Trans inclusive and competent clinical practices

This dissertation explores the trans and gender diverse (TGD) competence and inclusivity of clinical intakes and settings, focusing on the development of the Trans Inclusive Supplemental Intake Form (TISIF) and the impact of the use of popular media content that is associated with anti-trans public figures and anti-trans hate group dog whistles in healthcare environments, specifically through exploring TGD perceptions of and experiences with Harry Potter. Archival research was utilized throughout the development of the TISIF and the World Professional Association for Transgender Health’s Standards of Care Version 8 was reviewed to ensure best practices were incorporated. TGD experiences with Harry Potter content were explored through both quantitative (n=679) and preliminary qualitative (n=816) data analysis. Preliminary qualitative analysis identified the themes: the impact of anti-trans statements – including impact on politics and society and impact on feeling unwelcome or isolated, no excuses, childhood nostalgia, distrust, and separating the art from the artist – including those for separating and against separating the art from the artist. A subset of mostly mental health care providers was identified within the responses whose perspectives could help identify how TGD care providers navigate these experiences. Perceived experience ratings and adjectives associated with Harry Potter and J.K. Rowling were examined across time and setting, and patient response to Harry Potter content with providers was explored. Descriptive statistics and two-way linear mixed-effects modeling found statistically significant (p < 0.05) increases in negative experience ratings over time and increases in negative adjective associations over time, and that TGD patients are significantly LESS likely to contact (83.3%), feel comfortable with (76.6%), likely to disclose to (72.6%), and feel safe with (74.4%) providers who have Harry Potter content and references. The practical implications of the findings of this research emphasize adding the TISIF to existing electronic intake processes to bring them to a minimum standard of trans inclusivity, and removing activating content, such as Harry Potter references, to decrease minority stress and create more inclusive and competent clinical environments.