Assessing competence to provide care for sexually assaulted trans persons
Numerous studies have shown that trans persons are at an increased risk of experiencing sexual assault and other forms of violence. Despite this increased risk, trans individuals often do not seek care after sexual assault because they are afraid of or have experienced discrimination when accessing emergency health services. To address this gap, Janice Du Mont, EdD, senior scientist at Women’s College Research Institute(WCRI), collaborated with the Ontario Network of Sexual Assault/Domestic Violence Treatment Centres (ONSA/DVTC) to conduct the first Canadian study to assess the perceived level of competence among forensic nurses in caring for trans persons who have been sexually assaulted.
Recently published in BMJ Open, the study surveyed nurses working at hospital-based violence treatment centres within the ONSA/DVTC. Areas of care that were assessed included initial assessment, medical care, forensic examination and discharge and referral. By assessing these areas, Du Mont and collaborators were able to determine if the ONSA/DVTC nurses demonstrated adequate competence on how to respond to the complex and diverse needs of trans survivors.
They found that 73 per cent of nurses indicated that they had little or no experience in caring for trans clients who have been sexually assaulted, with 96 per cent agreeing that they would benefit from additional training. Particular areas requiring additional training included: understanding the difference between trans identity and intersex conditions, effects of hormones on contraception, awareness of specific equipment and tools for examination and the ability to refer patients to trans-positive resources or services in the community.
“It is critical that all survivors of sexual assault receive timely and comprehensive care from trained service providers,” says Du Mont. “Not accessing health services puts these individuals at increased risk for negative physical, psychological and social consequences. We hope that with additional trans-specific training, ONSA/DVTC nurses will be able to respond sensitively to the unique and diverse needs of trans survivors.”
Since the survey was completed, Du Mont and the ONSA/DVTCs have been working with Rainbow Health Ontario to develop a curriculum for ONSA/DVTC nurses focused on providing trans-affirming care. This project includes the creation of a Research Advisory Board comprised of trans community members and their allies, who have guided the development of the curriculum. The curriculum was successfully piloted and evaluated recently and is now in the process of being adapted to an online format, which will extend its reach to all ONSA/DVTC nurses across Ontario.