The Gap between Transgender Women and Community Pharmacists regarding The Use of Feminizing Hormones: A Qualitative Study

Abstract

This research aimed to examine the gap between transgender women and community pharmacists regarding the use of feminizing hormones. Methods: This study was qualitative research that collected data from 21 transgender women and 23 community pharmacists in all regions of Thailand. Key informants were selected using purposive sampling combined with snowball sampling. Data were collected through in-depth interviews based on a semi-structured interview between February and October 2023. Data analysis was performed by content analysis. Results: The 21 transgender women had an average age of 29.8 ± 8.1 years. All the transgender women had knowledge about the efficacy and side effects of hormonal therapy, and they perceived positive attitudes toward the use of hormonal therapy as a tool to support them in becoming more feminine. Most transgender women purchased hormonal therapy from drug stores but learned about using hormonal therapy from transgender communities and social media, which increased the risk of incorrect medication use. Most of the transgender women have never received advice from community pharmacists about medication use, and they desired more guidance on hormonal therapy usage from community pharmacists. The 23 community pharmacists had an average age of 35.2 ± 9.1 years. All of the community pharmacists knew the efficacy and side effects of hormonal therapy. However, some of them were aware that contraceptive pills were not suitable for transgender women. Most of the pharmacists have not studied information about using hormonal therapy for transgender. They perceived those transgender women required prompt service at drug stores. Over-interviewing can make them uncomfortable, which may result in the community pharmacist lacking some details and dispensing inappropriate hormonal therapy for transgender women. Conclusion: Although most transgender women self-learned about using hormonal therapy, they still required guidance from community pharmacists. At the same time, community pharmacists expressed concerns that excessive questioning might cause discomfort for transgender women. Therefore, community pharmacists need to develop their knowledge and skills in providing healthcare services to transgender women.