So, Where Do We Begin?
Starting the Journey to Gender-Affirming Care in Pharmacy
We’re diving into gender-affirming care in pharmacy this month — this article explores the foundational principles of gender-affirming pharmacy practice, with a focus on respectful communication, inclusive service delivery, and supporting trans and gender-diverse (TAGD) patients across community and clinical settings.
This article is accompanied by a CPD module, hosted on lrnrx, which explores these topics in detail through interactive learning built with Articulate Rise. Whether you're a pharmacist, intern, student, or assistant, this course will help you build on your values of care, dignity, and inclusion.
Walk into any pharmacy in Australia and you’ll witness care in action: questions asked, medicines explained, scripts filled, trust exchanged. But for many trans and gender-diverse (TAGD) people, pharmacies can also be sites of harm — not because pharmacists don’t care, but because we may not yet have the tools to truly show up with the knowledge, respect, and sensitivity that affirming care requires.
As healthcare professionals at the intersection of medicine and community, pharmacists are often the first point of contact for people seeking advice, medications, and support. Yet for TAGD patients, these encounters can sometimes be uncomfortable or even distressing when care isn’t inclusive. This harm is rarely intentional — it often stems from a lack of awareness about the nuances of gender identity and expression.
Misgendering, deadnaming, or being questioned inappropriately about prescribed medications are unfortunately common experiences for TAGD individuals in healthcare. These interactions can damage trust, delay access to essential care, and contribute to the emotional toll many already carry. In some cases, they become a barrier to accessing healthcare altogether.
That’s why affirming pharmacy practice matters. It’s not just about dispensing the right medicine — it’s about upholding each patient’s dignity throughout their healthcare journey.
What is Gender-Affirming Pharmacy?
Gender-affirming care refers to healthcare that supports a person’s gender identity and expression while acknowledging and valuing their lived experience. It’s about creating safe, inclusive spaces where individuals feel seen, respected, and empowered in their healthcare journey.
In pharmacy, gender-affirming care goes beyond simply dispensing hormones. It includes:
Using affirming language that respects gender identity;
Ensuring privacy and confidentiality at the counter and beyond;
Having clinical knowledge of gender-affirming treatments, including hormones, puberty blockers, and surgical options;
Understanding the unique barriers TAGD individuals face when accessing care;
Creating a safe, non-judgemental space where all patients feel supported.
At its core, gender-affirming pharmacy practice isn’t about being an expert in TAGD healthcare. It’s about being a pharmacist who listens, respects, and provides safe, dignified care to every patient.
Language Builds Trust
Words matter. The language we choose can significantly impact the level of trust a patient feels when interacting with a pharmacist. Small but powerful changes in how we speak can foster an environment of inclusion and respect. Below are key language guidelines, adapted from TransHub’s guidance, that help affirm gender diversity in our practice.
When speaking about or with trans and gender-diverse people, it’s important to use affirming and respectful language. For example, say “legal name” or “name on Medicare” rather than “real name,” as the latter can imply that a trans person’s affirmed name is somehow fake or less valid. Similarly, use “pronouns” instead of “preferred pronouns”—everyone has pronouns, and they’re not just a preference.
When referring to someone’s sex assigned at birth, use terms like “assigned male at birth (AMAB)” or “assigned female at birth (AFAB)” rather than “biological male/female.” These terms acknowledge that sex is assigned, not inherently tied to someone’s identity. And when describing a person, say “a trans person” or “a transgender woman/man”—avoid outdated and incorrect terms like “a transgendered” or “a transgender.”
It’s also important to avoid language that is outdated or harmful. Use “gender affirmation surgery” or refer to the specific procedure instead of saying “sex change,” which is considered reductive and inaccurate. If referring to intersex people, use the term “intersex”—not “hermaphrodite,” which is outdated and offensive. Avoid using the term “transsexual” unless it’s how someone self-identifies, and never use slurs such as “tranny.”
By using inclusive, affirming language, we help create safer and more respectful spaces for trans, gender-diverse, and intersex people—both in healthcare and beyond.
Always follow the patient’s lead when it comes to how they describe themselves. When in doubt, ask respectfully — or don’t ask at all if it isn’t clinically necessary.
Building a Strong Foundation
Affirming pharmacy practice begins with understanding and respect — starting with a shared vocabulary around gender identity.
Gender identity is a person’s internal sense of self — who they are. Some people identify as women or men; others as non-binary, agender, or elsewhere on the gender spectrum.
Gender expression is how someone outwardly communicates their gender — through clothing, voice, body language, and more. It’s not the same as gender identity.
Biological sex refers to physical traits like chromosomes or hormone profiles, typically assigned at birth. But biological sex is also a spectrum — not everyone fits into binary categories.
Intersex people are born with natural variations in sex characteristics. This is more common than many realise, and these variations are not inherently pathological.
Sexuality — or sexual orientation — is about who someone is emotionally, romantically, or physically attracted to. It exists independently of gender identity and biological sex.
Key Glossary Terms
AFAB/AMAB: Assigned female/male at birth.
Binary: A term for male/female genders; non-binary includes all others outside this dichotomy.
Brotherboy / Sistergirl: Aboriginal and Torres Strait Islander terms for gender-diverse individuals with strong cultural identity.
Cisgender: Someone whose gender identity aligns with their birth assignment.
Deadname: A trans person’s former name before affirmation.
Dysphoria / Gender euphoria: Emotional responses to being misgendered vs. being affirmed.
Endosex: A term for people who are not intersex.
Gender affirmation: The process of aligning gender identity with social, medical, and legal aspects.
GRS / HRT: Gender-affirming surgeries and hormone therapies.
Misgendering: Referring to someone using incorrect pronouns or gender terms.
Non-binary: Identities outside the male/female binary.
Tanner Stages: A puberty scale often used in clinical contexts.
The Bottom Line
Many pharmacists are already doing the work — listening, learning, and supporting trans and gender-diverse people every day. But there’s always room to grow.
Affirming care isn’t about perfection or expertise. It’s about showing up — with empathy, humility, and a willingness to learn. By building a strong foundation of understanding, using inclusive language, and staying committed to affirming practice, we can help ensure every person who walks into our pharmacy feels seen, respected, and safe.