Providing LGBTQ-Inclusive Care and Services At Your Pharmacy

[beautifulrobot]

Just came across this guide the other day and thought it was pretty neat to have a pharmacy-focused LGBTQ healthcare resource. Not to mention, I'm usually pretty skeptical of HRC, but it seems like they did a decent job with this (basic) guide: https://www.hrc.org/resources/providing-lgbtq-inclusive-care-and-services-at-your-pharmacy

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[Romz]

I like the quote at the end of the PDF. Acknowledging the patient for who they are, wherever they may lie on the LGBTQ spectrum, is a must. This means utilizing proper pronouns and the patient's preferred name of recognition, rather than their legal one.

I've made notes in the file so that Pharmacists and Auxiliary Staff can be sure to properly address the patient in situations where they have not undergone formal procedure to legally correct their name or gender. For example, our system requires the patient's legal name be entered in first and last name boxes for dispensing and insurance purposes. However, I'll add their preferred name in the middle name section or add a note onto the file itself. As title is not a legal requirement, I'll enter something like "Ms. Brad (Angelina) Pitt, Gender: Male" to give unaware staff a heads up all the while ticking the legal boxes required to their dispense medication.

 

[otterxavier]

I like the quote at the end of the PDF. Acknowledging the patient for who they are, wherever they may lie on the LGBTQ spectrum, is a must. This means utilizing proper pronouns and the patient's preferred name of recognition, rather than their legal one.

I've made notes in the file so that Pharmacists and Auxiliary Staff can be sure to properly address the patient in situations where they have not undergone formal procedure to legally correct their name or gender. For example, our system requires the patient's legal name be entered in first and last name boxes for dispensing and insurance purposes. However, I'll add their preferred name in the middle name section or add a note onto the file itself. As title is not a legal requirement, I'll enter something like "Ms. Brad (Angelina) Pitt, Gender: Male" to give unaware staff a heads up all the while ticking the legal boxes required to their dispense medication.

Love the hack of using the middle name field to encorporate the patient's preferred name. I've seen a lot of small bureaucratic acts of kindness from pharmacists toward trans patients, guidance jumping through insurance hoops, etc. ... it's great to have you in our corner!

 

[y0ssarian87]

Very cool, giga! LGBTQ care is particularly dear to me. A cousin of mine (who is gay) recently had issues with his health due to care that lacked cultural competence. He is not savvy about medical testing and pathophysiology, though he is engaged in his care. He is a responsible individual, and he has always gone regularly (3 to 6 months) to get STI testing. All his tests always came back negative. Shortly after one test that came back negative, he developed intense joint pain and fever. Because he couldn't afford to miss work he tried to go to work despite the pain, but had to leave shortly after and went to the ED. It turned out that he had a disseminated gonococcal infection that initiated in the throat (pharyngeal test was positive in the hospital). Unfortunately his primary care providers were not asking about his sexual behaviors, and they had only been performing urine testing for gonorrhea. I think he was on Rocephin for about a week, but he was in physical pain for many weeks after.


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[beautifulrobot]

Very cool, giga! LGBTQ care is particularly dear to me. A cousin of mine (who is gay) recently had issues with his health due to care that lacked cultural competence. He is not savvy about medical testing and pathophysiology, though he is engaged in his care. He is a responsible individual, and he has always gone regularly (3 to 6 months) to get STI testing. All his tests always came back negative. Shortly after one test that came back negative, he developed intense joint pain and fever. Because he couldn't afford to miss work he tried to go to work despite the pain, but had to leave shortly after and went to the ED. It turned out that he had a disseminated gonococcal infection that initiated in the throat (pharyngeal test was positive in the hospital). Unfortunately his primary care providers were not asking about his sexual behaviors, and they had only been performing urine testing for gonorrhea. I think he was on Rocephin for about a week, but he was in physical pain for many weeks after.


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@y0ssarian87 - Thanks for sharing this story. As tragic as it is, it greatly illustrates the dangers of not being mindful of sexual behavior diversity and of risk factors that may be more relevant to specific LGBTQ patient populations.

I remember once as a pharmacy student I had a very frustrating conversation with a faculty member about the importance of LGBT cultural competency. The faculty member said something along the lines of, "well, you would treat their hypertension the same way you would treat anyone's hypertension, so what does it matter?" and completely missing the point and proving it at the same time. It's not about treating people differently - people ultimately have the same needs - it's about knowing how to best approach their needs and account for differences in behavior and environment that can have an outcome on treatment. Even with hypertension, which is supposedly straightforward enough, I suppose I could ask all my patients if they use poppers, which might interact with their antihypertensives, but it might be more important to check in with my gay male patients about their popper usage. Not to mention, if I didn't have any LGBT cultural competency, I probably wouldn't even know what poppers were to begin with.

 

[y0ssarian87]

@y0ssarian87 - Thanks for sharing this story. As tragic as it is, it greatly illustrates the dangers of not being mindful of sexual behavior diversity and of risk factors that may be more relevant to specific LGBTQ patient populations.

I remember once as a pharmacy student I had a very frustrating conversation with a faculty member about the importance of LGBT cultural competency. The faculty member said something along the lines of, "well, you would treat their hypertension the same way you would treat anyone's hypertension, so what does it matter?" and completely missing the point and proving it at the same time. It's not about treating people differently - people ultimately have the same needs - it's about knowing how to best approach their needs and account for differences in behavior and environment that can have an outcome on treatment. Even with hypertension, which is supposedly straightforward enough, I suppose I could ask all my patients if they use poppers, which might interact with their antihypertensives, but it might be more important to check in with my gay male patients about their popper usage. Not to mention, if I didn't have any LGBT cultural competency, I probably wouldn't even know what poppers were to begin with.

I did a community pharmacy rotation in Houston last year, and I was shocked at the amount of sex shops there. Anyway, since I was staying in the "gayborhood" (Montrose), I decided to check one out near by. Right at the register, the store was selling Indian sildenafil literally right next to the poppers. No bueno.