The implicit and explicit attitudes of nursing students in Türkiye towards transgender individuals
S. Karakaya Çataldaş, T. Şahin Tokatlıoğlu, A. EminoğluIntroduction
Transgender individuals face significant barriers in healthcare, including systemic discrimination and limited provider knowledge, which reduce access and quality of care. Nurses play a vital role in ensuring equitable treatment for all patients, yet their explicit (conscious) and implicit (unconscious) attitudes shape care quality. Although studies have examined nursing students’ attitudes toward sexual minorities, few explored implicit and explicit attitudes toward transgender individuals in Türkiye. Understanding these attitudes is crucial for addressing potential biases and promoting inclusive, transgender-affirming nursing education.
Objectives
To examine the implicit and explicit attitudes of undergraduate nursing students in Türkiye toward transgender individuals and identify demographic and psychosocial factors associated with these attitudes.
Methods
A descriptive cross-sectional design was employed with 344 nursing students from universities in İstanbul, Türkiye. Data were collected online via Qualtrics and Inquisit. Explicit attitudes were measured using the Attitudes Toward Transgendered Individuals Scale (ATTI; 20–100, higher = more positive), and implicit attitudes with the Implicit Association Test – transgender version (D-scores −2 to +2). Sociodemographic data included gender, age, birthplace, residence, religious commitment, and previous contact or training on transgender health. Analyses used t-tests, ANOVA, correlations, and stepwise regression. Ethical approval was obtained from Koç University (2024.417.IRB3.179).
Results
Students showed moderately positive explicit attitudes (M = 60.48, SD = 15.53) but slightly negative implicit attitudes (M = 0.19, SD = 0.43). No significant correlation existed between explicit and implicit attitudes. Explicit attitudes were more positive among women, those born in Türkiye, residents of metropolitan areas, and students with transgender friends or training (p < .05). Religious commitment correlated negatively (r = −.37, p < .001). The regression model explained 30.6% of the variance (R² = 0.306). Implicit attitudes showed no demographic differences.
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