Building a Diverse Workforce: Professional Identity in Noncisgender Nursing Students

Abstract

Noncisgender college students experience marginalizing behaviors in the academic classroom, impacting their mental health and college completion. There is little data on this population’s experiences with uncivil behaviors in educational settings outside a traditional class, such as for nursing students in the clinical learning environment (CLE) interacting with health care professionals. Interactions in the CLE are foundational for building a sense of professional identity (PI) with health care students. Aims: To examine if noncisgender health care students report increased incivility in the CLE, and if these negative experiences impact noncisgender students’ PI development. Methods: Using the Gender Minority Stress and Resilience model as a framework, validated tools were selected to represent distal and proximal stressors. A national sample of health care students (67% nursing students) who had finished at least one semester in the CLE completed survey tools about incivility in the CLE, stress, level of internalized transphobia, and sense of PI. Participants identified their gender identity in the demographics section. Conclusions: Noncisgender health care students have a significantly lower sense of PI compared to cisgender students, and those who report experiencing incivility in the CLE have the lowest sense of PI. Internalized transphobia did not mediate the relationship between gender identity and incivility or gender identity and stress. Gender minority students have a significantly lower sense of PI, which may impact long term retention in the profession. Health care programs and health care organizations must consider ways to support this population’s inclusion in their profession.