Cross-sectional study links gender perception and homophobia among 447 health students

A cross-sectional study of 447 health education students found a statistically significant negative association between gender perception and attitudes toward homosexuality. The sample included students in Nutrition and Dietetics, Nursing, and First Aid and Emergency Care programs at Ağrı İbrahim Çeçen University. Researchers collected data between October 2021 and May 2022 and compared students’ total scores on scales measuring homophobia and gender perception.

The result indicates that students with higher gender-perception scores tended to report lower homophobia scores, although the design cannot establish that one measure causes the other. The association was examined with statistical modeling. A regression model testing whether gender perception accounted for variation in the homophobia score was statistically significant (F = 88.50, p < 0.001).

Gender perception explained 16% of the variance in the dependent variable, represented by R² = 0.16. Its model coefficient was negative and significant (β = −0.40; t = −9.408, p < 0.001). These results describe the relationship within the observed sample rather than a change in any individual student’s attitudes over time.

The researchers also applied SHAP values to evaluate the relative importance of variables in a model predicting the reported homophobia variable. Within that model, gender perception was identified as the most important variable for predicting the outcome. The study’s conclusion was that higher perceptions of gender were associated with lower levels of homophobia among the students surveyed.

SHAP values provided a model-based importance assessment, while the correlation and regression results quantified the association between the two measured constructs. The study’s stated rationale centers on homophobia as a social and public-health concern that may contribute to stigma, discrimination, and inequalities in healthcare. It also notes that gender perceptions and socially constructed gender roles may influence attitudes toward sexual and gender diversity.

Because students in these three fields are being prepared for healthcare professions, the investigators considered their attitudes relevant to the development of inclusive, equitable, and non-discriminatory healthcare practices. These points provide the study’s stated context rather than evidence that the measured attitudes produced better clinical care or patient outcomes. Several boundaries limit how far the findings can be generalized.

The investigation was cross-sectional, conducted at one university, and restricted to students in three health-related programs, so it does not establish whether the same pattern holds among all students, healthcare workers or the wider population. A time sequence was not measured, meaning the results cannot show whether shifts in gender perception precede shifts in homophobic attitudes. The study also does not establish that students’ attitudes changed after entering professional practice.

The available evidence therefore supports a precise conclusion: among 447 students at Ağrı İbrahim Çeçen University surveyed from October 2021 to May 2022, higher gender-perception scores were significantly associated with lower homophobia scores, and gender perception was the leading variable in the reported SHAP model for predicting that score.

Subject of Research: Association between gender perception and homophobia attitudes among students in three health education programs

Article Title: Investigation of the relationship between homophobia attitudes and gender perception among Nutrition and Dietetics, Nursing, First Aid and Emergency Care students

Article References: Dege, G., Elkoca, A., Yılmaz, Z., Yildirim, M. S., & Yıldız, M. (2026). Investigation of the relationship between homophobia attitudes and gender perception among Nutrition and Dietetics, Nursing, First Aid and Emergency Care students. BMC Medical Education. https://doi.org/10.1186/s12909-026-10174-1

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10174-1

Keywords: gender perception, homophobia attitudes, health education, cross-sectional study, student nurses, nutrition students, emergency care, regression analysis, SHAP values, Investigation, relationship, between