A Mixed Methods Investigation into the Experiences of Transgender Students in Higher Education in the UK

Despite increasing interest in transgender studies (Marques 2019), gender identity within post-compulsory education remains under-researched (Hafford-Letchfield et al*.* 2018). Beemyn (2003) proposed that it is often at college that students first have the opportunity to question their assigned gender and to identify or present themselves in a way that they feel most comfortable, as they are mostly away from people who have known them as they were growing up. Kaufman and Feldman (2004) suggested that exposure to a diversity of social interactions can encourage students to rethink normative assumptions, such as those around gender, and in Storrie and Rohleder’s (2018) study, trans students identified attending university as being a key point in their gender transition—a place where they could make a “new start.” For these students, being able to experiment with how they feel in a safe environment is important.

The main purpose of my research was to identify obstacles encountered by trans students in higher education in the UK, and to suggest how HEIs can address areas of concern. There is limited existing research investigating the experiences of trans HE students in the UK as a distinct group, rather than as part of research into LGBTQI+ students or as part of research into trans individuals in wider society.

The questions driving my research were: (1) What are the experiences of trans students in HE in respect of support services, institutional administration, peers, academics and curriculum, social experience and facilities? (2) How well are HEIs supporting trans students?

Terminology

In this article I use the term HEI for Higher Education Institutions, as this incorporates all higher education in the UK—universities, colleges, and alternative providers of Level 5 education or above. I use transgender or “trans” as an umbrella term for those whose gender identity and/or gender expression does not match the sex they were assigned at birth, and/or who do not conform to conventional gender binaries of man/woman. I use cisgender or “cis” to describe those whose gender identity is the same as the sex they were assigned at birth.

Literature Review

Reviewing existing literature, I identified four main themes that impact on the experience of trans students in HE.

Harassment, Bullying, and Transphobia

Experiences of harassment, bullying and transphobia, and ineffective or absent methods of dealing with these issues, have been reported although much of the previous research focused on LGBTQI+ experiences rather than those of trans students as a distinct group. In a study of LGBTQI+ students from one institution in Scotland, the university was found to be failing to protect LGBTQI+ people on campus from harassment and discrimination (Marzetti 2018), identifying verbal abuse, homophobic and transphobic comments, and physical and sexual abuse. They suggested that halls of residence and social spaces were the most likely places where such harassment would occur. Similarly, Storrie and Rohleder (2018), in a study with six trans students from different UK universities, reported increased risk of transphobic abuse within drinking spaces and how some trans students felt unable to take part in social events, even within LGBTQI+ societies, due to the strong drinking culture associated with these events.

Outside of academic literature, results of online research commissioned by the National Union of Students (NUS) with LGBTQI+ higher education (HE) students (N = 3,880) highlighted that only 21% of trans students (compared to 37% of cis LGB students) felt completely safe on campus, and that one in three trans participants (compared to one in five cis LGB participants) had experienced bullying or harassment on campus (Acciari 2014). In research on behalf of the LGBTQI+ rights organisation Stonewall, Bachmann and Gooch (2018b) asked 522 LGBTQI+ students, of whom 17% (88) identified as trans, about their experience at British universities. They reported that 36% of trans students and 7% of cis LGB students had faced negative comments and conduct from university staff, and 60% of trans students and 22% of cis LGB students had faced negative comments and conduct from other students. In a section looking specifically at HE in another report, Bachmann and Gooch (2018a) reported that one in seven trans students had either dropped out or considered dropping out of a course because of harassment or discrimination.

Harassment, bullying, and transphobia can take many forms, including physical violence, verbal abuse, discrimination when accessing services, and micro-aggressions. Microaggressions are subtle forms of discrimination directed towards people who are part of a marginalised community; for trans people this can include misgendering, objectification, disapproval, or condemnation of trans identities (Nadal et al. 2014), showing intrusive curiosity, or asking about “real” names or “preferred” pronouns (Khan 2019). Asking a trans person for a “preferred” pronoun is suggesting that trans identities are less authentic than cis identities, or that being trans is a preference rather than an inherent characteristic (Sevelius et al. 2020). Similarly, unless there is a requirement to know whether a person has a different legal name, asking this can be an unwelcome and unnecessary intrusion which invalidates trans identities (Turton 2021).

Hopkins and colleagues (2018) discussed how trans staff and students felt uncomfortable being misgendered, particularly with regards to power relations whereby students did not feel they could correct staff who misgendered them. This was an internal report from just one HEI, but similar results were found in peer-reviewed research with 146 LGBTQI+ participants (Formby 2015), where misnaming and misgendering were particular issues for trans students. They suggested that this could be symptomatic of a lack of awareness amongst peers and academics. Storrie and Rohleder (2018) described trans students experiencing microaggressions including being misgendered, especially where there were conflicting gender signals such as their physical presentation not matching their gender identity.

Inclusion/Exclusion in Higher Education

“Othering” is where certain individuals or groups are defined as not fitting in with the ’norms’ of society and, as such, experience marginalisation and inequality (Powell and Menendian 2016). Feelings of “otherness” can arise from perceived advantages and disadvantages that occur as a result of “deviation” from “the norm” (Santis 2022, 134). “Institutional cisheteronormativity” (Marzetti 2018, 702) describes how society in general, and in this case university education, is orientated around a presumption of cisgender, heterosexual identities. Research participants in Marzetti’s (2018) study illustrated how their university acknowledged LGBTQI+ student issues at a superficial level only, hosting events during LGBTQI+ History Month but not openly supporting students or understanding the issues they face. For trans students, I would suggest that “cisnormativity” in the HEI environment is the “norm” from which they can be said to “deviate.”

There is limited academic research about the experiences and impact of feelings of otherness or belonging for trans students in HE in the UK as a distinct group, although some research has been conducted in the USA. Lefevor and colleagues (2019) looked at the difference in various types of support (social, family, religious and living-situation) between cisgender (n = 2060) and trans (n = 1030) students, and how these types of support might buffer psychological distress. They highlighted disparities in distress and support between trans and cisgender students and concluded that trans students may have more difficulty building and accessing support networks due to a lack of societal acknowledgement and understanding of their experience, and that this can result in a reduction in feelings of belonging, a consequence of which is increased mental health difficulties. In contrast, Hill and colleagues (2021, 269) suggested that trans students’ “resiliency makes them capable of persisting and thriving at institutions that continue to not be created for them,” and that beyond gender and sexuality, these students find belonging in intersecting identities such as race, ethnicity, or disability. Nicolazzo and colleagues (2017, 310–311) suggested that LGBTQI+ student organisations provided important support for students to remain in their studies, with a trans participant describing a trans student group as “a big supportive family” in which “they basically justified my complaints and also helped me try to do something,” making it easier for them to manage their difficulties. They summarised LGBTQI+ student organisations as “vital domains for trans participants to create kinship networks and get the support they needed to be successful in college.”

Storrie and Rohleder (2018), researching trans HE students in the UK, suggested that the opportunity for activism within student societies, whereby students can be involved in challenging institutional discrimination and supporting change, has helped some trans students feel more included and allowed them to forge relationships with others who understood them. They also suggested that trans students are frequently “objectified and othered” (Storrie and Rohleder 2018, 7), describing examples of students being asked inappropriate questions about being trans, but noted that some trans students also related a need to answer these questions, however inappropriate, as they felt responsible for educating others about trans issues. Similarly, Nicolazzo (2016) suggested that cisgender faculty, students and staff in their research felt that it was up to trans people to teacher others about gender differences.

Representation in the Curriculum

It can be argued that as the curriculum is a main component of university life, the experiences of all students should be reflected and represented in the subjects they study. Limited literature exists about trans representation in the HE curriculum in the UK. I suggest that parallels can be drawn with the representation of other minority groups where issues of power and dominance, privilege and discrimination are equally applicable.

There is a push in HE in the UK to develop more diverse reading lists, which are typically dominated by white, male Euro-centric authors (Schucan Bird and Pitman 2020). Many UK HEIs are looking at better representation of Black, Asian, and minority ethnic (BAME) students in the curriculum after student campaigns arguing that teaching should be more representative of the modern world with regards to non-white communities in the UK (Hussain 2015).

The question of representation in the curriculum is an issue across all subjects but manifests itself in different ways in different subjects. For example, a lack of minority representation for women and BAME students in the curriculum for business courses can be said to reinforce the existing issues of power and dominance of “white male privilege” in business and discourage entrepreneurship from these students (Chaudhury 2020). With the growing numbers of women entering university to study STEM (Science, Technology, Engineering and Mathematics) subjects, Ertl and colleagues (2017) argue that there is a need to adequately reflect these students in what has traditionally been a male-orientated arena.

Hill and colleagues (2021) suggested that LGBTQI+ students thrive in classes where they can see themselves represented, although representation was often only included in specific modules, such as LGBTQI+ studies or gender studies, rather than being embedded into the curriculum. Formby (2017, 208) suggested that LGBTQI+ students felt “forgotten” or “tagged on” within the content of their learning. They reported one participant’s example of a statistics class where gender was used as a binary statistic, without consideration that some students may identify outside of the man/woman binary.

Pino (2016) suggested that, based on the results of a 2015 National School Climate survey looking at the experience of LGBTQI+ school students in the USA (Kosciw et al. 2015; Maitland et al. 2021), learning about the accomplishments of trans people as part of the curriculum provides all students with a more positive image of their trans peers, with the potential to reduce bullying and prepare students for the diverse world they will be entering when they leave education.

Trans representation is arguably even more important in professional health and social care subjects where students need sufficient knowledge around trans identities to enable them to work effectively with trans patients/clients when on placement and in their future careers. Atteberry-Ash and colleagues (2019) looked at the experiences of 12 LGBTQI+ social work students in the USA. They found a mixture of marginalisation and harmful discourse, including enforcing cisheteronormativity and issues with the language being used, including misgendering students and clients. They reported a gap between the values that social work teaches and how social work education is delivered. Specific education for students entering professions such as nursing, medicine and social work is key but lacking, according to Click and colleagues (2020), and De Vries and colleagues (2020) suggested that current curricula for health professionals in the UK do not provide sufficient teaching about gender-affirming healthcare, and that health professional ignorance, as well as systemic biases that reduce access to care, increase the inequalities that trans people face in the medical system.

Institutional Facilities and Administration

With reference to trans students in HE, the theme of institutional facilities and administration covers areas such as changing names/gender on electronic records, alternative gender options on forms and systems, and the provision of suitable toilet and changing facilities along with the acceptance of trans students being able to use the facility of their choice.

Goldberg and Kuvalanka (2018) in research specific to the experiences of trans college students in the USA, identified lack of clarity in how to change names and pronouns on university computer systems. Storrie and Rohleder (2018) made recommendations for policies to be consistent across UK HEIs and that they should include procedures for transitioning students to change their name and pronouns easily, as well as ensuring the inclusion of trans students in discussions when planning changes to facilities and policies. Lack of a third gender option for nonbinary students was a barrier reported in an overview of empirical research conducted by TransEdu Scotland with trans staff and students from HEIs across Scotland; Mckendry and Lawrence (2017) reported trans students’ fear of being ‘outed’ by ineffective administrative processes, after navigating the challenging administrative and bureaucratic systems to change their name and/or gender on university records.

Exploration of literature pertaining to institutional facilities suggested that gendered spaces were problematic. The failure of HEIs to provide gender-neutral toilets was reported by participants in a study in New Zealand (Allen et al*.* 2020), and nonbinary students in a Scottish HEI reported the lack of gender-neutral toilets on campus challenging (Marzetti 2018). Trans-hostile debates around the use of women’s toilets by trans women (Hines 2019) have made it harder for trans people to use toilets that corresponded with their gender identity in many areas of life, not just HE, and gendered facilities based on a male/female binary can result in nonbinary people experiencing harassment whichever toilet they use (Jones and Slater 2020). Acciari (2014) proposed that a lack of gender-neutral facilities on campus was a major issue which could lead to trans students avoiding using them or feeling unsafe doing so, and Bachmann and Gooch (2018b) reported that one in six trans students felt unable to use the toilet they were most comfortable with at university.

Gaps in the Literature

The review of the literature identified limited research investigating the experiences of trans HE students in the UK as a distinct group, rather than as part of research into LGBTQI+ students or as part of research into trans individuals in wider society.

With regards to harassment, bullying and transphobia, the literature reviewed lacked clarity regarding alternatives to support change in HEI policy and practice. My research sought to address this gap by investigating the experiences of trans HE students in the UK in respect of instances and impact of harassment, bullying and transphobia, the reporting systems in place, and the perceived ability of HEIs to address these issues. In respect of inclusion/exclusion, previous studies have largely failed to consider the impact of institutional cisnormativity, and I investigated this further in my research. Relating to representation in the curriculum, although there has been some LGBTQI+ student research, a lack of trans-specific academic research provided an opportunity to investigate further. Finally, concerning institutional facilities and administration, my research explored the current situation across UK HEIs and whether HEIs are addressing these issues.

Methodology

Theoretical Framework

Transformative paradigm

I used a transformative paradigm, with its emphasis on addressing issues of social injustice experienced by marginalised groups, to investigate the experiences trans HE students learning within a largely cisnormative environment, in order to inform practical change. The transformative paradigm grew out of dissatisfaction with existing dominant research paradigms in the 1980s and 1990s (Mackenzie and Knipe 2006). Although constructivist/interpretive approaches had begun to consider how a researcher with privilege associated with areas such as race, gender or social class for example could conduct research relating to populations without these privileges in an ethical way (Mertens 2019), these approaches were still not adequately addressing issues of social justice and marginalised people.

The following characteristics of the transformative paradigm show its relevance to my research: (1) It places central importance on the lives and experiences of marginalised communities, including the way oppression is structured and reproduced, and how lives are constrained by the actions of oppressors; (2) it analyses how and why inequities are reflected in asymmetric power relations; and (3) it links social inquiry to political and social action (Mertens 2009; Mertens 2019).

This fits very well with my study which investigates the experiences of trans HE students and the power imbalance of learning within a privileged cisnormative society, and which aims to influence policy change within that environment to reduce inequality. The goal of addressing inequality and injustice in society connects with the goal of critical theory in education, which focuses on how the educational system can reduce the barriers to education experienced by some students.

Critical theory

The aim of critical theory is to not only understand situations, but to change them (Fischer and Tepe 2011) with methodology that is “explanatory, normative and practical,” exploring not only “what is, but… what could and should be” (Govender 2020, 208). I felt that critical theory in education was relevant to the focus on policy, practice, and institutions in addressing issues specific to the experiences of trans students in the HE environment. The aim of critical theory in education is both practical and political: to question how the education system can offer the best education to all, by understanding the different perspectives of students who are at a disadvantage as a result of inequality in society; to examine how the education system perpetuates or reduces inequality; and to eradicate the effects of illegitimate power (Cohen et al*.* 2018).

Critical theory is a powerful framework for understanding disparities as functions of power, domination and exploitation in education, within both the curriculum and the HE environment. Strunk and Bettles (2019, 77) suggested that by using critical theory in education, systemic and ideological issues are addressed through a focus on “systems, ideologies and institutions rather than on individuals,” whereby although the data are collected from individual students, the focus is on the systems in which the students study. In respect of my study, critical theory as it applies in education investigates the challenges of trans students in the largely cisnormative HE environment and examines how these can be addressed by improving the systems and environments in which these students exist. Critical theoretical approaches typically acknowledge that social identities are ideological constructions (Strunk and Bettles 2019). Cisnormativity is a social construct in which cisgender identities are assumed and upheld as the norm; “a cultural phenomenon in which people privilege and normalise non-trans experiences which leads to marginalising and oppressing transgender people” (Boe et al*.* 2020, 158).

I analysed the data with the concept of cisnormativity in mind, and this enabled an investigation into how the construction of gender binaries governs what Foucault (1991, 187) termed “disciplinary power”—a mechanism of power that relies on everyday institutions and interactions, and that is “exercised through its invisibility.” Within HE, educators and administrators are implicated in allowing certain practices to continue, such as administrative systems that deny trans students’ identities and reiterate gender as a fixed binary (Frohard-Dourlent 2016). Foucault’s approach to power focuses on the ‘micro mechanisms’ which operate in everyday life, often unperceived (Crossley 2012), and relates well to the concept of how, in the background, cisnormativity wields power over those outside of cisnormative ideals. An understanding of cisnormativity in HE and how this makes it harder for trans students, is integral to bringing about change.

Research Design, Data Collection and Analysis

I used an online survey to gather information about trans students’ experiences in HE and one-to-one interviews to achieve a deeper understanding of these experiences. The quantitative data collected from the survey were used to deliver descriptive statistics, to describe what the data showed in a manageable form (Trochim 2022), rather than being used to understand patterns exhibited by the data (Babones 2016). This enabled me to collate evidence in a way that would be valued and understood by senior HEI managers in order to bring about change. The aim was not to generalise findings to all trans HE students, but to explore and explain the range of diverse perspectives and experiences using in-depth data gathered from different methods, from a range of respondents, in order to inform policy and practice.

Online survey

I chose the online survey method to allow the target participants to take part anonymously due to the sensitive nature of the research topic (Braun et al. 2021), and to reach a wide range of participants, with the target population being a relatively small group scattered across different locations (McInroy 2016). I began the survey with questions to ascertain the gender identity and pronouns of participants. I then included questions around the themes identified in existing literature: institutional facilities and administration; harassment, bullying and transphobia; inclusion/exclusion; and representation in the curriculum. I used open and closed questions and offered participants the opportunity to report on both positive and negative aspects related to these themes. I finished the survey with further demographic questions to enable me to interpret the data according to academic course of study and in reference to intersectionality with other protected characteristics. At the end of the survey, I provided a link for participants to select if they wished to register interest in the one-to-one interviews.

Interviews

The rationale for also using interviews was to allow participants to discuss lived experiences in greater detail, outside the defined questions of the survey. I used semi-structured informal guided interviews, using Skype video calling to provide participants with the opportunity to take part regardless of geographical distance. Allowing participants a degree of anonymity through the use of online interview methods can result in less inhibited responses when discussing sensitive topics, and this method has been used in other LGBTQI+ research (Jowett et al*.* 2011). I used a list of topics and prompts in order to allow participants to lead the discussion and talk about what was significant to them, whilst still being able to direct the flow of the conversation myself to ensure consistency across the interviews when analysing the data.

With participants’ permission, I recorded the interviews and then transcribed electronically using Otter.ai transcription software. I replayed the recordings, and edited the transcriptions manually for accuracy, and to remove reference to names, HEIs or the area of the country where participants were studying, to ensure there was nothing to identify them. I sent the transcriptions to participants, which helped to ensure it was their voice being represented, and that any interpretation of what they had said was correct.

Limitations

I considered disadvantages and limitations to using online surveys and interviews. Given the sensitivity of the topic, participants may have been more likely from those target students who were ‘out’ rather than those who were not; there may also have been some degree of bias in the sample, with those more interested in activism or having experienced discrimination more likely to participate. Another limitation could be that those from a higher socioeconomic status may be more likely to participate due to ease of computer and internet access (McInroy 2016; Ward et al. 2012), as those relying on HEI computers may not feel comfortable completing the survey or taking part in interviews in shared areas on campus (McInroy 2016). Results from a Universities and Colleges Admissions Service report (UCAS 2021) showed that 18% of trans students were from “disadvantaged” areas (from the lowest areas of HE participation by young people in the UK, known as POLAR4), in comparison to 13% of for non-LGBTQI+ students. There are also potential limitations in requirement for reliable technology, and during some of the interviews there were issues with poor internet connectivity which interrupted the flow of the conversation. However, I considered this preferable to telephone, online chat, or email interviews, which would not have provided me with the ability to see facial expressions during the interviews (Irani 2019), and for participants to see me in a one-on-one “virtual” environment.

Analysis

Thematic analysis allows for the identification, analysis and interpretation of themes within qualitative data, and I used this for its flexibility in terms of varying sample size and different methods of data collection (Clarke and Braun 2017) from survey responses and interview transcripts. I used a mixture of inductive and deductive methods (Braun and Clarke 2006); I had derived the themes in the survey and interviews from previous research and aimed to extract specific information from participants in order to address the research questions, but using a transformative approach it was important that the voice of the participants was heard and to be able to identify any additional themes arising. Transcribing the interviews allowed me to become familiar with the data. I read the transcriptions several times before uploading them into NVivo 12 software to organise the responses and identify patterns within the data, coding each interview using line-by-line coding.

I collected the survey data using Jisc Online Surveys, running the survey from 23^rd^ November 2019 until midnight on 29^th^ February 2020. I uploaded free text responses from the survey to NVivo 12, to organise the research using line-by-line coding in the same way as for the interview transcripts. I analysed closed questions using the Jisc Online Surveys analysis tools.

Ethical Considerations

Ethical considerations were important, given the marginalised population and sensitive topic. I applied to the Open University Human Research Ethics Committee (HREC) for authorisation, in compliance with the ethical guidelines of the British Educational Research Association (BERA 2011), which involved complying with an explicit protocol defining how consent to participate was sought, gained, and recorded; how data were collected, stored and accessed; and how participants were informed of their rights (Open University 2014). Requirements were met and permission to commence data collection was granted.

The trans population has been subject to ethically and methodologically flawed research practices in the past (Vincent 2018, 104), so it was important for me to be able to answer the question of “why is this study being done” and ensure my answers to this met prescribed ethical guidelines.

Researcher Background, Beliefs, and Biases

As a cis person researching the experiences of trans students, it was important to consider the insider/outsider dichotomy—whether or not a researcher should be part of the population being investigated when this is a marginalised community. A researcher studying a group or culture they belong to can bring an understanding of, engagement with, and commitment to the population that an outsider may not have (Breen 2007); however, for the insider researcher, familiarity can result in assumptions based on prior knowledge or experience (Levy 2013), with meaning communicated by “shared understanding of vague comments, innuendoes, and incomplete sentences and descriptions” (Breen 2007, 164).

I considered my position as a cisgender researcher and identified any potential problems this might generate. Thurairajah (2019) suggested that the nature of the relationship between a qualitative researcher and their participants can affect the outcome of the research, and that researchers need to identify the boundaries between themselves and participants, and the level to which these boundaries can be exposed or maintained in order to build trust and not compromise the “truth” of the participant’s story.

I did not disclose to participants that I worked in HE; on the Participant Information Sheets and Consent Forms I introduced myself as a Doctoral Researcher, placing myself as a student rather than someone with a potential position of power. I used informal guided interviews to reduce the power conflict as, although steered by me, participants were able to choose what they spoke about. I allowed participants time to answer and welcomed silences as “thinking time.”

I chose not to disclose to participants that I am cisgender; at the start of the interviews, I only confirmed my name and pronouns. I considered this to be important so that the focus would be solely on the participant; however, I was also concerned about how the participant would feel if they discovered I had been “hiding behind a cloak” (Thurairajah 2019, 138), particularly as I would be asking participants to be “uncloaked” in their responses. In retrospect, if conducting this study again I would declare my positionality as a cisgender researcher so that participants who may have had difficult experiences with cis researchers in the past would have that knowledge before consenting to taking part.

It was also important to ensure that my research ideas did not originate from personal experience or from preconceptions brought about by my own gender identity. Researching transgender issues involves studying an experience that is “positioned as nonnormative and consequentially conceptualised relative to the celebrated (cisgender) norm” (Galupo 2017, 241). I considered how my cisgender identity might impact how I phrased questions and tried to address this by ensuring that trans students were involved in making sure my research questions addressed their needs and were not based on my supposition of what their needs may be. To do this, I discussed my proposed questions with the Trans Officer from the student union at the HEI where I work, and then completed a pilot study with eight trans students from a single HEI, making some modifications to how questions were worded and additional questions that could be included, based on feedback from this.

Surveys could be seen as intrusive, both into the privacy of the participant and into their time. Vincent (2018) suggested a careful study of language is important when considering all research, but that particular attention should be paid to this when researching within the trans community. I explained my use of the umbrella term “trans” at the start of the survey*.* I used questions such as “What pronouns do you use” in preference to “What are your preferred pronouns,” which showed an understanding of pronoun awareness and respect, as did the inclusion of ’neopronouns’ (Vincent 2018) in the survey and an option to not provide an answer to this question. I considered how the participants might feel after completing the survey, as there was a possibility this could exacerbate feelings of exclusion or dysphoria, or increase frustration, and I included links to various support groups in the Participant Information Sheet. As knowing the aims of the study would not influence participant responses, I was able to provide useful information to help them make the decision to take part. This transparency about the aims of the research and how it might benefit the trans student community helped to reduce inequality due to my own privilege (Vincent 2018).

Findings

A total of N = 166 participants completed the online survey. I excluded one transphobic response from analysis and excluded another as no questions had been answered. Seven participants took part in one-on-one interviews. All survey questions were optional, so not all respondents indicated their HEI or course of study, but of those who did, there were participants from 60 different HEIs across the UK (England, Wales, Scotland, and Northern Ireland) and representation across the curriculum covering 83 distinct courses, with n = 64 students studying humanities courses, n = 38 health and social sciences, and n = 51 studying STEM subjects.

More trans men (n = 66) and nonbinary (n = 61) participants took part than trans women (n = 30). Those choosing “other” for gender identity (n = 7) self-described as: genderqueer male, none/neutral, man with a trans history, genderqueer (n = 2), agender, and questioning. More participants used he/him (n = 75) or they/them (n = 42) than she/her (n = 33). Of those choosing “other” (n = 12), all used both he/him and they/them.

The interview participants were from seven different HEIs in England, studying health and social sciences (n = 4) and humanities (n = 3). I did not ask interview participants to disclose their gender but provided them with the opportunity to share pronouns; four exclusively used he/him, one exclusively used they/them, and the other two participants used either he/him or they/them. No participants using she/her came forward for interviews; this, along with the lower numbers of trans women participants in the survey indicates that there is a need to explore further the experiences of trans women in HE.

Harassment, Bullying, and Transphobia

Where harassment, bullying and/or transphobia was reported, survey responses provided a breakdown of the type of experiences (Figure 1), where being outed without consent and purposeful misgendering were the highest reported incidents.

Figure 1. Have you experienced any of the following at university yourself, because of your trans identity?

The five “other” responses included transphobic comments made in class being unchallenged; transphobic teaching practices; people refusing to use nonbinary pronouns “because it’s linguistically challenging”; incorrect pronouns being used by someone who “doesn’t ‘agree’ with trans people”; and a participant being told their gender identity was the result of not being allowed to do “male things” as a child and that transitioning is “dangerous and likely a mental illness.” This shows that at least some misgendering is quite deliberate and used to harm, rather than being a genuine mistake. The majority either did not report the incident or did not know how or where to report such actions.

One interview participant reported having experienced bullying/transphobia at university. They described how a flatmate had started calling them “it” but that, although security was involved, “not much really was done about it, which really annoyed me, but he did apologise, so what more can you ask for?” The final part of the sentence—“what more can you ask for?”—seems to imply that they did not really expect for this to be taken seriously by the HEI or for anything to be done to stop this happening again.

Other interview participants reported being aware of others experiencing difficulties, with a common theme that there was a lack of confidence in how well the HEI would deal with the issue. Some participants said they were aware of systems in place to report bullying but were not sure how to do this. Even those in a position of supporting students did not always know how to signpost to report incidents. One interview participant, who was president of their student LGBTQI+ society, commented that:

If there is a process, which I’m sure there must be, it’s not advertised to students… We just run around, talk to everyone that we know until someone tells us what we can do about it, and then help the student with it. (Participant 4)

Most of the students interviewed mentioned the negative impact of incorrect name and pronoun use. Some of this clearly resulted from ineffective administrative processes, but the impact is clear:

It was a bit startling to see my given name printed on the card and it was a bit of a slap in the face really… All of these constant reminders are just really unpleasant and hurtful. (Participant 2)

Some students also faced misnaming or misgendering in person resulting in feeling invalidated:

They don’t check in with me about my pronouns… They don’t react to my facial expressions when they call me “lady” or “girl”... They just don’t notice; they don’t hear it. (Participant 2)

Even when accidental, this perpetuates cisnormativity and can have a negative impact when it is in front of others:

I’ve had a lecturer that’s misgendered me and it was very awkward because it was in front of the class and I got a bit red and felt a bit uncomfortable but at the end she’s pulled me over and says, “I am really sorry” and apologised. (Participant 3)

Some students in the survey gave examples of instances where the university had been particularly positive in supporting trans students; some of these included statements about correct use of names/pronouns:

Lecturers have asked which pronouns I would prefer when giving information about me.

Academic staff on my course have always been quick to take up preferred names and pronouns as soon as they are aware that they have changed.

Responses showed the positive impact that using a trans student’s correct name and pronouns can have, as well as the negative impact of misnaming, misgendering, and other microaggressions.

Representation in the Curriculum

Although the majority of participants (n = 146) felt trans representation in the curriculum was at least somewhat important, n = 91 did not feel at all represented. Some acknowledged that representation is “easier” in some subjects than in others; Acciari (2014) suggested that LGBTQI+ representation in humanities was higher than in STEM subjects. However, one participant, studying a gender and sexuality module in English literature, described how,

The gender side of it was a bit more problematic for me… If you are cis, you probably look at it and find it really interesting, but when you’re trans, you’re reading it and it’s really bad… I read it and I was like, this is awful, why are they making me read this? (Participant 1)

The participant described how this made them feel and the impact it had on the rest of their academic journey:

I felt so uncomfortable with it… I’m just some first year who isn’t out to my class except for the other trans people and I’m just there, I don’t want to say anything… I don’t wanna tell my tutor that she’s assigned a bad book… So, I just decided from that class to sort of sit in there in silence listening to people debating whether or not this character is a woman because he has a vagina. But, you know, it was not a comfortable experience. (Participant 1)

This is an example of the power relations in HE, where the student did not feel they could take issue with the book their tutor had assigned on the basis that it was derogatory towards trans people and made trans students feel uncomfortable.

One interview participant, a music student, talked about the silencing/erasure of trans people:

There are trans composers who, some of whom are still alive, some of whom were working in the 20th century, and we didn’t learn about any of them… Western classical music is founded on a system of racism and sexism and homophobia and transphobia and ableism. (Participant 6)

These examples highlight areas where trans representation really should be quite easy to incorporate into the curriculum and underlines the power imbalance of learning within a cisnormative environment.

Some participants described specific relevance of curriculum representation in health and social care subjects, where students are likely to come across trans clients/patients on placement, as well as in their working role after graduating. One participant, studying social work, commented:

There’s no trans representation so far. I know that they’re trying to decolonise the curriculum now… but I think currently, they’re mostly focusing on race and ethnicity. I’m hoping that queerness will enter soon... I’m fairly sure that every single person in my cohort will at some point have to deal with trans people… using the correct pronouns and a known as name, is quite important. (Participant 2)

Another, who was both working and studying in the National Health Service (NHS), felt trans representation in the curriculum was essential in providing students with the information and knowledge they need and the confidence to ask when unsure:

It needs to be demystified and debunked… the heat needs to be taken out of it… It’s about having a vocabulary for it, about feeling okay not knowing and feeling okay to be able to say “… I’m not that familiar with working with trans people, can you help me out here?… What pronouns do you like to use? How do you like to refer to things?”… It’s not one size fits all. Language that I might feel comfortable with might not be suitable for somebody else. (Participant 7)

These are examples of the assumptions of cisnormativity and the privileging of cisgender knowledge in teaching, despite the difficulties trans people experience accessing healthcare and research describing how trans-inclusive teaching in these subjects would help to improve this (De Vries et al. 2020).

There were two reports of positive representation in the interviews, one of which was from a paramedic student who noted:

We have had a couple of lectures about communication and people’s identities… It was really about respecting everyone’s identity and it mentioned people that had different genders and sexualities, and it was a good representation. (Participant 3)

The other was from a student studying linguistics, who described a LGBTQI+-focused module where they studied transmasculine voices and how the pitch of the voice can affect perception of gender.

Inclusion/Exclusion

Survey responses reported a good level of support from LGBTQI+ societies, and the majority (n = 71) confirmed that their student unions had a dedicated trans officer. Most felt that having a dedicated trans officer was beneficial, for “more representation of trans people and trans issues to the wider community,” “to have our voices heard,” and “to bring trans perspectives to the fore and support individual students.” Some were less enthusiastic about the role, commenting: “The group is so inclusive it would only segregate trans issues to a different place and not promote equality” and “They have an LGBT+ officer and I’m happy for that to remain this way. Not a fan of splitting up the community.” However, interview discussions identified a lack of trans-specific representation, and perceived challenges with LGBTQI+ societies being run by “cis white gays” (Participant 5), and that they were not representative or fully supportive of trans members.

Although most interview participants were encouraged by peer support, in many cases this was through developing support networks with other trans students, rather than from cis peers. The participant who had experienced the uncomfortable English literature class described earlier, remarked on how important this had been in helping them deal with this incident:

It helped that I was sitting in that class with another friend who is also trans, so we could just talk about it together, and be like “this is the worst.” But you know, if they hadn’t been there and I was the only trans person in that class, I would have had a horrible time. (Participant 1)

This level of support felt by having peers who are able to identify with trans students’ issues further stresses the importance of trans representation and the encouragement of trans participation in student union and LGBTQI+ Society events and activities.

Responses on the subject of supportive staff were varied, but particularly positive regarding support provided when trying to navigate the administrative processes for changing names on the university records. One comment also related to the visibility of staff allies:

I love that many of the lecturers wear these lanyards with the rainbow pattern on them, which signals to the students that they are LGBTQ+ allies and can be approached… I like that I have someone I can actually turn to very visibly… It makes me feel very welcome. (Participant 2)

There were negative comments regarding a lack of understanding from university counselling services. One interview participant described negative experiences they had themselves, and experiences other students had brought to them in their capacity within the student union:

We’d have a lot of students who come to us and be like, “I went to a counsellor, and this counsellor just blamed everything on me being gay, or just blamed everything on me being trans”… I go to a counsellor, but I can tell you that being trans is the least of my problems… I’ve also had the situation where they found out I’m trans, and then they wanted me to teach them about the whole process of transitioning and all this stuff that they can then go away and help other trans students, and it’s like, they’re supposed to be helping me… It has stopped quite a few students from wanting to access their services. (Participant 4)

Institutional Facilities and Administration

Many students in this study faced difficulties with changing their name and/or gender on university data systems and ID cards, often due to a lack of processes in place—an example of the problems that can occur due to the formal and bureaucratic procedures set up with cisnormative and binary gender assumptions. Two interview participants described having alerted the university in advance of starting their degree, with one commenting:

I got in touch… over email with the university beforehand, to let them know I’m trans, this is my preferred name, my pronouns, can you make sure that any staff I’m gonna be in touch with are aware of this, and they’re like, yeah, that’s fine, no problem. (Participant 1)

However, the participant explained that this did not happen, leading to difficulties once classes began where the register used their birth name, ‘outing’ them to staff and peers within their first few days at university. They had to email all their teaching staff to advise of the error, but said once this was done, the teaching staff immediately changed the register so that this would not happen again. However, it still was not updated in the university’s systems so the same thing happened at the start of semester two. This is an example of HEIs not having a clear process for changing student details, so all relevant staff are informed. The same participant also described the difficulties this delay caused when accessing university mental health support services:

The information hadn’t been passed on like I was expecting it to… I’d just without thinking signed off an email with the correct name. And they replied to me, like, “sorry, I don’t know who I’m speaking to”… [I had] a moment of I don’t know how I am meant to address myself to them in the emails now because I didn’t know who knew what anymore. (Participant 1)

This is an example of how disjointed administrative processes can affect trans students, where the student assumes changes have been made, but are then placed in uncomfortable situations when they find this is not the case. In the survey, n = 72 participants had requested a change of name to be made on their university record; half felt this information had not fully filtered down to relevant academics.

There was an opportunity on the survey for participants to expand on how easy it had been to record a change of gender, and of n = 49 responses, n = 28 reported this as being an easy process, with n = 21 having come across barriers. Those who faced barriers described universities being reluctant to make changes, and systems requiring a great deal of work on their part to request a change. One participant was told they were not able to change their details without a Gender Recognition Certificate, which is categorically incorrect and against the Equality Act 2010 (Women and Equalities Committee 2015); two others faced specific difficulties related to being nonbinary, as there was no gender option available for them on computer systems—both reported having to choose between a binary marker or “unknown.” Over half of the survey participants though found the process easy and their comments made it clear how straightforward this can be where the HEI is willing to make it so. In many cases it was resolved after a simple email and when reporting about positive experiences, one participant said changes to ID cards at their HEI were free where a name change is required, and that “Mx”—a recognised title that does not indicate gender—was a standard option for students.

Three interview participants reported that a legal name change (deed poll) was required by the HEI before they could change their name on internal university systems and ID cards. One described the difficulties this caused, having to choose between being outed to peers or to family:

I hadn’t changed my name legally because of family situations, and that can be a bit difficult because… all the online stuff, they wanted me to change my name legally to get all that changed. (Participant 5)

The lack of effective processes was frustrating for students, but also had emotional/mental health impacts. This was described by one interview participant:

I was constantly reminded of the name I didn’t choose. I don’t even care all that much about the pronoun stuff, to be honest, I care way more about the name because if they call me by my old name, I just feel 21 years of frustration and anxiety building up in me… That’s just all of these constant reminders are just really unpleasant and hurtful. (Participant 2)

The participant quotes in this section provide a powerful sense of the weariness of constantly being beaten down by what may be considered by HEIs to be seemingly small things. It is clear how a simple change to administrative processes could be supportive of trans students and would go some way towards reducing the negative impact on their mental health.

Students also reported challenges with gendered toilet facilities and with gender-neutral facilities often being a re-designation of disability-accessible toilets for “shared use.” All interview participants mentioned a lack of gender-neutral toilets as being an issue, and two explained their discomfort with having ‘disabled’ toilets as the gender-neutral option:

I always feel a bit wrong using them because of if someone who needs to use a disabled toilet comes along and is waiting ‘cos I’m there instead. (Participant 1)

The gender-neutral toilets are also the disabled toilets… I’m able-bodied and so I don’t always feel comfortable using toilets that are specifically for disabled people. (Participant 6)

A survey participant also touched on sharing disability-accessible spaces and how this sets up marginalised groups in opposition to each other; they described how someone had stuck a sign on the door saying “for disabilities only” despite it being designated by the HEI as a gender-neutral facility. They commented, “I wish I didn’t have to share a facility intended for the needs of another minority as it feels unfair to them too.”

Participants talked about a disconnect between policy and practice, with policy recommendations often not being backed up by change. One participant queried the motive behind having a trans student policy:

The fact that I’d come to this university partly because of the things they’d said they would be doing… in their trans policy, and then it made it feel like, oh, ok, you’re saying you’re going to do these things just so you sound good basically… they didn’t seem to actually worry about following through with it. Made it feel like they put this policy in place because they have to rather than because they cared. (Participant 1)

If prospective students are investigating trans student policies when making their choice of HEI, then these should be publicly accessible. It was surprising then that of 169 HEI websites I visited, 96 had no trans policies accessible to the public.

Discussion

In this section I interpret the findings in relation to the existing literature and examine assumptions of cisnormativity in HE revealed in the findings of the survey and interviews. I look at how feelings of segregation and otherness were reflected in the data, and the lack of representation for trans students in the curriculum. I also discuss the difficulties with mental health support services disclosed by participants.

Assumptions of Cisnormativity

Despite the lack of trans-specific research, parallels drawn with other marginalised groups in HE, for example Ertl and colleagues (2017) looking at the experiences of women studying STEM subjects in HE, and Chaudhury (2020) investigating women and BAME student representation in business courses, seem to imply that the privileging of cisnormative ideologies in HE which normalise binary and unmoveable gender would result in oppressive systems that can have a negative bearing for trans students.

I examined the marginalisation of trans students to identify how and where cisnormative practice occurs, and how these practices can be challenged. Using a transformative approach, I sought to identify the imbalance of power for trans students who are learning within a mainly cisnormative environment, and to transform the lives of this marginalised group by influencing change. In the survey and interviews, I identified many examples of trans students experiencing institutional discrimination—through poor administrative processes, lack of suitable facilities, inaction over transphobic incidents, absence and erasure of trans identities in the curriculum, and LGBTQI+ societies having to support students where HEI procedures are lacking.

Frequently, poor administrative processes resulted in the misnaming and misgendering of students. Even where these processes were less arduous, many HEIs failed in ensuring the changes filtered down to academic and support staff, which resulted in continued problems. Formby (2017) identified misnaming and misgendering as symptomatic of a lack of awareness about gender identity. Many of the problems highlighted could be resolved with effective training of staff and changes in administrative processes, to ensure trans students are not being misnamed or misgendered through administrative inaccuracies or ignorance.

Simple but effective administrative processes can have a huge impact on the wellbeing of trans students, and information on student data systems can have a positive or negative effect on students’ feelings of belonging. The impact on trans students’ mental health was clear from some of the participant responses, whether the negative impact of being “constantly reminded of the name I didn’t choose… [resulting in] frustration and anxiety building up in me” or the more positive “The first time I held a preferred name ID, student ID in my hand, I cried, tears of joy.”

Nonbinary students were challenged by many HEIs not having the option of a nonbinary gender marker. This is an example of institutional microaggression informed by cisnormativity, and of Foucault’s (1991) idea of disciplinary power, where upholding the gender binary and forcing students to choose between ‘male’ and ‘female’ gender markers, denies the existence of those outside of this binary. Having to negotiate cisnormative assumptions of gender binary can lead to increased negative mental health outcomes (Pulice-Farrow et al*.* 2020).

Feelings of Segregation and Otherness

Critical theory identifies how the influence of power relations in society leads to inequality and oppression, and in this study, I found that cisnormativity in HE can lead to feelings of segregation and otherness. From the findings, I identified that a lack of gender-neutral toilet facilities is a problem for many trans students, who may feel uncomfortable both when using the toilet of their affirmed gender, if for example they have not commenced physical transition or are not confident enough to use this toilet, and when using the toilet of their assigned sex due to the dysphoria this causes. Having gender-neutral facilities can make this easier, and for nonbinary students, a lack of gender-neutral facilities forces them to choose between only two options, or, as reported by one participant, not use the facilities at all, waiting until they are back in their own accommodation, which can affect physical as well as mental health.

Several participants also mentioned that where HEIs do have gender-neutral toilets, these are often just an “all welcome” sign on the “disabled” toilet. Slater and Jones (2018) suggested “all-gender” toilets should be provided alongside gendered facilities but that this should not be through the re-labelling of an accessible toilet, and that as accessible toilets were the only option for some disabled people, trans participants “were often aware that their need for an all-gender space may compete with the needs of those with physical impairments, whose use of the space was portrayed as more legitimate” (Jones and Slater 2020, 844).

Ignoring or Disregarding Trans Experience in the Curriculum

I used critical theory in education to question how HE could offer the best education to trans students by understanding the different perspectives of students who are at a disadvantage as a result of inequality. Cisnormativity in curriculum construction and presentation can result in the erasure and silencing of trans experiences, further marginalising trans students. Page (2016, 117) noted that LGBTQI+ students are “at greater personal and academic risk” than non-LGBTQI+ peers, for example with a negative learning environment impacting students’ academic achievement and goals. Trans representation in the curriculum can help to “cut through cisnormative silence” and reduce the “dominant and normative cisnormative organisation of power/knowledge” (McBride and Neary 2021, 1103).

Often, when HEIs consider the “inclusive curriculum,” LGBTQI+ identities can be left out, with the greater focus in the UK being on “decolonising” the curriculum which, as identified in previous literature, tends to focus on ethnicity (Chaudhury 2020), Euro-centrism (Schucan Bird and Pitman 2020), and women (Ertl et al. 2017) rather than gender identity. Diversifying reading lists to include trans writers as part of this process is just one way of working towards improving the learning experience of trans students.

Trans Inclusion in Professional Health and Social Care Curricula

The transformative paradigm asserts that power relations within society construct and influence reality and knowledge (Mertens 2019). The privileging of cisgender knowledge in respect of teaching students in professional health science subjects impacts not only on what students learn, but on what knowledge they take with them into professional careers. De Vries and colleagues (2020) suggested that trans people can find accessing healthcare hard, regularly experiencing stigma, discrimination and marginalisation, being faced with healthcare professionals who are not adequately prepared to meet their needs, and experiencing subtle microaggressions and cisnormative processes that can make them feel invalidated and unwelcome.

Therefore, of particular concern in this study were the students reporting poor or lacking representation in professional health and social care subjects, including nursing and social work. These students may work with transgender clients/patients on placement and in their working role after graduating, so the inclusion of trans identities in the curriculum is essential yet appeared to be mostly absent. Three interview participants were studying in this area (social work, paramedic science and health sciences); one gave their experiences from all sides—as a health sciences student, an NHS practitioner, and a trans patient—suggesting that teaching practitioners to feel confident with their language is lacking, as is effective training of teaching staff, particularly those who have been in the profession for a long time. They said practitioners need to feel confident to ask if unsure and described practitioners “treading on eggshells” around trans people, in fear of saying or doing the wrong thing. On the other hand, they explained that having transitioned some years ago, the reason they might see a doctor now is most likely nothing to do with being trans, and that practitioners need to learn “when it is a thing and where you should pay attention to it… and when that’s inappropriate.” This is what Wall and colleagues (2023) refer to as “trans broken arm syndrome”—medical discrimination where a practitioner incorrectly assumes that a presenting condition is a result of a trans patient’s gender identity or medical transition.

Similarly, the social work student was concerned that every person on their cohort would at some point work with trans people and having been shown little respect by their own lecturers and classmates with refusal to use their correct pronouns, they felt it was very important this should be included more actively in the curriculum. It was only the paramedic science student who reported more positive inclusion, describing having had lectures on communication and respecting everyone’s identities. This student noted how proud they felt when this was taught and how nice it was to hear and see positive reactions from classmates.

HEI Mental Health Support Services

Without HEIs acknowledging that assumptions of cisnormativity exist, trans students may face inequalities in accessing HEI support services. Institutional cisnormativity is often embedded in the structure, culture, and processes of HE (Frohard-Dourlent 2016) and has a negative effect on trans students, often resulting in them experiencing higher rates of marginalisation and harassment, which impacts upon mental health and wellbeing. Swanbrow Becker and colleagues (2017) identified that trans students were far more likely than cis peers to report a history of trauma, and a history of suicidal ideation and/or suicide attempts.

A report by the Office for Students (2019) noted that the mental health support needs of HE students must be considered: they may be living away from home for the first time; they may be juggling study and work in order to support their finances; and of particular interest to my study, the report identified how intersectionality with other factors such as ethnicity and sexuality could impact on outcomes and support for students. Given that mental health conditions reported by students in HE in the UK in 2020/21 were almost seven times higher than a decade before (Lewis and Bolton 2023), more could be done to train mental health advisers and counsellors to understand trans students’ specific needs. Trans students are often at higher risk of mental health difficulties due to a number of factors, including having experienced social exclusion, discrimination and violence, or having kept their identity hidden. Reducing the impact of cisnormativity is likely to have a positive effect on students’ mental health and educational achievement (McGlashan and Fitzpatrick 2018). The lack of knowledge within HEI support services about trans students’ mental health indicates a widespread cisnormative approach to student support that needs to be addressed in order to ensure this student group is able to receive effective assistance when needed.

Conclusion

In the context of this study, I used critical theory in education to question HE systems and practices and consider how HEIs can offer the best educational experience by understanding the perspectives of trans students who are at a disadvantage as a result of inequality in the HE environment. The results echoed claims made by earlier literature regarding a need for HEIs to improve the experiences of trans students. For example, the harassment of trans students in HE (Marzetti 2018) (Storrie and Rohleder 2018); the impact of poor administrative processes (Seelman 2014) (Goldberg and Kuvalanka 2018); and problems with trans-exclusive facilities in HE (Marzetti 2018) (Bachmann and Gooch 2018b).

My study bridged significant gaps in the previous literature, including the need for: (1) UK-specific research that provides data from multiple HEIs across the UK; (1) research that is trans student-specific rather than part of research into LGBTQI+ students or part of research into trans individuals in wider society; (3) research into the lack of trans representation in the curriculum; and (4) consideration of the impact of cisnormativity in HE.

In order to make change, HEIs need to acknowledge and question institutional cisnormativity. This can be addressed by the practices of the HEI, but to do this, HEIs need to acknowledge that these challenges exist. They need to acknowledge the privilege of a majority cisgender environment with majority cisgender decision makers at the higher levels of leadership and avoid approaches to equality and diversity in which “certain identities trump others in terms of what counts as diversity” (Calafell 2020).

Problems with cisnormativity were highlighted in the study: accidental misgendering perpetuating cisnormativity; administrative processes based on cisnormative assumptions of gender identity; binary normativity in the choice of gender markers and gendered toilet facilities. These problems result in feelings of invalidation and exclusion for trans students and the creation of an atmosphere of inequality. Small gestures around language in the teaching environment—using language that does not assume gender identity and not taking pronouns for granted—can go a long way towards making trans students feel validated. Resistance to using transphobic texts, language, pedagogies, and curricula should be constant and persistent, removing the assumption that all students share common identities and instead working to learn about, acknowledge and affirm differences. Avoiding repetition of privileged knowledge and practices will help to reduce oppression; “What is oppressive is having to experience, again and again, the privileging of only certain ways of identifying, thinking, or relating to others” (Kumashiro 2002).

Improving the curriculum in health and social care courses will help to reduce the variation that exists for trans people in health and mental health care and improve their experiences. These students must learn about how to address and talk to trans people, the value of affirming language, and how to recognise and address prejudice and bias. A lack of gender-affirming healthcare teaching means health professionals are often not adequately prepared to provide appropriate support to trans patients (De Vries et al. 2020). Better knowledge of the specific barriers and experiences that trans patients will have when accessing health and social care services, as well as the understanding that being trans is not always the number one reason for accessing medical or mental health care, are important in reducing the invalidation and invisibility that trans people frequently face. In a societal climate where trans people experience hostility and vulnerability, practitioners who are supportive, non-discriminatory and culturally competent are more important than ever.

By undertaking this study, I aimed not just to make the experiences of trans students bearable, but to ensure they receive the same exciting and amazing experience that all HE students deserve. To do this, HEIs need to be ready for trans students, providing an affirming experience founded on understanding.

References

Acciari, Louisa. 2014. “Education Beyond the Straight and Narrow: LGBT Students’ Experience in Higher Education.” Cheshire: NUS Charity. https://www.nusconnect.org.uk/resources/education-beyond-the-straight-and-narrow-2014.

Allen, Louisa, Lucy Cowie, and John Fenaughty. 2020. “Safe but Not Safe: LGBTTIQA+ Students’ Experiences of a University Campus.” Higher Education Research & Development 39 (6): 1075–90. https://doi.org/10.1080/07294360.2019.1706453.

Atteberry-Ash, Brittanie, Stephanie Rachel Speer, Shanna K Kattari, and M Killian Kinney. 2019. “Does It Get Better? LGBTQ Social Work Students and Experiences with Harmful Discourse.” Journal of Gay & Lesbian Social Services 31 (2): 223–41. https://doi.org/10.1080/10538720.2019.1568337.

Babones, Salvatore. 2016. “Interpretive Quantitative Methods for the Social Sciences.” Sociology 50 (3): 453–69. https://doi.org/10.1177/0038038515583637.

Bachmann, Chaka L, and Becca Gooch. 2018a. “LGBT in Britain Trans Report.” London: Stonewall. https://www.stonewall.org.uk/sites/default/files/lgbt-in-britain-trans.pdf.

Bachmann, Chaka L, and Becca Gooch. 2018b. “LGBT in Britain University Report.” London: Stonewall. https://www.stonewall.org.uk/sites/default/files/lgbt_in_britain_universities_report.pdf.

Beemyn, Brett. 2003. “Serving the Needs of Transgender College Students.” Journal of Gay & Lesbian Issues in Education 1 (1): 33–50. https://doi.org/10.1300/J367v01n01_03.

BERA. 2011. “Ethical Guidelines for Educational Research.” London: British Educational Research Association. https://www.bera.ac.uk/publication/bera-ethical-guidelines-for-educational-research-2011.

Boe, Joshua L, Emilie M Ellis, Kalene A Sharstrom, and Jerry E Gale. 2020. “Disrupting Cisnormativity, Transnormativity, and Transmisogyny in Healthcare: Advancing Trans Inclusive Practices for Medical Family Therapists.” Journal of Feminist Family Therapy 32 (3–4): 157–75. https://doi.org/10.1080/08952833.2020.1848051.

Braun, Virginia, and Victoria Clarke. 2006. “Using Thematic Analysis in Psychology.” Qualitative Research in Psychology 3 (2): 77–101. https://doi.org/10.1191/1478088706qp063oa.

Braun, Virginia, Victoria Clarke, Elicia Boulton, Louise Davey, and Charlotte McEvoy. 2021. “The Online Survey as a Qualitative Research Tool.” International Journal of Social Research Methodology 24 (6), 641–54. https://doi.org/10.1080/13645579.2020.1805550.

Breen, Lauren J. 2007. “The Researcher ‘in the Middle’: Negotiating the Insider/Outsider Dichotomy.” The Australian Community Psychologist 19 (1): 163–75.

Calafell, Bernadette Marie. 2020. “Cisnormativity, Whiteness, and the Fear of Contagion in Academia.” QED: A Journal in GLBTQ Worldmaking 7 (1): 68–74.

Chaudhury, Tasnuva. 2020. “Women’s Representation in Business Case Studies-a Framework of Postmodernism to Uncover Hidden Assumptions.” Transnational Corporations Review 12 (2): 149–61. https://doi.org/10.1080/19186444.2020.1748992.

Clarke, Victoria, and Virginia Braun. 2017. “Thematic Analysis.” The Journal of Positive Psychology 12 (3): 297–98. https://doi.org/10.1080/17439760.2016.1262613.

Click, Ivy A, Abbey K Mann, Morgan Buda, Anahita Rahimi-Saber, Abby Schultz, Maureen Shelton, and Leigh Johnson. 2020. “Transgender Health Education for Medical Students.” The Clinical Teacher 17 (2): 190–94.

Cohen, Louis, Lawrence Manion, and Keith Morrison. 2018. Research Methods in Education. Abingdon: Routledge.

Crossley, Nick. 2012. Key Concepts in Critical Social Theory. London: SAGE.

Ertl, Bernhard, Silke Luttenberger, and Manuela Paechter. 2017. “The Impact of Gender Stereotypes on the Self-Concept of Female Students in STEM Subjects with an Under-Representation of Females.” Frontiers in Psychology 8: 703. https://doi.org/10.3389/fpsyg.2017.00703.

Fischer, Anita, and Daniela Tepe. 2011. “‘What’s “Critical” about Critical Theory’: Capturing the Social Totality (Das Gesellschaftliche Ganze).” Journal of International Relations and Development 14 (3): 366–75. https://doi.org/10.1057/jird.2011.12.

Formby, Eleanor. 2015. “Limitations of Focussing on Homophobic, Biphobic and Transphobic ‘bullying’ to Understand and Address LGBT Young People’s Experiences within and beyond School.” Sex Education 15 (6): 626–40. https://doi.org/10.1080/14681811.2015.1054024.

Formby, Eleanor. 2017. “How Should We ‘care’ for LGBT+ Students within Higher Education?” Pastoral Care in Education 35 (3): 203–20. https://doi.org/10.1080/02643944.2017.1363811.

Foucault, Michel. 1991. Discipline and Punsih: The Birth of the Prison. New York: Penguin Books.

Frohard-Dourlent, Hélène. 2016. “‘I Don’t Care What’s under Your Clothes’: The Discursive Positioning of Educators Working with Trans and Gender-Nonconforming Students.” Sex Education 16 (1): 63–76. https://doi.org/10.1080/14681811.2015.1022819.

Galupo, M Paz. 2017. “Researching While Cisgender: Identity Considerations for Transgender Research.” International Journal of Transgender Health 18 (3): 241–42. https://doi.org/10.1080/15532739.2017.1342503.

Goldberg, Abbie E, and Katherine A Kuvalanka. 2018. “Navigating Identity Development and Community Belonging When ‘There Are Only Two Boxes to Check’: An Exploratory Study of Nonbinary Trans College Students.” Journal of LGBT Youth 15 (2): 106–31. https://doi.org/10.1080/19361653.2018.1429979.

Govender, Nathisvaran. 2020. “Alienation, Reification and the Banking Model of Education: Paulo Freire’s Critical Theory of Education.” Acta Academia 52 (2): 204–22. https://doi.org/10.18820/24150479/aa52i2/11.

Hafford-Letchfield, Trish, Alfonso Pezzella, Laura Cole, and Rebecca Manning. 2018. “Transgender Students in Post-Compulsory Education: A Systematic Review.” International Journal of Educational Research 86: 1–12. https://doi.org/10.1016/j.ijer.2017.08.004.

Hill, Robert Loren, David J Nguyen, Cindy Ann Kilgo, Alex C Lange, Heather D Shea, Kristen A Renn, and Michael R Woodford. 2021. “How LGBTQ+ Students Thrive in College.” Journal of Student Affairs Research and Practice 58 (3): 267–81. https://doi.org/10.1080/19496591.2020.1738241.

Hines, Sally. 2019. “The Feminist Frontier: On Trans and Feminism.” Journal of Gender Studies 28 (2): 145–57. https://doi.org/10.1080/09589236.2017.1411791.

Hopkins, Peter, Graeme Mearns, and Carl Bonner-Thompson. 2018. “Transgender Experiences of Newcastle University 2018.” Newcastle: Newcasle University. https://eprints.ncl.ac.uk/file_store/production/251901/304B0DF0-658A-44F0-BBAC-360253D41EE3.pdf.

Hussain, Mariya. 2015. “Why Is My Curriculum White?” London: National Union of Students. https://www.nus.org.uk/en/news/why-is-my-curriculum-white/.

Irani, Elliane. 2019. “The Use of Videoconferencing for Qualitative Interviewing: Opportunities, Challenges, and Considerations.” Clinical Nursing Research 28 (1): 3–8. https://doi.org/10.1177/1054773818803170.

Jones, Charlotte, and Jen Slater. 2020. “The Toilet Debate: Stalling Trans Possibilities and Defending ‘Women’s Protected Spaces.’” The Sociological Review Monographs 68 (4): 834–51. https://doi.org/10.1177/0038026120934697.

Jowett, Adam, Elizabeth Peel, and Rachel Shaw. 2011. “Online Interviewing in Psychology: Reflections on the Process.” Qualitative Research in Psychology 8 (4): 354–69. https://doi.org/10.1080/14780887.2010.500352.

Kaufman, Peter, and Kenneth A Feldman. 2004. “Forming Identities in College: A Sociological Approach.” Research in Higher Education 45 (5): 463–96. https://about.jstor.org/terms.

Khan, Jesse. 2019. “7 Microagressoins Trans People Face in Health and Mental Healthcase Settings.” The Body Is Not an Apology, August 29, 2019. https://thebodyisnotanapology.com/magazine/7-microaggressions-trans-people-face-in-health-and-mental-healthcare-settings/.

Kosciw, Joseph G., Emily A. Greytak, Noreen M. Giga, Christian Villenas, and David J. Danischewski. 2015. “The 2015 National School Climate Survey.” New York: GLSEN. https://www.glsen.org/sites/default/files/2020-01/GLSEN 2015 National School Climate Survey %28NSCS%29 - Full Report.pdf.

Kumashiro, Kevin K. 2002. “Against Repetition: Addressing Resistance to Anti-Oppressive Change in the Practices of Learning, Teaching, Supervising, and Researching.” Harvard Educational Review 72 (1): 67–92.

Lefevor, G Tyler, Brianna M Sprague, Caroline C Boyd-Rogers, and Abigail C P Smack. 2019. “How Well Do Various Types of Support Buffer Psychological Distress among Transgender and Gender Nonconforming Students?” International Journal of Transgender Health 20 (1): 39–48. https://doi.org/10.1080/15532739.2018.1452172.

Levy, Denise L. 2013. “On the Outside Looking In? The Experience of Being a Straight, Cisgender Qualitative Researcher.” Journal of Gay & Lesbian Social Services 25 (2): 197–209. https://doi.org/10.1080/10538720.2013.782833.

Lewis, Joe, and Paul Bolton. 2023. “Student Mental Health in England: Statistics, Policy, and Guidance.” London: House of Commons Library. https://researchbriefings.files.parliament.uk/documents/CBP-8593/CBP-8593.pdf.

Mackenzie, Noella, and Sally Knipe. 2006. “Research Dilemmas: Paradigms, Methods and Methodology.” Issues in Educational Research 16 (2): 193–205. http://www.iier.org.au/iier16/mackenzie.html.

Maitland, Cameron A., Sinead Rhodes, Anne O’Hare, and Mary E. Stewart. 2021. “Social Identities and Mental Well-Being in Autistic Adults.” Autism 25 (6): 1771–83. https://doi.org/10.1177/13623613211004328.

Marques, Ana Cristina. 2019. “Displaying Gender: Transgender People’s Strategies in Everyday Life.” Symbolic Interaction 42 (2): 202–28. https:///doi.org/10.1002/symb.412.

Marzetti, Hazel. 2018. “Proudly Proactive: Celebrating and Supporting LGBT+ Students in Scotland, Teaching in Higher Education.” Teaching in Higher Education 23 (6): 701–17. https://doi.org/10.1080/13562517.2017.1414788.

McBride, Ruari-Santiago, and Aoife Neary. 2021. “Trans and Gender Diverse Youth Resisting Cisnormativity in School.” Gender and Education 33 (8): 1090–107. https://doi.org/10.1080/09540253.2021.1884201.

McGlashan, Hayley, and Katie Fitzpatrick. 2018. “‘I Use Any Pronouns, and I’m Questioning Everything Else’: Transgender Youth and the Issue of Gender Pronouns.” Sex Education 18 (3): 239–52. https://doi.org/10.1080/14681811.2017.1419949.

McInroy, Lauren B. 2016. “Pitfalls, Potentials, and Ethics of Online Survey Research: LGBTQ and Other Marginalized and Hard-to-Access Youths.” Social Work Research 40 (2): 83–93. https://doi.org/10.1093/swr/svw005.

Mckendry, Stephanie, and Matson Lawrence. 2017. “Researching the Experience of Trans and Gender Diverse Applicants, Students and Staff in Scotland’s Colleges and Universities.” Glasgow: University of Strathclyde.

Mertens, Donna M. 2009. Transformative Research and Evaluation. New York: The Guildford Press.

Mertens, Donna M. 2019. Research and Evaluation in Education and Psychology: Integrating Diversity with Quantitative, Qualitative, and Mixed Methods. Los Angeles: SAGE.

Nadal, Kevin L., Kristin C. Davidoff, Lindsey S. Davis, and Yinglee Wong. 2014. “Emotional, Behavioral, and Cognitive Reactions to Microaggressions: Transgender Perspectives.” Psychology of Sexual Orientation and Gender Diversity 1 (1): 72–81.

Nicolazzo, Z. 2016. “‘Just Go In Looking Good’: The Resilience, Resistance, and Kinship-Building of Trans* College Students.” Journal of College Student Development 57 (5): 538–56. https://doi.org/10.1353/csd.2016.0057.

Nicolazzo, Z, Erich N Pitcher, Kristen A Renn, and Michael Woodford. 2017. “An Exploration of Trans* Kinship as a Strategy for Student Success.” International Journal of Qualitative Studies in Education 30 (3): 305–19. https://doi.org/10.1080/09518398.2016.1254300.

Office for Students. 2019. “Mental Health—Are All Students Being Properly Supported?” Bristol: Office for Students. https://www.officeforstudents.org.uk/media/b3e6669e-5337-4caa-9553-049b3e8e7803/insight-brief-mental-health-are-all-students-being-properly-supported.pdf.

Open University. 2014. “Ethics Principles for Research Involving Human Participants.” Milton Keynes: Open University. /www.open.ac.uk.research/files/files/ecms/research-pr/web-content/Ethics-Principles-for-Research-involving-Human-Participants.pdf.

Page, Michelle L. 2016. “LGBTQ Inclusion as an Outcome of Critical Pedagogy.” International Journal of Critical Pedagogy 7 (1): 115–41.

Pino, Mark. 2016. “The Necessity of LGBT-Inclusive Curriculum.” HuffPost, February 2, 2016. https://www.huffpost.com/entry/the-necessity-of-lgbt-inclusive-curriculum_b_6928438.

Powell, John A., and Stephen Menendian. 2016. “The Problem of Othering: Towards Inclusiveness and Belonging.” Othering and Belonging 1: 14–40. https://www.otheringandbelonging.org/the-problem-of-othering/.

Pulice-Farrow, Lex, Sebastian B Mcnary, and M Paz Galupo. 2020. “‘Bigender Is Just a Tumblr Thing’: Microaggressions in the Romantic Relationships of Gender Non-Conforming and Agender Transgender Individuals.” Sexual and Relationship Therapy 35 (3): 362–81. https://doi.org/10.1080/14681994.2018.1533245.

Santis, Esteban Leonardo. 2022. “Otherness: An Unfinished Project in Public Administration.” Administrative Theory & Praxis 44 (2): 133–42. https://doi.org/10.1080/10841806.2021.1918989.

Schucan Bird, K, and Lesley Pitman. 2020. “How Diverse Is Your Reading List? Exploring Issues of Representation and Decolonisation in the UK.” Higher Education 79: 903–20. https://doi.org/10.1007/s10734-019-00446-9.

Seelman, Kristie L. 2014. “Transgender Individuals’ Access to College Housing and Bathrooms: Findings from the National Transgender Discrimination Survey.” Journal of Gay & Lesbian Social Services 26 (2): 186–206. https://doi.org/10.1080/10538720.2014.891091.

Sevelius, Jae M, Deepalika Chakravarty, Samantha E Dilworth, Greg Rebchook, and Torsten B Neilands. 2020. “Gender Affirmation through Correct Pronoun Usage: Development and Validation of the Transgender Women’s Importance of Pronouns (TW-IP) Scale.” International Journal of Environmental Research and Public Health 17 (24): 1–13. https://doi.org/10.3390/ijerph17249525.

Slater, Jen, and Charlotte Jones. 2018. “Around the Toilet: A Research Project Report about What Makes a Safe and Accessible Toilet Space.” Sheffield: Sheffield Hallam University. https://doi.org/10.7190/9781843874195.

Storrie, Rhiannon, and Poul Rohleder. 2018. “‘I Think If I Had Turned up Sporting a Beard and a Dress Then You Get in Trouble’: Experiences of Transgender Students at UK Universities.” Psychology & Sexuality 9 (4): 317–28. https://doi.org/10.1080/19419899.2018.1492435.

Strunk, Kamden K., and Jasmine S. Bettles. 2019. “Using Critical Theory in Educational Research.” In Research Methods for Social Justice and Equity in Education, edited by K. K. Strunk and L. A. Locke,, 71–79. London: Palgrave Macmillan. https://doi.org/https://doi.org/10.1007/978-3-030-05900-2_6.

Swanbrow Becker, Martin A, Stacey F Nemeth Roberts, Sam M Ritts, William Tyler Branagan, Alia R Warner, and Sheri L Clark. 2017. “Supporting Transgender College Students: Implications for Clinical Intervention and Campus Prevention.” Journal of College Student Psychotherapy 31 (2): 155–76. https://doi.org/10.1080/87568225.2016.1253441.

Thurairajah, Kalyani. 2019. “Uncloaking the Researcher: Boundaries in Qualitative Research.” Qualitative Sociology Review 15 (1): 132–47.

Trochim, William M.K. 2022. “Descriptive Statistics.” Research Methods Knowledge Base. https://conjointly.com/kb/descriptive-statistics/.

Turton, Stephen. 2021. “Deadnaming as Disformative Utterance: The Redefinition of Trans Womanhood on Urban Dictionary.” Gender and Language 15 (1): 42–64. https://doi.org/10.1558/genl.18816.

UCAS. 2021. “Next Steps: What Is the Experience of LGBT+ Students in Education?” Cheltenham: UCAS. https://www.ucas.com/file/535266/download?token=XF_6zKDw.

Vincent, Benjamin William. 2018. “Studying Trans: Recommendations for Ethical Recruitment and Collaboration with Transgender Participants in Academic Research.” Psychology & Sexuality 9 (2): 102–16. https://doi.org/10.1080/19419899.2018.1434558.

Vries, Elma De, Harsha Kathard, and Alex Müller. 2020. “Debate: Why Should Gender-Affirming Health Care Be Included in Health Science Curricula?” BMC Medical Education 20 (51): 1–10. https://doi.org/10.1186/s12909-020-1963-6.

Wall, Catherine S.J., Alison J. Patev, and Eric G. Benotsch. 2023. “Trans Broken Arm Syndrome: A Mixed-Methods Exploration of Gender-Related Medical Misattribution and Invasive Questioning.” Social Science & Medicine 320: 115748. https://doi.org/10.1016/J.SOCSCIMED.2023.115748.

Ward, Peter, Taralyn Clark, Ramon Zabriskie, and Trevor Morris. 2012. “Paper/Pencil Versus Online Data Collection: An Exploratory Study.” Journal of Leisure Research 44 (4): 507–30. https://doi.org/10.1080/00222216.2012.11950276.

Women and Equalities Committee. 2015. “Transgender Equality—First Report of Session 2015-16 Report, Together with Formal Minutes Relating to the Report.” London: The Stationery Office Limited.