Inside the Inaugural LGBTQ+ Pharmacy Course

A new course, conceived of by a current student, dives into health-care issues particular to the LGBTQ+ community

Story by Emma Ives | photos by Ryan McDaniel & Irene Ulrich | Published June 18, 2024

The UNC Eshelman School of Pharmacy is no stranger to firsts and being at the forefront of innovation and pharmacy education. This past spring, the School held its first Gender Affirming Care course, designed to focus on LGBTQIA+ health care and to educate the next generation of pharmacy students on caring for this population. “This class is one of the few of its kind in the country for pharmacy students,” says course TA and third-year PharmD student, Preetish Patil (he/him).

Preetish Patil

As a first year student, Preetish noticed a lack of LGBTQIA+ representation and topics within the PharmD curriculum. Inspired by the 2023 Asheville Summit (themed around Diversity, Equity, and Inclusion in the pharmacy space), he approached several faculty and staff members to create the course. “Creating this course meant doing my part to address health disparities and to educate the next generations of pharmacists in caring for my community,” he says. He was able to connect with alumna and Adjunct Associate Professor, Irene Ulrich, PharmD ‘12, MPH ’23 (she/her), and Amanda Storyward (them/they), Director for Organizational Diversity and Inclusion. Together, they drafted a course proposal for approval by the Curriculum Assessment Committee. “By having this class, we can ensure the students we train are confident and informed about how to approach patients with health-care trauma and affirm their patients’ identities,” states Amanda.

Irene Ulrich

When designing the course, Irene wanted to bring in many community partners to share their experiences with students to make them better clinicians. The course focused not only on what pharmacists needed to know clinically, but also critical thinking skills and cultural humility. She wanted students to have an opportunity to gain valuable exposure and to practice taking care of a historically marginalized patient group with well-documented health disparities. The course also gave students an opportunity to become familiar with what literature is available on this patient population and to develop some comfort in clinical “gray” areas. “Comprehensive gender-affirming care does not have large-scale, randomized, controlled trials to inform practice,” explains Irene.

Amanda Storyward

Amanda agrees, “It isn’t easy to get information about patient experiences, treatment guidelines, and what it looks like to exercise clinical judgement in a space where there is a lot more research to be done.” Students appreciated the discussion surrounding the data available and how best to apply it in clinical scenarios, as this content is not yet fully integrated into the current curriculum.

The responses from students who took the course were positive, with some saying it was their favorite elective. Fourth-year student, Kevin Cheng, wanted to take the class to better care for LGBTQIA+ patients and understand the hurdles faced by the community. “Although LGBTQIA+ identities are not disease states, they contain distinctive health-care concerns,” Kevin shares. “Currently, very few providers are educated about LGBTQIA+ health care . . .  [many] transgender people go into medical spaces expecting to need to educate their providers.”

The course discussed underlying causes of disparities among the community and how best to close the gaps in care. The final project for the course encouraged students to come up with provider or patient education materials to help close the knowledge gap surrounding LGBTQIA+ care. “I couldn’t be happier with how things went and how amazing the final student projects were,” explains Amanda. “I know that they’ll go into the world and make huge impacts on communities.” Many students commented they could see themselves using such materials while on immersion or in future practice.

Students also gave valuable feedback on what they want to see in future iterations of the course. The first iteration focused on mostly hormonal pharmacotherapy, with discussion of health-care disparities. In the future, there is hope to add in more pharmacotherapy for other conditions. “There is still not much data on how hormone replacement therapy affects health care/medicine dosing,” says Kevin. “It is important for UNC to stay ahead of the curve to continue producing the top pharmacists in the nation.” Irene and Preetish also discussed the addition of more patient simulations. “It would provide students with multiple chances to practice and build their patient interaction skills of being inclusive and non-assumptive,” shares Preetish. Amanda hopes the elective coursework ends up in the general curriculum in both the School and other health professional programs at UNC. “I’d like for it to become an interprofessional course, so all of our health science students can learn this together.”