Advanced pharmacy practice experiences (APPE) in academia as strategy to fill the gap on transgender health.

Dear editor,

We read the CPPI Pharmacy Forum article entitled “Strategies for inclusion of lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) education throughout pharmacy school curricula” by Llayton CK, and Caldas LM, published by Pharmacy Practice and would like to make some contributions.1

Llayton and Caldas provide excellent approaches for the inclusion of LGBTQIA+ education into pharmacy school curricula. However, psychosocial focused strategies to transgender care should be emphasized. In 2017, the American Society of Health-System Pharmacists (ASHP) adopted a policy to promote research on, education about, and development and implementation of therapeutic and biopsychosocial best practices in the care of transgender patients.2

A previous assessment of pharmacist’s readiness and the transgender patient’s perception of their readiness in Puerto Rico showed an overall positive attitude towards transgender care.3 Despite these perceptions, providers and transgender patients pointed out stigma, discrimination and lack of knowledge as barriers during healthcare process.3 The latter study correlates with national findings and suggest that, rather than mainly focusing on pharmacotherapy and clinical considerations, incorporating learning experiences with psychosocial emphasis may reduce the insensitivity and enhance cultural competence during provision of care.4,5 Moreover, educational efforts should foster empathy trainings that would allow the student to treat the transgender patient as a person and not as a medical condition.6

Future strategies may benefit from formats beyond the lecture style or panel discussion.5 For example, pharmacy schools may coordinate Advanced Pharmacy Practice Experiences (APPE) in academia where the student can address clinical and psychosocial aspects by engaging on activities such as research, literature review, design and implementation of educational initiatives like lectures, informational material and audio-visual production.4 A selective academia rotation offers the student an opportunity to work with pharmacy and non-pharmacy faculty members with expertise on transgender health. Furthermore, pharmacy schools can create agreements with LGBTQIA+ specialized clinics to provide the student with utmost experiences in ambulatory care settings. Ultimately, adopting a gender-inclusive curriculum that is not limited to clinical consideration and integrate social, economic and ethical principles may reduce stigmatization and discrimination while enhancing health outcome for transgender persons.2-6