Evaluating Pharmacists’ Perceptions And Knowledge Of Transgender And Gender-diverse Healthcare

• By: MERCER, Julianne (University of Texas At Austin College Of Pharmacy, United States)
• Co-author(s): Dr Julianne Mercer (University of Texas at Austin College of Pharmacy, Austin, United States / University of Texas Health Science Center at San Antonio, San Antonio, United States)
  Dr Sarah Bandy (University of Texas at Austin College of Pharmacy, Austin, United States / University of Texas Health Science Center at San Antonio, San Antonio, United States)
  Dr Grace Lee (University of Texas at Austin College of Pharmacy, Austin, United States / University of Texas Health Science Center at San Antonio, San Antonio, United States)
  Dr Justina Lipscomb (University of Texas at Austin College of Pharmacy, Austin, United States / University of Texas Health Science Center at San Antonio, San Antonio, United States)
  
• Abstract:

  Background information: Many transgender and gender-diverse (TGD) individuals may seek gender-affirming hormone therapy (GAHT) to achieve physical changes congruent with their gender identity and minimize gender dysphoria. In addition, GAHT has been shown to mitigate depression, anxiety, and suicidality, all of which are disproportionately higher in TGD individuals than in cisgender individuals. Pharmacists have a role in optimizing these medically-necessary and lifesaving treatments' safety and efficacy. However, several studies demonstrate that pharmacists are poorly prepared to provide pharmaceutical care for TGD patients despite understanding that their role in TGD healthcare is important. It is unknown whether this lack of perceived preparedness has improved alongside the increasing social acceptability of TGD identities.
  
  Purpose: To evaluate pharmacists’ perceptions and knowledge of transgender and gender-diverse healthcare in Central Texas.
  
  Methods: Pharmacists were recruited to complete a de-identified survey assessing perceptions and knowledge of TGD healthcare. The survey was disseminated at a local professional meeting for pharmacists in Central Texas and during a didactic course for pharmacy residents in residency programs affiliated with the University of Texas at Austin College of Pharmacy. The demographic data collected included professional titles and prior education in TGD healthcare. The survey included 18 items related to perceptions and knowledge of TGD healthcare. Six multiple-choice items were regarding TGD healthcare knowledge with themes in health outcomes, GAHT, and preventative health screenings. Each knowledge question was assigned a value of “1” if answered correctly, and a composite score was calculated for each participant (score range = 0-6). The answers to Likert scale responses (1=strongly disagree to 5=strongly agree) and multiple-choice items were analyzed with descriptive statistics.
  
  Results: A total of 17 respondents completed the survey and were included in the final analyses. Twelve respondents (71%) were female. Seven respondents (41%) reported they were practicing pharmacists, while the others reported they were faculty, preceptors, pharmacy residents, or graduate students. Only six respondents (35%) reported that they received education regarding TGD healthcare during pharmacy school. Approximately 82% of respondents either agreed or strongly agreed regarding the importance of understanding the healthcare needs of TGD patients. All respondents strongly agreed or agreed that TGD patients deserved the same level of care as cisgender patients. Only one respondent strongly agreed that they were prepared to counsel patients or provide recommendations regarding GAHT. The median composite score for TGD healthcare knowledge questions was 4 (IQR, 3.5-4). About 47% of respondents answered questions regarding feminizing hormone therapy or masculinizing hormone therapy correctly.
  
  Conclusion: Although most pharmacists acknowledged the importance of understanding the healthcare needs of TGD patients, only a small number felt prepared to provide necessary services such as counseling and GAHT recommendations. These outcomes suggest that pharmacists have not made substantial improvements in bridging knowledge gaps, specifically concerning GAHT. It is essential to take measures that address these gaps which may be achieved through increased coverage of TGD healthcare in pharmacy curricula and post-graduate learning opportunities.