An Interview with Pamela Levesque: The Lived Experience of the Transgender Nursing Student

In today’s society, research suggests that lesbian, gay, bisexual, transgender or queer (LGBTQ) nurses are the focus of two types of oppression: internalized negative attitudes and external sources of harassment or discrimination. In the nursing workforce, LGBTQ nurses are frequently found to be invisible, absent from discourses of professional nursing organizations, ignored or pathologized in the nursing curriculum, and infrequently found in nursing journals. To date, there has been little published about the experiences of the transgender nursing student.

This past fall, Nursing@Simmons faculty member Dr. Pamela Levesque (DNP, APRN-BC, FNP, CNE) presented the preliminary findings of her qualitative research study entitled, “The Lived Experience of the Transgender Nursing Student” at two conferences — the 2014 Qualitative Research Conference in Victoria, BC and the 2014 National Institute on Minority Health & Health Disparities Conference in Maryland. Funded by the University of North Carolina at Wilmington (UNCW) School of Nursing Corbett Grant, her new research takes a closer look at lived experience of transgender nursing students.

In a recent interview with Nursing@Simmons, Levesque talks about her background, the inspiration for her research, and her advice to MSN students interested in performing qualitative research.

Tell us a little bit about your background and how your interest in transgendered health care came about.

Dr. Levesque: I’ve been in the nursing field for over 33 years — this includes working as a Family Nurse Practitioner for 18 years, as well as teaching for 18 years. My interest in transgendered health care came about while working in a university health care setting. I was enrolled in a doctoral program at the time and realized that education never talked about LGBT issues. Embarrassed at my own ignorance, I was concerned that I might offend or have trouble cultivating healing relationships with LGBT students.

As part of getting my Doctor of Nursing Practice (DNP) degree, I decided to do a research/cultural project that explored nurse practitioner knowledge, attitudes, and self-efficacy in caring for transgendered people. What I found was that most nurse practitioners were very open and stated “full respect” and “acceptance” toward transgender patients. At the same time they also reported a low level of self-efficacy for providing care.

What was your inspiration for this new research?

Dr. Levesque: If there is no content, what does that say to students who are transgendered? My hope was to fill the void, increase awareness, and support respectful treatment of those who do not fit comfortably within culturally defined parameters of male and female.

What was your approach?

Dr. Levesque: I performed qualitative research, interviewing 17 transgender nursing students from across the country. I wanted to know about their lived experience. I did not use any leading questions, but rather invited them to speak about their time in nursing school. Each interview was about an hour and a half long. They were all taped and transcribed; then data analysis was performed. From these interviews I observed a clustering of themes that included, but was not limited to: compounded stress from nursing school, stigma, fear, lack of educator knowledge, a paucity of transgender health content in nursing curricula, inconsistent support from administration, faculty and staff nurses, as well as a lack of institutional and personal support systems.

What have been some of the biggest rewards that have resulted from your research?

Dr. Levesque: It’s been amazing. When speaking with each one of the transgendered students, they are so giving and so willing to share their experience. They’ve truly impacted me. As a researcher, it was important to try to maintain a balance and distance, but it’s really hard because you hear these stories about the real lives of people. One student dropped out of high school, was suicidal, and then homeless — but went on to get a GED, then an associate’s degree, and is now enrolled in an RN to BSN program.

What were some of the challenges of your research?

Dr. Levesque: I was exhausted afterwards. It’s challenging to process what you hear. As a researcher I had to be objective. I had to leave behind being a nurse and focus on being a researcher.

What did you due to maintain emotional stability throughout your research?

Dr. Levesque: I kept a journal, took notes, and did what I needed to do to process. I meditated and did yoga. I also had a few colleagues I could talk to about my research and still maintain anonymity.

What advice do you have for students taking the MSN Scholarly Inquiry (NURP 507) course?

Dr. Levesque: Have a good mentor. If you are a student going into your project and you choose to do qualitative research on a sensitive area, pick one that you are passionate about, something that has touched you. It could become something you can build upon. Also, be sure to network across countries and across disciplines. It’s okay to reach out to resources outside of nursing.