Pharmacological management of transgender patients

Meghan Ross, Senior Associate Editor of Pharmacy Times, has written a call for Pharmacists to educate themselves on the "unique needs" of transgender patients: 5 Ways Pharmacists Can Help Transgender Patients

Transgender patients have unique health needs, but few health care professionals have received adequate training on how to best care for these patients.

--Ross

Bryan Bishop, PharmD, BCPS, clinical assistant professor at the University of Toledo College of Pharmacy and Pharmaceutical Sciences, recently wrote about pharmacotherapy considerations in the management of transgender patients in Pharmacotherapy.

Not being a peruser of that no-doubt fine journal, I'm glad Ms. Ross is.

Dr. Bishop told Pharmacy Times that he believes education on transgender patients warrants inclusion in diversity training at pharmacy schools and should also be a part of all health care professionals’ training.

In his review of pharmacotherapy considerations, Dr. Bishop noted that around 1 in 100,000 Americans are transgender women, and the number of transgender men is estimated at around 1 in 400,000. However, both of these figures are likely conservative.

Pharmacists who are interested in or specially trained in endocrinology and transgender health can get more involved in the care of these patients through counseling, medication therapy recommendations, dose adjustments, and adverse reaction management.

The promised Five activities in the title?

  • Direct transgender patients to the best available resources.

Within health care systems, providing education to staff—particularly on interactions with patients—is the best way to advocate. Having an inclusive, welcoming pharmacy or health care system is one of the best ways to advocate for transgender health care in my opinion.

--Dr. Bishop

  • Start a conversation.

Pharmacists should be sensitive about patients’ preferred gender identity, names, and pronouns. Dr. Bishop told Pharmacy Times that pharmacists should keep lines of communication open and use gender-inclusive terms when applicable.

  • Know the increased risks for transgender patients.

Pharmacists should know that transgender patients face increased risks for suicide attempts and tobacco, alcohol, and substance abuse. They are also more likely to experience significant stressors such as violence, discrimination, and abuse. (The latter being the divers of the former.--Robyn)

Dr. Bishop’s research cited a study that found 21% of transgender patients do not go to the emergency department because they fear their transgender status could negatively affect the encounter.

  • Identify barriers to care.

Dr. Bishop’s research cited a study that found 21% of transgender patients do not go to the emergency department because they fear their transgender status could negatively affect the encounter.

  • Help transgender patients and their families understand their medications.

Pharmacists can and should be an essential member of health care teams providing medical treatment to transgender patients.

Pharmacists can help inform and recognize when transgender patients are having adverse drug reactions associated with these medications and provide therapy recommendations if possible. Pharmacists can also help set expectations for patients regarding when changes should start to occur and how much of an effect they might experience from the medications.

--Dr. Bishop

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