Development and Validation of the Trans-Inclusive Provider Scale

Area of Science:

• Healthcare Equity
• Health Services Research
• Social Determinants of Health

Background:

• Transgender and gender diverse (TGD) individuals face significant barriers accessing culturally responsive healthcare.
• Existing healthcare systems often lack practices that affirm TGD identities, leading to disparities in care.
• There is a need for validated tools to assess and improve trans-inclusive healthcare practices.

Purpose of the Study:

• To develop and validate a scale measuring trans-inclusive healthcare practices.
• To provide a tool for assessing provider behaviors and identifying areas for growth in TGD patient care.
• To support the improvement of culturally responsive healthcare for TGD individuals.

Main Methods:

• Development of 34 initial practices by authors and community partners.
• Online survey data collected from 626 TGD adults in Michigan (2018).
• Exploratory factor analysis and principal components analysis conducted on survey data (2019).

Main Results:

• A 27-item scale across 6 components was validated: trans-inclusive messaging, name/pronoun usage, outreach, gender-affirming practice, referral comfort, and inclusive intake forms.
• The Trans-Inclusive Provider Scale demonstrated high reliability (Cronbach's α = 0.91).
• Factor analysis confirmed the scale's validity and consistency across different sample subsets.

Conclusions:

• The Trans-Inclusive Provider Scale is a reliable and valid instrument for assessing provider inclusivity towards TGD patients.
• The scale can identify opportunities for individual and practice-level improvements in culturally responsive care.
• Findings support the scale's utility in guiding training, interventions, and quality improvement initiatives in healthcare settings.