Pharmacist, Advocate, Ally: Delivering Comprehensive Gender-Affirming Care

Over the last 10 years, society has become more aware and accepting of LGBTQ+ individuals, but this progress has been disproportionate among the identities. Among members of the LGBTQ+ community, 66% acknowledge there is more acceptance of transgender individuals today than 10 years ago, yet only 13% agree that transgender individuals currently experience a great deal or fair amount of social acceptance.¹

The tension between increased education and social inertia is particularly evident in health care, where transgender and gender-diverse patients often do not receive respectful, affirming treatment.

Now more than ever, pharmacists participate in direct patient care that gives them the opportunity to serve as both medication experts and supportive allies for transgender and gender-diverse patients. To explore the impact pharmacists can make in delivering gender-affirming care, researchers at the Pride Health Center within NYC Health + Hospitals/Bellevue constructed a pharmacist-led collaborative drug therapy management (CDTM) program. This CDTM allowed a board-certified ambulatory care pharmacist to independently initiate and titrate gender-affirming hormone therapy (GAHT), provide HIV prevention and sexually transmitted infection (STI) care, and manage comorbid chronic diseases.²

Program Outcomes and Patient Satisfaction

The CDTM program enrolled 70 patients, who completed a total of 223 pharmacist visits. The pharmacist documented 573 interventions, most commonly medication education (n = 107) and GAHT initiation (n = 76). Patient satisfaction was exceptionally high, with 95% of survey respondents strongly agreeing they were pleased with the service and 93% strongly agreeing they would return for another visit. Most notably, all 58 respondents (100%) reported feeling respected and supported by their pharmacist and were comfortable discussing their gender identity.²

Expanding the Pharmacist's Role in Gender-Affirming Care

The findings, published in the American Journal of Health-System Pharmacy (AJHP), indicate that pharmacists can serve as more than medication educators in gender-affirming care. A collaborative practice framework allows pharmacists to manage hormone therapy, adverse effects, and prior authorization barriers, as well as provide preventive care. This team-oriented approach between pharmacists and medical professionals can lighten physician workloads, therefore allowing more patients to be treated and making health care more accessible and efficient for the LGBTQ+ community.

Limitations and Future Directions

Although these findings demonstrate significant potential, methodological limitations warrant additional studies for support. Most notably, the study's generalizability is limited by its small sample size and reliance on a single urban safety-net hospital. Furthermore, because patient referrals were made at the discretion of primary care providers, the potential for selection bias is high. Despite these limitations, this pilot program demonstrates a viable model for broadening the scope of pharmacy practice in gender-affirming care.

Looking ahead, as health systems expand their LGBTQ+ services, integrating pharmacists will remain crucial to providing accessible, medication-focused, and patient-centered care.

About the Author

Marissa Hurd is a pharmacy student at the University of Connecticut School of Pharmacy and Pharmaceutical Sciences in Storrs, CT

REFERENCES

1. Minkin R, Horowitz JM, Lin L, Braga D. Social acceptance for gay, lesbian, bisexual, nonbinary and transgender people. Pew Research Center. Published May 29, 2025. Accessed September 14, 2026. https://www.pewresearch.org/social-trends/2025/05/29/social-acceptance-for-gay-lesbian-bisexual-nonbinary-and-transgender-people/

2. Gerber A, Rickard J. The impact of physician-pharmacist collaborative drug therapy management in gender-affirming care. Am J Health Syst Pharm. (2026). doi: 10.1093/ajhp/zxag278