"It's Very Cisnormatively Structured": An Interpretive Description of Undergraduate Nursing Students' Experiences of Gender Inclusive and Affirming Practices.

This study explores the experiences of undergraduate nursing students learning about transgender and gender diverse (TGD) health. We discuss nursing education's perpetuation of discrimination and erasure of TGD people and upholding of gender norms (cisnorms) is not sufficiently preparing students to care for TGD patients. Further, this rampant cisnormativity harms TGD nursing students. This interpretive description drew on queer theory and Hafferty's three levels of curriculum and engaged 18 undergraduate nursing students in initial and 13 in follow-up focus groups or interviews. Three key themes included (1) cisnormativity is perpetuated in nursing education through pervasive power and norms across the three levels of curriculum; (2) "The Trans Problem": Transgender and gender diverse people are othered in nursing education; and (3) Welcoming the other: Individual educators who welcome and affirm TGD people are crucial. Critical recommendations from students to advance gender inclusive and affirming practices are provided, including normalizing gender diversity in formal nursing education, the importance of accountability and representation in schools of nursing, and the need for nursing governing bodies to disrupt cisnormativity.