Redefining inclusive workplaces: Advocating for trans and non-binary nurses and students
Nursing professor Erin Ziegler’s research sheds light on the systemic discrimination trans and non-binary nurses and students face from colleagues, superiors and peers within the Canadian health-care system.
As a primary health-care nurse practitioner, educator and director of a gender-affirming care clinic, Erin Ziegler has long championed inclusive health care. Through her research on transgender and non-binary access to health care, a question arose: What are we doing to support our nursing colleagues and nursing students who are gender diverse, trans and non-binary, and what does their experience look like in Canada’s health-care system?
Acknowledging discrimination in the workplace
To learn more, professor Ziegler, from the Daphne Cockwell School of Nursing at Toronto Metropolitan University (TMU), launched a study that sheds light on the systemic discrimination trans and non-binary nurses and students face in Canada. Surveying 101 anonymous participants, the research uncovered a troubling reality: 80% reported experiencing discrimination not from patients, but from colleagues, superiors or peers within the health-care system.
“I was really surprised by that,” said professor Ziegler. “As nurses, we pride ourselves on being compassionate caregivers. Yet many trans and non-binary nurses are stigmatized while they’re just trying to do their job.”
Nursing has a reputation as one of Canada’s most trusted and inclusive professions. The findings of this survey painted a different picture – one where many health-care workers felt compelled to hide their identities and stay silent to avoid backlash or jeopardizing their education or careers.
Participants described inconsistent experiences disclosing their gender identity – often feeling safe with friends or peers but not at school or in the workplace. Many were “out” socially but chose to conceal their identity professionally due to fear of rejection or retaliation. 67.3% reported experiencing derogatory comments targeting their gender identity.
Addressing gaps in nursing education
Ziegler’s research also points to significant gaps in nursing education. Fewer than one-third of participants said they received little to no instruction on providing inclusive, gender-affirming care. In some cases, 2SLGBTQ+ health was only briefly mentioned in the context of sexually transmitted infections. “That’s not good enough,” professor Ziegler insisted. “Inclusive care shouldn’t be a single lecture – it needs to be embedded across nursing curricula.”
Policy changes to make nursing safer and more inclusive
A second phase of this work – a qualitative grounded theory study exploring personal narratives – will be submitted for publication this summer. Together, both studies aim to fuel policy changes in nursing education and workplace environments across Canada.
Professor Ziegler is advocating for institutions to go beyond reactive support. From ensuring trans and non-binary nurses have access to safe changing areas to using correct names and pronouns on ID badges, the work must be proactive. “Policies should already be in place to support these professionals,” she explained. “It shouldn’t be on them to educate their schools or employers on how to treat them with respect.”
Looking ahead, Ziegler hopes her research will spark lasting change – starting with education, extending into the workplace and creating ripple effects across the health-care system. “Nursing is about care,” she said. “But we can’t claim to care for patients if we’re failing our colleagues. It’s time we make the profession safer for everyone.”
The research described in this article was supported by the Social Sciences and Humanities Research Council (SSHRC).
