Date of Award

Summer 8-2020

Document Type


Degree Name

Doctor of Philosophy (PhD)


Health Services Research


Health Services Research

Committee Director

Shelley C. Mishoe

Committee Member

Robert J. Cramer

Committee Member

Linda K. Bennington

Committee Member

Bonnie Van Lunen


Sexual and gender minority (SGM) individuals endure a number of health disparities, such as higher rates of violence, mental health conditions, and more medical conditions. These disparities are exacerbated by the fact that SGM individuals face issues such as accessing health insurance, social support programs, and health service providers who are knowledgeable about SGM health issues. Certain health service provider governing organizations (i.e., the American Psychological Association, the Association of American Medical Colleges, and the Gay and Lesbian Medical Association) have recognized the need for guidelines regarding SGM care in recent years and published guidelines for health service providers regarding culturally competent care of SGM clients. SGM individuals represent a highly stigmatized and understudied population in regard to health service education and training.

The primary purpose of this dissertation was to understand health service providers SGM competency by developing a measure (the HCAF-SGM), examining theories (Dual Process Model of Prejudice and SIT) that may be related to SGM competency, and identifying correlates of SGM competency. Study one of the dissertation was a systematic review that examined rates and correlates of health service providers competency working with SGM individuals. Study two of the dissertation was a review of a psycho-educational training with military sexual assault victim advocates (SAVAs) serving SGM victims. Study three of the dissertation developed and assessed a measure of health service provider SGM competency.