Confirmatory validation of the transgender health care humanization scale

BACKGROUND: Despite the critical importance of humanized healthcare for transgender individuals, no existing measures specifically assess care humanization for this population. The Transgender Health Care Humanization Scale (THcH Scale) was developed to address this gap, yet it initially lacked confirmatory validation. This study validates the Transgender THcH scale for evaluating healthcare providers' sensitivity towards transgender patients. METHODS: This study involved 443 healthcare professionals and students from a public university and associated hospital. Participants were divided randomly into two groups for Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). Using the Kaiser-Meyer-Olkin Measure of Sampling Adequacy and Bartlett's Test of Sphericity, EFA confirmed data suitability for factor analysis. Factors were identified using parallel analysis with an oblique Promax rotation to allow for inter-factor correlations. The internal consistency of the factors was assessed using Cronbach's alpha. CFA was performed using Maximum Likelihood estimation, with goodness-of-fit evaluated by multiple indices. The THcH Scale's divergent validity was assessed through Spearman's correlation analysis with the Duke University Religion Index (DUREL). RESULTS: Exploratory and Confirmatory Factor Analyses confirmed the scale's two-factor structure with excellent psychometric properties, including high internal consistency (Cronbach's alpha > 0.8) and good fit indices (χ²/df = 1.74, CFI = 0.972, TLI = 0.964, GFI = 0.989, RMSEA = 0.069, SRMR = 0.043). Divergent validity was established through moderate correlations with the DUREL index. CONCLUSIONS: The THcH scale is a reliable and valid tool for promoting sensitivity and awareness among healthcare professionals, thereby enhancing healthcare access and quality for the transgender population. Further research should expand its application to primary care and diverse populations and settings.