Identifying Themes in the Knowledge and Attitudes of UK Healthcare Professionals Towards Transgender and Nonbinary Patients: An Evidence Review

BACKGROUND: Trans (trans) is an umbrella term referring to diverse gender identities including transgender and nonbinary. Trans people have faced discrimination in healthcare settings as demonstrated in research reporting the experiences of trans patients. There is limited UK-based literature on this topic, particularly from healthcare professional (HCP) perspectives. This review draws together existing evidence on themes in the attitudes and knowledge of HCPs towards trans patients. METHODS: In this evidence review, a systematic search was conducted of multiple key databases using key concepts: (1) transgender, (2) attitudes and (3) healthcare professionals. Reflexive thematic analysis was used to analyse the qualitative data and narrative synthesis for the quantitative data. MMAT checklists were used to critically appraise the data. FINDINGS: After thematic analysis of 14 articles, five themes were developed: (1) discriminatory attitudes towards trans patients, (2) knowledge gaps and training needs, (3) uncertainty around caring for trans patients, (4) impact of HCP knowledge and attitudes on trans patients, (5) trans inclusive attitudes of HCPs. CONCLUSION: The main themes were interlinked: Discriminatory attitudes (Theme 1) were connected to knowledge gaps (Theme 2), which were linked with uncertainty (Theme 3), ultimately all negatively impacting trans patients (Theme 4). Recommendations such as embedding trans healthcare education in HCP curriculums and implementing trans-inclusive policy were made. Recommendations from these findings aim to contribute to a more trans-inclusive healthcare culture where trans patients feel welcome instead of stigmatised and can build trusting HCP-patient relationships with positive consequences for patient care.