Bridging the Gap in Transgender Health Care

Published on 15 March 2021

As the role of the pharmacist expands, so does the opportunity to help the medically underserved.

P4 student Rexhian “Reggie” Brisku, B.S. '18, is working to address health care disparities within the transgender community by helping to integrate transgender health care education into the pharmacy curriculum at St. Louis College of Pharmacy at University of Health Sciences and Pharmacy in St. Louis.

“There are more people who are transgender than there are people who have Type 1 diabetes,” Brisku said. “It’s important to recognize the needs and barriers of the transgender community since it’s a population we will care for in our future careers.”

After learning more about the barriers and health disparities that affect patients who identify as transgender, a spark was ignited within Brisku.

“When I first identified the gap in transgender health care education, I thought to myself – someone should change this,” Brisku said. “As I thought more about it, I realized I could help bring this topic to the forefront of pharmacy. Transitioning is a difficult process and not having the right support from health care providers makes it that much harder.”

Brisku was inspired to help bridge the gap between pharmacy education and transgender medicine by figuring out a way to not only educate himself on the topic, but his peers too.

“I knew the LGBT community had barriers, but I was surprised to learn about the lack of education that pharmacists and other health care professionals receive in terms of therapeutic protocols and experience working directly with patients who identify as transgender,” Brisku said. “As the medication experts, pharmacists are well positioned to assist patients with their medications.”

During his P3 year, Brisku collected demographic data and information about transgender health care from medical journals and articles.

“There isn’t a lot of existing research available that explains the best practices for working with patients who are transgender,” he said. “Medications used to help develop desired secondary sex characteristics while suppressing the undesired characteristics are considered off-label use because they are approved by the U.S. Food and Drug Administration for another use. It’s important for pharmacists to be just as knowledgeable in off-label use as approved use in order to better support patients who identify as transgender.”

Brisku collaborated with Metro Trans Umbrella Group, a nonprofit organization dedicated to creating an inclusive and supportive community in St. Louis, and Chris Lewis, M.D., pediatric endocrinologist and co-director of the Washington University Transgender Center at St. Louis Children’s Hospital.

“Working with the Metro Trans Umbrella Group and Dr. Lewis provided me with invaluable firsthand knowledge of the challenges that individuals face,” he said.

Once Brisku collected quantitative and qualitative data, he reported his findings to the University.

“Reggie’s report provided the education the faculty and curriculum committee needed to ensure this critical health care topic is included in our required pharmacotherapy course moving forward,” said Isaac Butler, Pharm.D., MBA, vice president for career services and education and chief diversity officer. “As pharmacists our main role is to provide patient-centered medication therapy to all patients that is inclusive of a patient’s culture and identities including their gender identity. The oath of a pharmacist states we will care for the well-being of society, and our students must be educated on transgender health to effectively provide patient care. “

After Brisku reported his findings, the University asked Lewis to serve as a guest lecturer in the special populations course to help educate student pharmacists on how to best support the transgender community.

“During the lecture, Dr. Lewis presented ways pharmacists can support their patients who identify as transgender and highlighted the current pharmacotherapy treatment strategies that are utilized for patients,” Brisku said. “He also shared the history of transgender health care, demographic data and barriers that people who identify as transgender experience when seeking treatment.”

In the future, Brisku hopes to publish his findings to encourage other universities to incorporate transgender health care into their pharmacy curriculums.

“When you are passionate about something, it doesn’t feel like work,” Brisku said. “I’m hopeful that by bringing awareness to health care barriers and taking the initiative to integrate transgender health care education at my University, others will be inspired to do the same. Each person can make a difference toward making positive changes within health care.”

The University is committed to fostering a diverse and inclusive environment that prepares students for a rewarding career in health care.

Learn more about diversity and inclusion at the University.

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