# Pharmacists’ professional and service qualifications for the care of Trans, Travesti, and Gender-Diverse people in southern Brazil: a grounded theory study

## TL;DR

This study explores how prepared pharmacists in Brazil are to care for transgender and gender-diverse people, finding gaps in education and training that hinder inclusive healthcare.

## Contribution

The study provides novel insights into pharmacists' qualifications and challenges in delivering care to TTGD populations within Brazil's public health system.

## Key findings

- Pharmacists lack sufficient education on TTGD healthcare at all training levels.
- Cisheteronormative norms and regulatory constraints limit inclusive care.
- Engaging with TTGD narratives improves pharmacists' ability to provide respectful care.

## Abstract

Trans, Travesti, and Gender Diverse (TTGD) populations face barriers to healthcare, limited by the qualifications of health professionals; however, information on pharmacists’ qualifications to deliver this care is scarce in the literature.

To examine pharmacists’ professional and service qualifications to provide care for TTGD populations within the Brazilian Unified Health System (SUS) in a southern Brazilian capital.

A Grounded Theory study was conducted with ten pharmacists working in primary and secondary healthcare, within the SUS. Participants were recruited through theoretical sampling and included pharmacists employed in SUS services within the municipality, excluding pharmacy residency trainees. Semi-structured interviews were conducted in participants’ workplaces, audio-recorded, transcribed verbatim, and translated into English. Data were analyzed using open, axial, and selective coding with NVIVO® 14. The study received ethical approval from the Federal University of Santa Catarina and followed the COREQ guidelines.

Pharmacists’ qualifications were limited by insufficient undergraduate, postgraduate, and continuing education on TTGD healthcare. Contextual and intervening factors included cisheteronormative norms, regulatory constraints, and incidental engagement with TTGD narratives. Central phenomena involved knowledge gaps, communication difficulties, limited multidisciplinary collaboration, and a product-focused approach. Strategies ranged from respecting social names and pronouns to providing superficial service and referring TTGD users to specialized clinics. Consequences included feelings of not being qualified, negative emotions, and centralization of TTGD care in specialized services. Contact with trans narratives, however, facilitated more respectful and effective care.

Structural and educational reforms, professional training, curricular integration, engagement with TTGD narratives, multidisciplinary collaboration, and full implementation of the National Policy for Comprehensive Health Care for Lesbian, Gay, Bisexual, Travesti, and Trans Populations are critical to enhancing pharmacists’ capacity to provide inclusive, equitable, and humanized care within the Brazilian SUS.