Leveraging pharmacists' scope of practice to improve access to gender‐affirming care: A scoping review
Bibliographic record
Abstract
Abstract Background Transgender and gender‐diverse (TGD) individuals experience health inequities at a substantially higher rate than their cisgender counterparts. Gender‐affirming care (GAC) is a lifesaving measure that encompasses a range of social, psychological, behavioral, and medical interventions designed to affirm an individual's gender identity. Access to GAC is limited worldwide and pharmacists may be optimally situated to bridge this gap. Objectives To determine strategies to improve access to GAC within community pharmacists' scope of practice for TGD patients. Methods This was a scoping review of published literature. Three databases (PubMed, Embase, and CINAHL) were searched and supplemented with a manual citation to yield 324 articles. Articles were included if they described or evaluated GAC services performed by pharmacists. Screening and extraction were conducted independently by two reviewers. Extracted data was mapped into six categories (prescribing, monitoring, patient education and counseling, healthcare advocacy, interprofessional and collaborative care, and non‐pharmacological), which were identified during the extraction process to represent GAC initiatives. Results Twenty‐one articles met the inclusion criteria from the 324 articles initially screened. Most articles were published in the United States ( n = 17). More than half of the articles described prescribing ( n = 12), monitoring ( n = 15), and patient education and counseling ( n = 17). Healthcare advocacy was mentioned in 9 articles, with interprofessional and collaborative care being mentioned in 8 articles. Non‐pharmacological care was the least mentioned among the six categories ( n = 2). Conclusions Current literature shows that pharmacists' scope of practice can be leveraged to provide GAC through prescribing medications, monitoring therapy, educating and counseling patients, advocating for TGD individuals within the healthcare system, providing collaborative care, and through the provision of non‐pharmacological GAC options.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.022 | 0.101 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.004 |
| Bibliometrics | 0.020 | 0.019 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.006 | 0.006 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".