{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T08:45:24Z","timestamp":1782895524336,"version":"3.54.5"},"reference-count":33,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Promotion Practice"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>Transgender and gender-nonconforming individuals need access to diverse health services in welcoming, affirming, clinically appropriate, and culturally sensitive environments. Nursing students often feel underprepared due to limited knowledge and attitudes about transgender and gender nonconforming issues, and despite growing interest, research on their care remains limited. This study explores the perspectives of nursing students nearing graduation on providing care to transgender and gender-nonconforming persons. We conducted a qualitative descriptive exploratory study at the Fondazione IRCCS Istituto Nazionale dei Tumori, part of the University of Milan\u2019s Bachelor\u2019s School of Nursing. Individual semi-structured interviews were transcribed and analyzed using NVivo Version 14.23.2. Thematic analysis by Braun and Clarke was employed to derive themes from the data. Nineteen interviews were conducted, uncovering three main themes and eight subthemes related to students\u2019 knowledge, perspectives, and experiences on transgender and gender-nonconforming care. The findings indicated that the current curriculum often neglects transgender and gender-nonconforming specific issues, leading to insufficient practical experience and contributing to students\u2019 feelings of inadequacy. The participants highlighted the significant impact of societal attitudes and cisnormativity of the health care system on transgender and gender-nonconforming care. Furthermore, a generational gap was observed in attitudes toward transgender and gender-nonconforming individuals, with older health care providers often lacking sensitivity and knowledge compared with their younger counterparts. This study underscored the urgent need for educational reforms and ongoing professional development to address transgender and gender-nonconforming health issues, improve nursing education, and bridge generational gaps, thus fostering a more inclusive and equitable health care system to effectively address the unique needs of this population.<\/jats:p>","DOI":"10.1177\/15248399251354963","type":"journal-article","created":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T13:14:59Z","timestamp":1753967699000},"page":"681-691","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Nursing Students\u2019 Perceptions, Knowledge, and Experience in Providing Care to Transgender and Gender-Nonconforming Persons: A Qualitative Study"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9033-9934","authenticated-orcid":false,"given":"Ilaria","family":"Basile","sequence":"first","affiliation":[{"name":"High-Complexity Unit of Palliative Care, Pain Therapy and Rehabilitation, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0450-2605","authenticated-orcid":false,"given":"Daniele","family":"Rusconi","sequence":"additional","affiliation":[{"name":"Healthcare Professions Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Livia","family":"Pellegatta","sequence":"additional","affiliation":[{"name":"General, Vascular and Thoracic Surgery Unit, ASST Brianza, Vimercate, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Ghezzi","sequence":"additional","affiliation":[{"name":"Head and Neck Cancer and Rare Tumor Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Luisa","family":"Pancheri","sequence":"additional","affiliation":[{"name":"Bachelor School of Nursing, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7207-2586","authenticated-orcid":false,"given":"Letteria","family":"Consolo","sequence":"additional","affiliation":[{"name":"Healthcare Professions Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,31]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordhb\/9780190673741.001.0001"},{"key":"e_1_3_2_3_1","doi-asserted-by":"crossref","unstructured":"Braun V. Clarke V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology 3(2) 77\u2013101. https:\/\/doi.org\/10.1191\/1478088706qp063oa","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_3_2_4_1","volume-title":"Successful qualitative research: A practical guide for beginners","author":"Braun V.","year":"2013","unstructured":"Braun V., Clarke V. (2013). Successful qualitative research: A practical guide for beginners. Sage."},{"key":"e_1_3_2_5_1","doi-asserted-by":"crossref","unstructured":"Braun V. Clarke V. (2021). To saturate or not to saturate? Questioning data saturation as a useful concept for thematic analysis and sample-size rationales. Qualitative Research in Sport Exercise and Health 13(2) 201\u2013216. https:\/\/doi.org\/10.1080\/2159676X.2019.1704846","DOI":"10.1080\/2159676X.2019.1704846"},{"key":"e_1_3_2_6_1","doi-asserted-by":"crossref","unstructured":"Chapman R. Watkins R. Zappia T. Nicol P. Shields L. (2012). Nursing and medical students\u2019 attitude knowledge and beliefs regarding lesbian gay bisexual and transgender parents seeking health care for their children. Journal of Clinical Nursing 21(7\u20138) 938\u2013945. https:\/\/doi.org\/10.1111\/j.1365-2702.2011.03892.x","DOI":"10.1111\/j.1365-2702.2011.03892.x"},{"key":"e_1_3_2_7_1","doi-asserted-by":"crossref","unstructured":"Cheung A. S. Wynne K. Erasmus J. Murray S. Zajac J. D. (2019). Position statement on the hormonal management of adult transgender and gender diverse individuals. Medical Journal of Australia 211(3) 127\u2013133. https:\/\/doi.org\/10.5694\/mja2.50259","DOI":"10.5694\/mja2.50259"},{"key":"e_1_3_2_8_1","doi-asserted-by":"crossref","unstructured":"Cicero E. C. Reisner S. L. Merwin E. I. Humphreys J. C. Silva S. G. (2020). The health status of transgender and gender nonbinary adults in the United States. PLOS ONE 15(2) Article e0228765. https:\/\/doi.org\/10.1371\/journal.pone.0228765","DOI":"10.1371\/journal.pone.0228765"},{"key":"e_1_3_2_9_1","doi-asserted-by":"crossref","unstructured":"Coleman E. Radix A. E. Bouman W. P. Brown G. R. de Vries A. L. C. Deutsch M. B. Ettner R. Fraser L. Goodman M. Green J. Hancock A. B. Johnson T. W. Karasic D. H. Knudson G. A. Leibowitz S. F. Meyer-Bahlburg H. F. L. Monstrey S. J. Motmans J. Nahata L. .\u2004.\u2004. Arcelus J. (2022). Standards of care for the health of transgender and gender diverse people version 8. International Journal of Transgender Health 23(Suppl. 1) S1\u2013S259. https:\/\/doi.org\/10.1080\/26895269.2022.2100644","DOI":"10.1080\/26895269.2022.2100644"},{"key":"e_1_3_2_10_1","doi-asserted-by":"crossref","unstructured":"Cornelius J. B. Carrick J. (2015). A survey of nursing students\u2019 knowledge of and attitudes toward LGBT health care concerns. Nursing Education Perspectives 36(3) 176\u2013178. https:\/\/doi.org\/10.5480\/13-1223","DOI":"10.5480\/13-1223"},{"key":"e_1_3_2_11_1","doi-asserted-by":"crossref","unstructured":"Cypress B. (2018). Qualitative research methods: A phenomenological focus. Dimensions of Critical Care Nursing 37(6) 302\u2013309. https:\/\/doi.org\/10.1097\/DCC.0000000000000322","DOI":"10.1097\/DCC.0000000000000322"},{"key":"e_1_3_2_12_1","doi-asserted-by":"crossref","unstructured":"Dhakal K. (2022). NVivo. Journal of the Medical Library Association 110(2). https:\/\/doi.org\/10.5195\/jmla.2022.1271","DOI":"10.5195\/jmla.2022.1271"},{"key":"e_1_3_2_13_1","doi-asserted-by":"crossref","unstructured":"Ding J. M. Ehrenfeld J. M. Edmiston E. K. Eckstrand K. Beach L. B. (2020). A model for improving health care quality for transgender and gender nonconforming patients. The Joint Commission Journal on Quality and Patient Safety 46(1) 37\u201343. https:\/\/doi.org\/10.1016\/j.jcjq.2019.09.005","DOI":"10.1016\/j.jcjq.2019.09.005"},{"key":"e_1_3_2_14_1","doi-asserted-by":"crossref","unstructured":"Doyle L. McCabe C. Keogh B. Brady A. McCann M. (2020). An overview of the qualitative descriptive design within nursing research. Journal of Research in Nursing 25(5) 443\u2013455. https:\/\/doi.org\/10.1177\/1744987119880234","DOI":"10.1177\/1744987119880234"},{"key":"e_1_3_2_15_1","doi-asserted-by":"crossref","unstructured":"Ercan-\u015eahin N. Aslan F. (2020). Nursing students\u2019 perspectives on the inclusion of course content on lesbian gay bisexual and transgender health in the nursing curriculum: A descriptive qualitative study. Nursing & Health Sciences 22(3) 822\u2013829. https:\/\/doi.org\/10.1111\/nhs.12742","DOI":"10.1111\/nhs.12742"},{"key":"e_1_3_2_16_1","doi-asserted-by":"crossref","unstructured":"Goodman M. Adams N. Corneil T. Kreukels B. Motmans J. Coleman E. (2019). Size and distribution of transgender and gender nonconforming populations. Endocrinology and Metabolism Clinics of North America 48(2) 303\u2013321. https:\/\/doi.org\/10.1016\/j.ecl.2019.01.001","DOI":"10.1016\/j.ecl.2019.01.001"},{"key":"e_1_3_2_17_1","doi-asserted-by":"crossref","unstructured":"Gupta S. Imborek K. L. Krasowski M. D. (2016). Challenges in transgender healthcare: The pathology perspective. Laboratory Medicine 47(3) 180\u2013188. https:\/\/doi.org\/10.1093\/labmed\/lmw020","DOI":"10.1093\/labmed\/lmw020"},{"issue":"1","key":"e_1_3_2_18_1","article-title":"Defining Exploratory-Descriptive Qualitative (EDQ) research and considering its application to healthcare","volume":"4","author":"Hunter D. J.","year":"2019","unstructured":"Hunter D. J., Mccallum J., Howes D. (2019). Defining Exploratory-Descriptive Qualitative (EDQ) research and considering its application to healthcare. Journal of Nursing and Health Care, 4(1).","journal-title":"Journal of Nursing and Health Care"},{"key":"e_1_3_2_19_1","doi-asserted-by":"crossref","unstructured":"Kcomt L. (2019). Profound health-care discrimination experienced by transgender people: Rapid systematic review. Social Work in Health Care 58(2) 201\u2013219. https:\/\/doi.org\/10.1080\/00981389.2018.1532941","DOI":"10.1080\/00981389.2018.1532941"},{"key":"e_1_3_2_20_1","doi-asserted-by":"crossref","unstructured":"Lim F. A. Hsu R. (2016). Nursing students\u2019 attitudes toward lesbian gay bisexual and transgender persons. Nursing Education Perspectives 37(3) 144\u2013152. https:\/\/doi.org\/10.1097\/01.NEP.0000000000000004","DOI":"10.1097\/01.NEP.0000000000000004"},{"key":"e_1_3_2_21_1","doi-asserted-by":"crossref","unstructured":"Medina-Mart\u00ednez J. Saus-Ortega C. S\u00e1nchez-Lorente M. M. Sosa-Palanca E. M. Garc\u00eda-Mart\u00ednez P. M\u00e1rmol-L\u00f3pez M. I. (2021). Health inequities in LGBT people and nursing interventions to reduce them: A systematic review. International Journal of Environmental Research and Public Health 18(22) 11801. https:\/\/doi.org\/10.3390\/ijerph182211801","DOI":"10.3390\/ijerph182211801"},{"key":"e_1_3_2_22_1","doi-asserted-by":"crossref","unstructured":"Montes-Galdeano F. Roman P. Ropero-Padilla C. Romero-L\u00f3pez A. Ruiz-Gonz\u00e1lez C. Rodriguez-Arrastia M. (2021). Improving the care management of trans patients: Focus groups of nursing students\u2019 perceptions. Journal of Nursing Management 29(1) 75\u201384. https:\/\/doi.org\/10.1111\/jonm.13160","DOI":"10.1111\/jonm.13160"},{"key":"e_1_3_2_23_1","doi-asserted-by":"crossref","unstructured":"Palinkas L. A. Horwitz S. M. Green C. A. Wisdom J. P. Duan N. Hoagwood K. (2015). Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Administration and Policy in Mental Health 42(5) 533. https:\/\/doi.org\/10.1007\/S10488-013-0528-Y","DOI":"10.1007\/s10488-013-0528-y"},{"key":"e_1_3_2_24_1","doi-asserted-by":"crossref","unstructured":"Richardson B. P. Ondracek A. E. Anderson D. (2017). Do student nurses feel a lack of comfort in providing support for Lesbian Gay Bisexual or Questioning adolescents: What factors influence their comfort level? Journal of Advanced Nursing 73(5) 1196\u20131207. https:\/\/doi.org\/10.1111\/jan.13213","DOI":"10.1111\/jan.13213"},{"key":"e_1_3_2_25_1","doi-asserted-by":"crossref","unstructured":"Rosenkrantz D. E. Black W. W. Abreu R. L. Aleshire M. E. Fallin-Bennett K. (2017). Health and health care of rural sexual and gender minorities: A systematic review. Stigma and Health 2(3) 229\u2013243. https:\/\/doi.org\/10.1037\/sah0000055","DOI":"10.1037\/sah0000055"},{"key":"e_1_3_2_26_1","doi-asserted-by":"crossref","unstructured":"Rucco D. Toffoli G. Anzani A. Prunas A. (2024). A networked model of ecological systems theory to discuss concerns in Italian bisexual+ and transgender people after the block of the \u201cZan Bill\u201d by Senate. Sexuality Research and Social Policy 21 313\u2013338. https:\/\/doi.org\/10.1007\/s13178-023-00906-z","DOI":"10.1007\/s13178-023-00906-z"},{"key":"e_1_3_2_27_1","doi-asserted-by":"crossref","unstructured":"Saunders B. Sim J. Kingstone T. Baker S. Waterfield J. Bartlam B. Burroughs H. Jinks C. (2018). Saturation in qualitative research: Exploring its conceptualization and operationalization. Quality & Quantity 52(4) 1893\u20131907. https:\/\/doi.org\/10.1007\/s11135-017-0574-8","DOI":"10.1007\/s11135-017-0574-8"},{"key":"e_1_3_2_28_1","doi-asserted-by":"crossref","unstructured":"Scheim A. I. Baker K. E. Restar A. J. Sell R. L. (2022). Health and health care among transgender adults in the United States. Annual Review of Public Health 43(1) 503\u2013523. https:\/\/doi.org\/10.1146\/annurev-publhealth-052620-100313","DOI":"10.1146\/annurev-publhealth-052620-100313"},{"key":"e_1_3_2_29_1","doi-asserted-by":"crossref","unstructured":"Sherman A. D. F. McDowell A. Clark K. D. Balthazar M. Klepper M. Bower K. (2021). Transgender and gender diverse health education for future nurses: Students\u2019 knowledge and attitudes. Nurse Education Today 97 104690. https:\/\/doi.org\/10.1016\/j.nedt.2020.104690","DOI":"10.1016\/j.nedt.2020.104690"},{"key":"e_1_3_2_30_1","doi-asserted-by":"crossref","unstructured":"Strong K. L. Folse V. N. (2015). Assessing undergraduate nursing students\u2019 knowledge attitudes and cultural competence in caring for lesbian gay bisexual and transgender patients. Journal of Nursing Education 54(1) 45\u201349. https:\/\/doi.org\/10.3928\/01484834-20141224-07","DOI":"10.3928\/01484834-20141224-07"},{"key":"e_1_3_2_31_1","doi-asserted-by":"crossref","unstructured":"Sundus A. Shahzad S. Younas A. (2021). Ethical and culturally competent care of transgender patients: A scoping review. Nursing Ethics 28(6) 1041\u20131060. https:\/\/doi.org\/10.1177\/0969733020988307","DOI":"10.1177\/0969733020988307"},{"key":"e_1_3_2_32_1","doi-asserted-by":"crossref","unstructured":"Tong A. Sainsbury P. Craig J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care 19(6) 349\u2013357. https:\/\/doi.org\/10.1093\/INTQHC\/MZM042","DOI":"10.1093\/intqhc\/mzm042"},{"key":"e_1_3_2_33_1","doi-asserted-by":"crossref","unstructured":"Yingling C. T. Cotler K. Hughes T. L. (2017). Building nurses\u2019 capacity to address health inequities: Incorporating lesbian gay bisexual and transgender health content in a family nurse practitioner programme. Journal of Clinical Nursing 26(17\u201318) 2807\u20132817. https:\/\/doi.org\/10.1111\/jocn.13707","DOI":"10.1111\/jocn.13707"},{"key":"e_1_3_2_34_1","doi-asserted-by":"crossref","unstructured":"Zhang Q. Goodman M. Adams N. Corneil T. Hashemi L. Kreukels B. Motmans J. Snyder R. Coleman E. (2020). Epidemiological considerations in transgender health: A systematic review with focus on higher quality data. International Journal of Transgender Health 21(2) 125\u2013137. https:\/\/doi.org\/10.1080\/26895269.2020.1753136","DOI":"10.1080\/26895269.2020.1753136"}],"container-title":["Health Promotion Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15248399251354963","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15248399251354963","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15248399251354963","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T07:56:32Z","timestamp":1782892592000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15248399251354963"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,31]]},"references-count":33,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1177\/15248399251354963"],"URL":"https:\/\/doi.org\/10.1177\/15248399251354963","relation":{},"ISSN":["1524-8399","1552-6372"],"issn-type":[{"value":"1524-8399","type":"print"},{"value":"1552-6372","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,31]]}}}