with skills for providing inclusive and equitable care for LGBTQ persons.


I would like to thank Dr. Nora Ahmad, for statistical analysis support as well as Dr. Kathryn Hyndman and Kathryn Chachula for assistance in dissemination and data analysis. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors

About the Researcher

Nadine Henriquez

Nadine Henriquez, RN, MN

Nadine Henriquez is a Registered Nurse and an Assistant Professor in the Department of Nursing, Faculty of Health Studies, at Brandon University.


  • baccalaureate nursing program
  • family nursing
  • nursing education
  • older adult
  • transgender

Editor: Christiane Ramsey

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