Date of Award
1-1-2025
Degree Type
Dissertation
Degree Name
Doctor of Philosophy in Nursing
Department
Nursing
First Advisor
Melissa Sutherland
Abstract
Increasing numbers of individuals in the U.S. are identifying as sexual and gender minorities (SGM). Approximately 17-21% of U.S. college students identify as SGM, comprising a sizable portion of minoritized groups on college campuses. College students who identify as SGM are at significant risk for physical and mental health issues, experiences of victimization, and poorer health outcomes. It is essential that colleges and universities ensure their campuses are meeting the needs of their entire student body, including SGM students. This study aims to: (1) obtain an in-depth understanding of college healthcare provider (HCP) experiences and their perceptions with inclusive and affirming health care of SGM college students; and (2) explore college HCPs’ perceptions on inclusivity (e.g., SGM-inclusive policies, programs, practices, and healthcare) of their campus health center and university.
Semi-structured interviews with a sample of 16 HCPs from multiple universities across the U.S. were conducted in this qualitative descriptive study. Interviews were guided by the Sexual and Gender Minority Health Disparities Framework (NIMHD) and the Consolidated Framework for Implementation Research (CFIR) to better understand the experiences of college HCPs working with SGM college students. Data analysis was guided by a hybrid thematic analysis approach using a combination of deductive and inductive methods; findings were then organized across key NIMHD and CFIR domains. Four main themes were identified: (1) commitment to providing inclusive and affirming care for SGM college students; (2) concern for the SGM student health care experience; (3) challenges to providing inclusive and affirming care for SGM college students; and (4) supporting factors that make it easier to provide inclusive and affirming care for SGM college students.
Providers in this study expressed a personal investment in learning more about inclusive and affirming care for students and wanted to create affirming environments for students to feel safe and accepted. Providers also recognized the importance of accessible and convenient care as necessary to improve health outcomes for SGM college students. College HCPs also reported several barriers experienced by students and their impact on care delivery. Reported barriers included experience of discrimination in past healthcare encounters, financial and privacy concerns, difficulty navigating the health care system, and unique and specific healthcare needs. Obstacles that providers experienced were also explored and were described as challenges to providing inclusive and affirming care for SGM college students. These included a lack of resources, state laws and local policies, managing insurance and limitations of the electronic health record.
Findings from this qualitative study support the need for increased provider education and training, provider champions for inclusive and affirming care for SGM college students, integrated care on college campuses, and partnerships with campus resources. This study supports the advancement of SGM healthcare best practices by identifying barriers and facilitators relevant to SGM- inclusive and gender-affirming care delivery. The study contributes to the limited available literature on college HCP experiences working with SGM college students in campus health centers. Findings provide the beginnings of a formative assessment that can be used for future implementation of gender-affirming best practice guidelines in college health centers. Finally, the study identifies the current environment of college healthcare practices as it relates to inclusive and affirming care on college campuses and contributes to the formative assessment necessary for successful implementation of evidence-based best practice recommendations in the future.
Recommended Citation
Connolly, Somatra Lynn, "College Health Provider Experiences with Inclusive and Affirming Care of Sexual and Gender Minorities" (2025). Open Access Dissertations. Paper 4447.
https://digitalcommons.uri.edu/oa_diss/4447
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