Providing gender-affirming care on rotation

Jordan Manno is a final-year PharmD candidate at The University of New Mexico College of Pharmacy.

In the fall, I had the opportunity to experience a nontraditional rotation at Truman Health Services in Albuquerque, NM. This rotation was different in the sense of the patient population being served as well as the services being provided. Within this rotation, I was able to serve an LGBTQ+ patient population by helping provide gender-affirming care as well as other types of services such as diabetes medication management and cardiovascular risk reduction.

This rotation was unique to me because hormone therapy and/or gender-affirming care is not an area of pharmacy that was covered much in my pharmacy school. I recall having a single lecture covering this type of care, and that lecture is what initially sparked my interest in pursuing a rotation in this pharmacy practice area.

Communicating with patients

On rotation, I came to realize that an important aspect of providing excellent care for this patient population is using the correct language. Language is important because you want to ensure your patient is comfortable when you are communicating with them and that you’re able to refer to them with the appropriate terms. Proper language helps to develop trust and rapport in this patient population. Some terminology to be familiar with is designated male at birth; designated female at birth; gender identity; trans, nonbinary; and especially pronouns including she/her, he/him, and they/them. A quality source to become familiar with these terms is Trans Student Educational Resources.

There are 2 types of hormone therapy: masculinizing hormone therapy and feminizing hormone therapy. Most of the new patients that we saw in clinic seeking gender-affirming care were adolescents, so these initial visits were spent on hormone therapy education with the patient and their parent/guardian. When initiating either masculinizing hormone therapy or feminizing hormone therapy, it is important to discuss with the patient the physical effects they can expect to see, when they can expect to see them, and the duration as some of these effects can be permanent. During initial visits, we also discussed safety and possible adverse effects of the medications and determined which formulation the patient desired for their care. It’s very patient-inclusive and centered on helping patients attain their care goals.

Emotional visits

I will attest that gender-affirming care visits can be emotional for the patient and/or their parent/ guardian. These emotions can be both positive and negative, which is important to be aware of when approaching an initial visit.

Throughout my rotation, my preceptor voiced that her favorite aspect of providing gender-affirming care was the ability to ask patients what they were most excited for when starting hormone therapy, which isn’t a typical question you get to ask patients who are starting a new medication. I have to say that this was also a favorite aspect of my rotation because you get to help an individual pharmacologically express themselves more fully and be who they want to be.