Introduction
The term "transgender" refers to individuals
whose gender identity does not align with the sex
they were assigned at birth. This term can
encompass a wide range of gender identities and
expressions, from individuals who have undergone
medical sex reassignment procedures to
individuals who self-identify with a different gender
identity without any changes to their bodies.
According to research by Collin and colleagues
(2016), the perception of what it means to be
transgender depends on the definition adopted,
with significant variations in prevalence rates
depending on the methodology. Also, as pointed
out by Buck (2016), misconceptions and a lack of
understanding of the concept of gender identity can
lead to prejudice and discrimination.
The discrimination and dehumanization that
transgender people face are particularly intense,
both in society and in health services. According to
research, transgender people are often targeted by
microaggressions, objectification, and
discrimination, which lead to the loss of their
humanness through the rejection of characteristics
that are considered uniquely human, such as
emotional sensitivity and moral conscience
(Kcomt, 2019; Haslam, 2006; Cascalheira & Choi,
2023). In the context of health services, this
dehumanization manifests itself in the indifference
to the subjectivity and needs of patients, but also in
the objectification of them as passive recipients of
treatment. At the same time, these experiences
lead to increased internalized negativity, shame,
and mental health problems, which are often
associated with poorer mental health (Cascalheira
& Choi, 2023; Safer et al., 2016). Transgender
individuals face higher rates of anxiety, depression,
and suicidal ideation due to societal stigma and
discrimination. Experiences of rejection, workplace
bias, and inadequate healthcare contribute to
chronic stress and psychological distress. Minority
stress theory explains how cumulative
discrimination leads to poor mental health
outcomes. A systematic review highlights that
transgender people are at significantly increased
risk of mental health disorders compared to
cisgender individuals (Budge et al., 2013).
Addressing these issues requires strengthening
legislative protections and raising awareness
among health professionals to provide
comprehensive and humane care.
Nursing students' attitudes towards transgender
people vary, but most studies show that they are
characterized by a lack of knowledge (Fradelos et
al.,2022), prejudices, and stereotypical
perceptions, which affect them in providing
provision of quality care. According to the study by
Derbyshire and Keay (2023), many students show
confusion about gender and gender identity, with
many agreeing with statements such as "the
male/female dichotomy is natural" and "a person
can never change their gender". Furthermore, they
exhibit higher levels of implicit bias compared to
other health professional groups, while education
about trans health remains limited. Similarly,
research by Day and Nicholls (2019) highlights that
students use language that heteronormatively
treats trans people, positioning them as “other” and
reinforcing social stereotypes, while there is a lack
of understanding of the complexities of trans
identity. The findings highlight the need for targeted
education that will reduce bias and enhance
inclusive health care (Albani et al, 2022; Day &
Nicholls, 2019; Derbyshire & Keay, 2023).
Nursing students’ attitudes toward transgender
people are influenced by several factors, with
education playing a central role. Research
suggests that curricula often lack sufficient
information about the needs of the transgender
community, leading to students being inadequately
prepared to provide quality care. Lack of
knowledge about issues such as psychological
support, management of transgender patients, and
their medical needs reinforces prejudices and
stereotypes (Gentil et al., 2023). Furthermore, the
lack of specialized educational tools and clinical
scenarios limits students’ ability to fully understand
the challenges transgender people face in the
healthcare system (Mizock & Lundquist, 2016).
At the same time, personal contact and clinical
experience play an important role. When students
can meet and care for transgender people, they
form more positive and well-informed views about
the needs of this group (Jecke & Zepf, 2024). On
the other hand, the lack of such experiences often
leads to uncertainty and insecurity when providing
care, which highlights the importance of adapting
educational programs (Roy & Clark,2024; Jecke &
Zepf, 2024). By incorporating interactive seminars,
partnerships with transgender organizations, and
internship opportunities, educational institutions
can reduce prejudice and enhance students’
cultural sensitivity (Stewart & O’Reilly, 2017).
Personality traits and empathy play a central
role in shaping nursing students’ attitudes toward
transgender people individuals. Individuals with
high emotional stability, openness to experience,
and a heightened level of social responsibility tend
to express greater acceptance of diversity.
Empathy, as the ability to understand and share the
feelings and experiences of others, is a catalyst for
reducing prejudice. Studies show that educational
programs aimed at enhancing empathy can
significantly reduce negative attitudes toward
LGBTQ+ individuals, including transgender
individuals (Ozturk & Demirden, 2023).
Beyond theoretical knowledge, experiential
learning plays an equally important role.
Educational interventions based on experiential
exercises, such as participating in virtual scenarios
or personal contact with trans people, enhance
empathy and reduce discrimination. At the same