Dr Tam Phan Highlights Positive Impact Pharmacists Can Have on Transgender, Nonbinary Patients


Tam C. Phan, PharmD, AAHIVP, assistant professor of clinical pharmacy, USC School of Pharmacy, explains why it's important for pharmacists to learn about and advocate for their patients who are transgender or gender nonbinary.

In general, more research and education on transgender or gender nonbinary health is needed, said Tam C. Phan, PharmD, assistant professor of clinical pharmacy, USC School of Pharmacy at the Academy of Managed Care Pharmacy Nexus 2022 fall meeting.


What is the pharmacist’s role in providing health care for individuals who are transgender or gender nonbinary?

Patients, typically when they're navigating through their transitioning process, it's typically a very complex and vulnerable time for the patient. As a health care team member, it is our job as pharmacists to help advocate for our patients, help them get access to the treatment that they're being prescribed or being initiated on, and also providing the right education in terms of what is the appropriate medication to take, how to take it, and what can they expect throughout their transitioning process. As medication experts, we should be responsible for knowing the impact and the outcomes of these medications.

What gender affirming therapies are currently available?

There are currently 2 types of gender affirmation therapy we can categorize, and that would be feminization therapy or masculinizing therapy for those who wish to transition to more of a feminine character or also a masculine character, respectively. Currently, for our feminizing therapy, we have our estrogen products that we can give and that's going to be similar to endogenous estradiol. We also use an androgen blocker, typically we see that with spironolactone. And overall the goal is then to increase the estrogen level for feminizing therapy to cisgender women, versus for men we use our testosterone product, and that could be coming in different formulations, so patches, injectables as well. And the idea there is to increase their testosterone levels, as well, to cisgender men level.

Are there other options you hope to see further researched?

The 2 that I've mentioned or the 3 classes of drugs I've mentioned in gender affirmation are commonly used, but there are also a couple of other medications that have antiandrogenic effects, for example. That would require more data in terms of its role in treatment and therapy because we have more data with the available products that we have now. So definitely more research in general for transgender health or gender nonbinary health is warranted.

What lesson do you hope student pharmacists took away from your session at AMCP Nexus, “The Impact of Managed Care Pharmacists on Transgender Care?”

That they don't have to be a pharmacist to positively impact transgender and gender nonbinary patients. Typically, from the moment they walk into a pharmacy, a clinic, or any type of health care setting, they're often interacted and historically have been facing microaggressions, for example. But as student pharmacists, if they're aware of the needs of our transgender and gender nonbinary communities, then they can start to first and foremost self-educate and then practice is what they have learned to create a more affirming environment for our patients.

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