Document Type

DNP Project


School of Nursing

Date of Degree

Spring 2018


Doctor of Nursing Practice (DNP)

Primary Advisor

Dana D. Hines, PhD, RN; Jeanne Geiger Brown, PhD, RN, FAAN


Background: Transgender and Gender-Nonconforming (TGNC) populations comprise approximately 6% of the U.S. population. Socially and within the medical treatment system TGNC individuals face widespread stigmatization and discrimination which negatively impacts their mental, physical, and emotional health and contributes to health disparities. Real and perceived barriers to safe and effective healthcare are worsened by the scarcity of primary care providers knowledgeable in caring for these populations.

Objectives: The aim of this quality improvement project was to examine the impact of inclusive gender-affirming integration on the utilization of preventive and primary care services.

Methods: A one group pre- and post-intervention design was used to measure utilization of preventive and primary care services prior to and following integration of inclusive and affirming care. The Chi-Square Test of Associations (X²) analysis was performed for the project aim.

Results: Results revealed a correlation between integration of inclusive and affirming services and tobacco use screening (p<0.001), cervical cancer screening (p=0.022), BMI screening (p<0.001), and HIV screening (p=0.212). Screening rates that noted a small negative correlation to integrating gender-affirming services into primary care: Depression screening (p<0.001; X²=64.518; PHI=-0.250) and HTN screening (p=0.240, X²=1.378, Phi=-0.036).

Conclusion: Results of this project successfully noted that four of the six preventive health screenings showed a positive association between the integration of inclusive gender-affirming services into primary care and did affect the rate at which preventive screenings were utilized by TGNC patients accessing primary care services. More significantly, the project also revealed a significant increase of TGNC patients seeking care.

Open Access




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