DNP Scholarly Projects


Health inequities such as chronic medical conditions, mental health disorders, substance abuse, and suicide are prevalent in the LGBTQ population, resulting in part from minority stress, stigma, discrimination, and isolation. Studies showed mixed results regarding nurses’ and other healthcare professionals’ attitudes toward these individuals. Relatively little research has focused specifically on nurses, and most studies have centered on healthcare professionals’ explicit attitudes. Given the lack of studies on nurses and implicit bias, more research is needed on nurses’ implicit attitudes regarding LGBTQ patients. Using a retrospective design with secondary data from Project Implicit, the study compared United States (US) nurses’ Transgender Implicit Association Test (IAT) scores with other types of healthcare providers and nonproviders (N = 53,586), determined if a significant difference existed between nurses’ Transgender IAT scores and self-reported explicit attitudes (n = 1558), and identified whether nurses’ implicit attitudes on sexuality had changed over time (N = 25,791). Results indicated that the nurses group held the strongest implicit preference for cisgender people. Although a comparison of means found no significant difference between nurses’ implicit and explicit preferences (p = .052), some evidence of discrepancy existed between implicit preferences and self-reported explicit attitudes. In addition, nurses’ implicit attitudes on sexuality trended toward less biased scores. Increased awareness of the implications of implicit bias may aid in the development of education strategies and training to mitigate nurses’ negative attitudes and improve the overall quality of nursing care delivered.


Spring 4-13-2022

First Advisor

Linda Wofford, DNP, CPNP

Scholarly Project Team Member

David Phillippi, PhD

Scholarly Project Team Member

Del Ray Zimmerman


Nursing, School of


Health Sciences & Nursing, Gordon E. Inman College of

Document Type

Scholarly Project


Doctorate of Nursing Practice (DNP)

Degree Level


Degree Grantor

Belmont University


implicit bias, LGBTQ, transgender, IAT, implicit association test