Many years ago, when I was a second-degree BSN student, a guest lecturer from the organ transplant team at the hospital affiliated with my nursing school was talking about liver disease, liver transplantation and risk factors. At one point she said, very casually, “Gay men are at higher risk of getting hepatitis B and hepatitis C,” and then went on to talk about how untreated hepatitis can lead to liver failure and the need for a transplant.
My heart started pounding. I looked around at the lecture hall. I raised my hand. “Why?”
She stammered. She turned bright red. She giggled. And then she managed to sputter out something about how a particular sex act, when unprotected, put this population at higher risk. “So,” I said, “It’s not that being gay puts them at higher risk, it’s that this is a high-risk behavior, right?” She didn’t answer, she just continued on with her lecture. This was one of the very few mentions of lesbian, gay, bisexual, transgender or queer/questioning (LGBTQ+) health in my baccalaureate program.
I didn’t realize it at the time, but that experience, in 2004, started me on a journey to change how we approach LGBTQ+ health and social topics in pre-licensure, undergraduate nursing curricula. While there are more robust resources for incorporating LGBTQ+ health into curricula now than there were in the early 2000s, current research suggests we still have a long way to go.
One study showed that while 70% of nursing faculty respondents indicated they were “moderately or fully” prepared to teach LGBTQ+ health topics, 23-63% stated that they never or seldom taught these topics (Lim, et al., 2015). Another showed that while 78.6% of educators said that teaching about “homosexuality” is very to extremely important, only 28.1% of faculty said they felt very or extremely well prepared to teach about homosexuality (Sirota, 2013). National surveys about the amount of time dedicated to LGBTQ+ topics in baccalaureate programs reflect the gap between faculty interest and inclusion of these topics in curricula. An average of 2.25 hours and a median of 2.12 hours are spent on these topics within BSN curricula (Lim, et al., 2015; Carabez et al, 2015; Hickerson, et al., 2018).
While there is no clear evidence about how much time is “enough,” the gap between interest in teaching these health topics and actually doing it suggests there are opportunities for better preparation of nursing educators to develop and deliver more LGBTQ+ inclusive course content.
Here are some of my recommendations for developing and delivering more LGBTQ+-inclusive course content for undergraduate nursing students:
These recommendations are not necessarily a strict “how-to,” but keeping these considerations in mind as nurse educators seek to make their curricula and course offerings more inclusive of LGBTQ+ populations will ensure that future nursing graduates enter the workforce well-equipped to provide informed, compassionate and knowledgeable care for their LGBTQ+ patients.
Caitlin Nye, MSN, RN, NPD-BC, is enrolled in the PhD program at UB School of Nursing. She is also an assistant professor at SUNY Upstate University Hospital College of Nursing. Her doctoral research focuses on improving the preparation and self-efficacy of nursing faculty to include LGBTQ+ health topics in undergraduate nursing curricula.
Carabez, R., Pellegrini, M., Mankovitz, A., Eliason, M. J., & Dariotis, W. M. (2015). Nursing students' perceptions of their knowledge of lesbian, gay, bisexual, and transgender issues: Effectiveness of a multi-purpose assignment in a public health nursing class. Journal of Nursing Education, 54(1), 50-53. doi:10.3928/01484834-20141228-03
Hickerson, K., Hawkins, L. A., & Hoyt-Brennan, A. M. (2018). Sexual orientation and gender identity cultural competence: A simulation pilot study. Clinical Simulation in Nursing, 16, 2-5. doi:10.1016/j.ecns.2017.10.011
Lim, F., Johnson, M., & Eliason, M. (2015). A national survey of faculty knowledge, experience, and readiness for teaching lesbian, gay, bisexual, and transgender health in baccalaureate nursing programs. Nursing Education Perspectives, 36(3), 144-152. doi:10.5480/14-1355
Sirota, T. (2013). Attitudes among nurse educators toward homosexuality. Journal of Nursing Education, 52(4), 219-227. doi:10.3928/01484834-20130320-01