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Introduction: Pharmacists must be knowledgeable to care for all patients, including transgender and gender diverse individuals. Some institutions may have gaps in their pharmacy school curriculum specific to transgender contraceptive care. The current study evaluated and offered recommendations regarding the current state of transgender contraceptive care education within pharmacy curricula., Methods: An 18-question anonymous survey was developed and sent to members of the American Association of Colleges of Pharmacy - Pharmacy Practice section contact list. The survey collected baseline demographic characteristics and curricular information, including whether contraception for transgender individuals was taught and the modalities utilized. The institutional review board at Butler University reviewed and approved this survey project., Results: A response rate of 68% was obtained (99 of 144 institutions). Of those institutions responding, 39% reported that contraception for transgender individuals is taught as part of the curriculum at their respective institutions. In addition, a diverse set of teaching modalities were reported, such as didactic and team-based learning. Only six (4.3%) of the 138 individual faculty respondents indicated they obtained training focused on transgender care., Conclusions: Approximately 40% of the responding institutions reported teaching about contraception care for transgender individuals. Based on this survey, the authors encourage institutions to assess their current curriculum and incorporate this topic accordingly. In addition, the authors recommend offering development opportunities for faculty and student pharmacists so that current and future health care professionals are best equipped to provide care for all patients in any practice., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Introduction Transgender people have specific healthcare needs and experience difficulty in accessing health services. Medical students should receive teaching on general and gynaecological healthcare issues in this population. Our aim was to assess medical students' knowledge of healthcare needs of transgender people before and after a newly implemented teaching session on transgender healthcare. Method A mixed-method study was carried out over a three month period in a university obstetric and gynaecology hospital in Dublin. A one-hour teaching session was developed and delivered to final year medical students. Students completed a survey before and after receiving the lecture. Results Seventy-one students completed the pre-lecture survey and forty-three completed the post-lecture survey. Pre-lecture, 64 students (90%) reported some-to-no understanding of healthcare issues of transgender people, and only 13 (18%) reported understanding gynaecological issues faced by transgender people. Post-lecture, 41 (95%) had a better understanding of health issues faced by this population and 40 (93%) had a better understanding of gynaecological health issues faced. Most students (81%) wanted further teaching on the topic. Conclusion A one-hour teaching session was effective at improving student knowledge of care of transgender people. This teaching could be expanded to all Irish medical schools. Going forward, the teaching could be adapted for post-graduate obstetric and gynaecology teaching., Competing Interests: The authors have no conflicts of interest to declare. No funding was received for this study.

Objectives: Previous negative experiences with the medical community often leave transgender people reluctant to seek medical care. Inadequate teaching and exposure to transgender health during medical training perpetuates the health disparities experienced by this community. Although undergraduate medical education is uniquely positioned to address these disparities, curricular coverage of these topics remains inadequate., Methods: The second-year clinical skills course at the Florida International University Herbert Wertheim College of Medicine includes a workshop consisting of a 1-hour lecture about the inclusive sexual history, followed by a 1.5-hour small group during which students interview a standardized patient playing the role of a transgender man and participate in a faculty-facilitated debriefing. To evaluate the 2019 workshop, students were provided with an optional, anonymous, pre- and postsession survey consisting of multiple choice and Likert-type questions., Results: After the session, there was a statistically significant increase in students' knowledge of the components of an inclusive sexual history, in the number of students who believed that their medical training had prepared them to effectively provide care for transgender patients, and in the number who reported feeling comfortable taking a sexual history from a patient who identifies as transgender. Most students thought the standardized patient case was realistic and found the postencounter debriefing session helpful in identifying their own strengths and weaknesses., Conclusions: Our findings suggest that students found this brief, interactive sexual history workshop, which included a lecture and standardized patient case, to be an effective component of their medical training. Although our transgender patient case was acted primarily by cis-gender people, students perceived this as a realistic opportunity to actively explore the nuances of obtaining a history from a transgender patient. In addition, our findings suggest that it is possible to merge teaching on sexual history and transgender health care, which is important in time-limited undergraduate medical education curricula.

Purpose: To describe the effect of transgender health-related objective structured clinical examination (THOSCE) case exposure on learner activation regarding gender-affirming care., Method: A modified grounded theory approach was applied to identify the educational value of THOSCE cases. Focus groups with current and former primary care internal medicine residents who participated in THOSCE cases were conducted in 2018-2019. Transcripts were analyzed and coded until saturation to identify themes., Results: Eighteen (72%) eligible learners participated in the focus groups. Themes were identified relating to gender-affirming care, and modified grounded theory analysis was used as a framework to organize the themes into 4 stages of learner activation: (1) believing the learner role is important, (2) having the confidence and knowledge necessary to take action, (3) taking action to maintain and improve one's skills, and (4) staying the course even under stress., Conclusions: Residents were grateful for the opportunity to practice the skills involved in transgender health in a simulation. Many felt unprepared and were concerned about how they were perceived by the standardized patient and faculty. Residents identified feeling more comfortable with gender-affirming language in the inpatient setting, which may provide an opportunity for learning in the future. Residents identified the psychosocial skills of gender-affirming care as more directly relevant while biomedical aspects of gender-affirming care seemed less accessible to residents, given the lack of outpatient experience. The authors propose a staged approach to teaching the skills of gender-affirming care using simulation to address learners of all levels.

Purpose: No educational and decision support tools exist to aid transgender and non-binary (TNB) adolescents and young adults (AYA) in making decisions about fertility preservation in the context of initiating gender-affirming medical care that can impair fertility. This study identified critical content areas and learning objectives to include in a decision aid about fertility preservation targeted for TNB AYA., Methods: Delphi methodology was leveraged to engage 80 multidisciplinary experts in reproductive medicine and pediatric transgender health care in a two round consensus building procedure. Proposed content areas rated as "probably keep" or "definitely keep" by 75% of experts were retained. Proposed learning objectives reaching 75% agreement on ratings of importance and priority were also identified., Results: The Delphi procedure identified five priority content areas (Basic Reproduction; Gender-Affirming Medical Interventions: Impacts on Fertility; Established Fertility Preservation Options; Benefits and Risks of Established Fertility Preservation Procedures; Alternative Pathways to Parenting) and 25 learning objectives to prioritize in a fertility-related decision aid for TNB AYA., Conclusion: A multidisciplinary panel of experts achieved agreement around content areas and learning objectives to incorporate into a decision aid about fertility preservation for TNB AYA.

Studies indicate that tobacco use among lesbian, gay, bisexual, transgender, or queer (LGBTQ) community members is consistently higher than the general population. The Last Drag is a tobacco cessation program developed and implemented in 1991 in San Francisco, California, that has shown promise in assisting LGBTQ members with tobacco cessation. This article describes the practical challenges of adapting The Last Drag to be implemented in a southcentral Texas community. Primary challenges included short time line to expected implementation, issues with culturally insensitive language, and barriers to participant recruitment. Acknowledging and overcoming these challenges can assist public health educators who are addressing tobacco cessation in LGBTQ populations.

Introduction: To measure the general perceptions and attitudes of pharmacy students toward transgender patients and health and evaluate students' level of support for receiving education in transgender healthcare., Methods: This study was a cross-sectional survey delivered online to approximately 60 s-year pharmacy students enrolled in a required pharmacotherapy course at the University of Maryland School of Pharmacy. Students received a survey link, with five questions for completion prior to the "Gender Transition Therapeutics" lecture and a separate link with 11 questions for completion post-lecture. Responses were anonymous with no identifiers collected and multiple-choice, using Likert-scale questions aimed at gathering respondents' perceptions of managing transgender patients and support for receiving additional education in transgender healthcare., Results: Survey results indicated that students' cultural competency and confidence in managing transgender patients increased after lecture, and that they support integrating transgender health into pharmacy education. Significant findings include: 67% of students lacked confidence in their ability to treat transgender patients prior to the lecture while only 20% of students reported this lack after the lecture. 51% of students reported being aware of barriers-to-care experienced by the transgender population compared to 92% of students after the lecture. After the lecture, 87% agree pharmacists need more education in transgender health, and 74% support integrating this education into pharmacy curricula., Conclusions: Students' confidence in managing transgender health increases after didactic education, and overall, students support integrating transgender health education into pharmacy school curricula., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Objective. To design, implement and assess a lesbian, gay, bisexual, and transgender (LGBT) health and practice elective course for second- and third-year Doctor of Pharmacy (PharmD) students. Methods. The course focused on health promotion, health care barriers, disease prevention, and treatment throughout an LGBT person's lifespan. The course included topic discussions, reading assignments, various active-learning activities, an objective structured clinical examination (OSCE) with a transgender person, and guest speakers from the LGBT community. Five quizzes were administered during the course that were mapped to specific session learning objectives and course learning outcomes. Students completed an anonymous pre- and post-course survey on the seven course learning outcomes to assess their knowledge and skills regarding the health of LGBT people. Results. Students exhibited significant learning with improvement in the seven course learning outcomes. The two most improved course learning outcomes were the medications used for LGBT people and summarizing health care resources available to LGBT people. The content of student portfolios included general themes of discrimination, health care access problems, advocacy, inclusive pharmacy environments, and desire to be a better practitioner. More than 91% of the students actively engaged the guest speakers from the LGBT community. Student performance on quizzes and in the OSCE activity was excellent. The capstone presentations covered a variety of topics including LGBT in Islam. Conclusion. Students demonstrated knowledge of the unique health care issues among the LGBT community. This elective course provides a framework for other pharmacy programs to incorporate LGBT health topics into the curriculum and to engage with their local LGBT community., (© 2019 American Association of Colleges of Pharmacy.)

Introduction: The objectives of this study are to evaluate the extent of transgender-related care in current pharmacy school curricula, identify where transgender-related care is covered in the curriculum, describe how the content is delivered to pharmacy students, and review how student knowledge of transgender-related care is evaluated., Methods: This cross-sectional study utilized an online survey of curricular contacts of 142 pharmacy schools in the United States. Survey questions regarding transgender-related care were presented as multiple choice, ranking, and free-response. The survey inquired about transgender-related care information taught, teaching methods, hours of education, and student assessment., Results: Of the 66 schools that responded to the survey, 53% indicated that transgender-related education is a topic that is currently addressed somewhere within the curriculum. Twenty-two pharmacy schools incorporate this topic into the didactic curriculum, two into the experiential curriculum, and 10 into both didactic and experiential. Transgender-related care is only taught in the required curriculum of 41.2% of schools that responded to the survey., Conclusion: Transgender-related care education is taught to variable degrees throughout US doctor of pharmacy programs. This study should serve as a call to action to incorporate this necessary transgender-related care education and training into pharmacy curricula to effectively reduce health disparities among this population that is increasingly seeking care., (Copyright © 2019. Published by Elsevier Inc.)

Individuals of transgender experience (ITE) in the United States face an elevated risk of HIV infection. Several conditions have been attributed to the high HIV incidence and prevalence within this group, including experiences of discrimination, unemployment, incarceration, stigma, and elevated rates of sexual risk and substance use. In response to these needs, the Gay and Lesbian Latino AIDS Education Initiative and Prevention Point Philadelphia, two local community-based organizations in Philadelphia, developed the Transhealth Information Project (TIP). TIP is a peer-led six-session hybrid individual- and group-based intervention emphasizing leadership, social and structural interventions, and HIV risk reduction that incorporates other evidence-based practices for HIV prevention and care. Since 2003, TIP has served over 1,500 ITE and linked them to HIV prevention and care services. TIP has an established record of reaching ITE and linking them to HIV prevention services and HIV primary care. TIP's utilization speaks to the need for interventions to respond to the complex, interacting syndemic factors that cumulatively determine HIV vulnerability among ITE., (© 2019 National Association of Social Workers.)

Background Cisgender men and transgender individuals who have sex with men (MSM/TG) and use methamphetamine are at elevated risk for HIV and have had limited pre-exposure prophylaxis (PrEP) uptake. The aim of this study was to quantify the knowledge and use of PrEP, identify barriers to PrEP use, and develop a targeted educational campaign to promote PrEP among MSM/TG who use methamphetamine., Methods: We conducted three consultations with peer educators of Project Needle and Sex Education Outreach Network (NEON) to develop and disseminate educational materials. We surveyed the peers' HIV-negative contacts before and after this work to explore knowledge and opinions about PrEP and to assess the effect of our materials., Results: There were 221 respondents at baseline (August 2016) and 100 at follow-up (April-May 2017). At baseline, nearly all participants had 'heard of PrEP' (96%) and were insured (97%). However, only 3% had ever used PrEP. Peers suggested educational cards that included a definition of PrEP, adherence tips and that PrEP does not prevent other sexually transmissible infections. Peers distributed approximately 2560 educational cards. At follow-up, approximately half the respondents (53%) had seen the cards, and those who did reported significantly more agreement with the majority of the card messages about PrEP. Significantly more participants reported ever receiving PrEP at follow-up (21%; P<0.001). There was a trend between seeing the cards and PrEP use (P=0.053)., Conclusions: Although we cannot be certain that the effect was due to our intervention, a greater number of the peers' contacts reported receiving PrEP at follow-up, and those who saw our materials were more likely to agree with factual statements about PrEP. There is continued need for PrEP education for MSM/TG who use methamphetamine.

Background : Sex workers in South Africa face various forms of structural and interpersonal violence, including police violence, exclusion from health services, and stigmatization and marginalization within their communities. In an attempt to counteract the harmful health effects of criminalization and exclusion, risk-reduction workshops are a key component of HIV prevention programs globally. This paper offers a critical investigation of Creative Space workshops - a South African model of risk-reduction workshops for sex workers - taking place in Soweto, Johannesburg. Drawing on Paulo Freire's work, the paper explores the potential of these workshops to contribute to the empowerment, health and well-being of sex workers. Objectives : The aim of this paper is to investigate the social and psychological effects of peer-led risk-reduction workshops for sex workers in Soweto, South Africa, with a particular focus on the ways in which they might contribute to community empowerment. Methods : This paper is based on in-depth interviews and focus group discussions with 32 sex workers conducted as part of a 20-month ethnographic study (December 2015 to July 2017). Data was analyzed combining inductive thematic analysis with a theoretical frame based on Freire's theory of community empowerment. Results : Peer-led risk-reduction workshops can serve as a 'safe space' for sex workers and distribute empowering forms of knowledge, particularly regarding health issues and rights. However, divisions between different groups of sex workers and between sex workers and non-sex workers counteract the potential benefits of the workshops. Conclusions : Peer-led sex worker programs are likely to be more empowering when they are committed to raising critical consciousness and creating solidarity, and embedded in community action, focusing on common issues such as institutionalized racism, livelihood insecurity, and lack of access to safe and secure housing. Such actions would have positive outcomes on health and well-being.

Background: We aimed to evaluate the effect of online modules - as stand-alone training - on paediatric transgender-related self-perceived knowledge, objective knowledge, and clinical self-efficacy of learners. We previously evaluated the online modules as part of a larger curriculum that included observation in a paediatric transgender clinic, and assessed change in self-perceived knowledge., Methods: Paediatric interns, psychiatry interns, fourth-year medical students and nurse practitioner students were administered assessments before and after the completion of six online modules focused on medical and psychosocial considerations for transgender youth. The assessments queried learner demographics and transgender clinical exposure. Nine items tested transgender-related objective knowledge. Twenty-four items asked learners to rate self-perceived transgender-specific knowledge (1, not at all knowledgeable; 5, completely knowledgeable). Thirteen self-efficacy items asked learners to rate confidence in their ability to evaluate and counsel these youth (0, not at all confident; 10, completely confident). Overall and subscores were calculated for each domain. Wilcoxon signed-rank tests were used to compare the pre- and post-module scores., Results: Thirty-six learners were eligible to join the study and 86% (n = 31) participated. Among the participants, 90% (n = 28) completed both assessments. The median number of transgender patients seen before the curriculum was one, and 10% had past experience in a transgender clinic. Comparing pre- and post-module scores, the overall objective knowledge scores increased from 22 to 56% (p < 0.001), self-perceived knowledge scores increased from 1.8 to 3.8 (p < 0.001) and self-efficacy scores increased from 3.5 to 7.0 (p < 0.001). [What is] the effect of online modules on paediatric transgender-related self-perceived knowledge [?] DISCUSSION: This study suggests that e-learning was an effective stand-alone intervention to enhance transgender-related knowledge and self-efficacy in interdisciplinary learners., (© 2018 John Wiley & Sons Ltd and The Association for the Study of Medical Education.)

While gender transition is a very exciting time for most students embarking upon this personal journey, it is not without its stressors as well. For students choosing to further their education and become pharmacists, the complexity and demands of pharmacy education during the transition period can be one such additive stressor. As pharmacy educators and administrators, we have the ability to help shape this professional journey and alleviate stress by maintaining our obligation to provide a safe and non-discriminatory learning environment for all students. Therefore, this two-part commentary will serve as a means to provide information and insights to administrators and faculty advisors in order to ensure transgender students, including those actively undergoing gender transition, achieve both a successful transition and pharmacy school career., (Copyright © 2017 Elsevier Inc. All rights reserved.)

The Safe Schools program has attracted great controversy. On one end of the spectrum, it is defended as an anti-bullying program for young people who identify themselves as gay or lesbian, or have issues concerning their gender identity. On the other end of the spectrum, it is regarded as social engineering. This article seeks to promote a discussion of the way in which gender identity issues are addressed in the Safe Schools program. It is argued that the information in this program to Principals, teachers and young people is inaccurate and misleading. The program, as presently designed, may actually cause harm to children and young people who experience gender identity issues because it promotes gender transitioning without expert medical advice. The Safe Schools materials do not acknowledge that the great majority of children resolve gender dysphoria issues around the time of puberty. It may be much more difficult for a child to accept his or her gender at puberty if he or she has already changed name and gender identity in primary school. These deficits need to be addressed if the program is to continue.

Background The United Nations (UN) and related UN bodies have recognised transgender and gender diverse (TGD) students' rights at the global level to full equitable access to education, and specifically sexuality education, repeatedly., Methods: This article explores the available support for this equal access in Australia. It discusses TGD student rights in a range of Australian laws and education policies., Results: It shows how the inclusion of TGD students, particularly in sexuality education, is reinforced in the current Australian National Curricula. Finally, it considers research on Australian TGD students' educational attainment, experiences of transphobic abuse and violence, and experiences in contexts where they do and do not have staff (and other) support. It also shows that contrary to the picture of TGD students as victims leading inherently negative lives often seen in research, this group is nevertheless capable of resilience and positive education activism, which promotes their wellbeing and social outcomes., Conclusion: It argues for a shift from harmful approaches of victimising TGD students or treating them only as victims, towards celebrating the contributions of these students to their schools and societies.

Context: The transgender population continues to face challenges in accessing appropriate health care. Adequate training of endocrinologists in this area is a priority., Objectives: Assess the status of transgender health care education in US endocrinology fellowship training programs and assess knowledge and practice of transgender health among practicing US endocrinologists., Design: Mayo Clinic and the Endocrine Society developed and administered a Web-based anonymous survey to 104 endocrinology fellowship program directors (PDs; members of the Association of Program Directors in Endocrinology, Diabetes and Metabolism) and 6992 US medical doctor members of Endocrine Society., Results: There were 54 total responses from 104 PDs (51.9%). Thirty-five of these 54 programs (72.2%) provide teaching on transgender health topics; however, 93.8% respondents indicated that fellowship training in this area is important. Barriers to provision of education included lack of faculty interest or experience. The most desired strategies to increase transgender-specific content included online training modules for trainees and faculty. Of 411 practicing clinician responders, almost 80% have treated a transgender patient, but 80.6% have never received training on care of transgender patients. Clinicians were very or somewhat confident in terms of definitions (77.1%), taking a history (63.3%), and prescribing hormones (64.8%); however, low confidence was reported outside of the hormonal realm. The most requested methods of education included online training modules and presentation of transgender topics at meetings., Conclusions: Confidence and competence in transgender health needs to increase among endocrinologists. Strategies include the development of online training modules, expansion of formal transgender curricula in fellowship programs, and presentations at national and international meetings., (Copyright © 2017 by the Endocrine Society)

Although the number of new HIV infections has declined by over 30% in the past decade, the number of people who acquire HIV each year remains unacceptably high. In 2014 the Joint United Nations Programme on HIV/AIDS (UNAIDS) estimated that there were about 2 million new HIV infections. The virus continues to spread, particularly in key populations, such as men who have sex with men (MSM), transgender individuals, sex workers and people who inject drugs. In Africa, young women have the highest HIV incidence rates. Scaling up known efficacious HIV prevention strategies for these groups at high risk is therefore a high priority. HIV prevention has generally been targeted at HIV-negative individuals or in some instances, entire communities. Prevention efforts are, however, shifting from a narrow focus on HIV-uninfected persons to a continuum of prevention that includes both HIV-negative and HIV-positive individuals. Given that a single HIV prevention intervention is unlikely to be able to alter the epidemic trajectory as HIV epidemics in communities are complex and comprise a mosaic of different risk factors and different routes of transmission, there is need to provide combination prevention. Hence, a mix of behavioural, biomedical and structural HIV prevention options is likely to be needed to alter the course of the HIV epidemic. The combination of HIV prevention interventions needed will vary depending on cultural context, the population targeted and the stage of the epidemic. This paper reviews the available HIV prevention strategies for young women and discusses new HIV prevention approaches in development.

Using the example of a human rights training in Nepal, the author looks at global body politics in a reflexive piece on her engagement in development practices that translate western feminist ideas on gender inequality and empowerment via UN human rights policies into non-western contexts. It firsts look at postcolonial and critical literature on feminist engagement in gender and development processes including a discussion on the concept of global body politics before examining briefly the framing of gender-based violence in Nepal. The core of the paper is a reflexive analysis and interrogation of the training in Nepal in order to bring out the tensions and contradictions around western developmental, feminist and human rights discourses. The discussion looks at how difficult it is for feminist, human rights and developmental discourses and practices to unmoor themselves from the notion of the 'expert' and those who do the rights/work/righting rights training and those who are perennially seen as requiring training. The conclusion reflects on possibilities of other epistemic practices found in intercultural dialogues.

Healing Our Women (HOW) is a group-level HIV risk-reduction intervention developed to address the role of prior sexual victimization in HIV risk and protective behaviors among HIV-positive women of color. This article describes the process of adapting HOW for transgender women of color in New York City in accordance with CDC guidance for the adaptation of efficacious interventions. Twenty-one transgender women were enrolled in a study to evaluate the acceptability and fidelity of the adapted intervention, and to assess HIV knowledge, depressive symptoms, coping, condom use self-efficacy, and condom use via pre- and post-intervention surveys. We found the adapted program to be feasible to implement and acceptable to participants. We also found significant decreases in depressive symptoms and increases in positive coping from pre- to post-intervention, although replication with a larger sample and a control group comparison is needed to determine efficacy with this population.

Safe and effective HIV prevention strategies are needed for transwomen. Transwomen in the US have a 34 times greater odds of being infected with HIV than all adults age 15-49, and in San Francisco, California 42.4% of transwomen are estimated to be infected with HIV. Pre-exposure prophylaxis (PrEP) is the first biomedical intervention with promise for reducing HIV acquisition in transwomen. However, little is known about whether transwomen know about PrEP, are taking PrEP and would be good candidates for PrEP based on their risk profile and behaviors. A population-based dataset was analyzed to determine how many transwomen in San Francisco knew about PrEP by the end of 2013 - more than a year after iPrex results demonstrated efficacy of PrEP in preventing HIV. We found that of 233 transwomen, only 13.7% had heard of PrEP. Transwomen who were living with HIV compared to those who were HIV-negative, and those who recently injected drugs compared to non-injection drug users were more likely to have heard of PrEP. Based on CDC guidelines for PrEP among MSM and IDU, 45 (30.2%) transwomen of the 149 HIV-negative transwomen in the sample were candidates for PrEP. This estimate based on CDC criteria is arguably low. Given that almost half of transwomen in San Francisco are living with HIV, this findings points to a need for further consideration of PrEP criteria that are specific and tailored to the risks for HIV faced by transwomen that are different from MSM and injection drug users. Research to scale up access and test the effectiveness of PrEP for transwomen is also urgently needed.

Purpose: Increasingly, people are living their lives without strict attachment to one gender. In this paper, we discuss key discourses identified in a literature review of transgender and transsexual issues in nursing. Our aim is to highlight the power of dominant discourse and lack of adequate understanding of gender diversity on the part of nurses. We use stories of trans people to illustrate these discourses. An increased awareness may support respectful care of those who do not fit comfortably within culturally defined parameters of male and female., Conclusion: The invisibility of gender diversity in health care remains a threat to ethical nursing care. The effects of invisibility of transgender people in health care result in a cycle of repetition where those who have been denied recognition in turn avoid disclosure. Key discourses addressing trans people in nursing literature include invisibility, advocacy, cultural competence, and emancipation., Practice Implications: There is a need for further education about gender diversity in order to dispel and counter misunderstandings, stigma, and invisibility. This can be achieved through sustained efforts in nursing research and educational curricula to include gender diversity and trans people. Policies for the protection of those who change their sex or identify outside the dominant gender schema are urgently needed., (© 2014 Wiley Periodicals, Inc.)