‘Support doesn’t always come in the form of a prescription’: U of T students hear from Two-Spirit trans advocate

Shasha Wolfe, an Indigenous Two-Spirit trans woman, grew up in the small community of Doig River First Nation, BC, with no awareness that gender-affirming care existed. When she moved to Vancouver at age 19, she learned that this care was available, but accessing it was neither easy nor positive.At the busy clinic she visited, her concerns about treatments weren’t adequately addressed, and she wasn’t made aware of other options that might have been available. These experiences limited her motivation to seek the care she needed.Wolfe, who now lives in Toronto, recently shared those experiences with University of Toronto pharmacy students during a conversation with Jaris Swidrovich, assistant professor at the Leslie Dan Faculty of Pharmacy.The session provided students with an important patient perspective and helped students gain a better understanding of the importance of gender-affirming and patient-centred care.“Too often, conversations about transgender health in professional programs focus exclusively on the medical components of care,” said Swidrovich. “Bringing Shasha into the classroom created an opportunity for students to learn from lived experience and to better understand the human, social and structural realities that shape people’s experiences with healthcare.” “Those perspectives are essential for providing compassionate, patient-centred care.” “Healthcare providers need to keep an open mind and recognize that people are different. There are many different approaches to gender-affirming care, and support doesn’t always come in the form of a prescription,” said Wolfe. “Being in the classroom and seeing students be so open and receptive to hearing my story was encouraging. Hopefully they’ll remember that experience and use it to help other people who face similar barriers.”The University of Toronto’s three-year PharmD program includes a series of Applied Therapeutics courses, designed to provide students with the knowledge and skills to support their role as care providers, professionals and health advocates, through the provision of pharmacy care. The third course, Applied Therapeutics 3, focuses on endocrinology and reproductive health, exploring the social, ethical, cultural and structural factors that influence healthcare experiences and outcomes.“These conversations are integrated directly into therapeutics education, so students can explore ethical, social and clinical issues alongside the therapeutic content itself. That integration creates much richer conversations and allows students to see how these concepts apply in practice,” said Alison Thompson, the faculty's associate dean of student success, and course co-coordinator of Applied Therapeutics 3 alongside assistant professor Jennifer Lake. “What makes this course particularly exciting is that it provides an opportunity to apply therapeutics to the real world and to real people’s lives.”Inviting people with lived experience to share their stories with students is an important part of helping students to learn patient perspectives, including the structural barriers that people face in accessing care and how they can shape outcomes.In Wolfe’s conversation with Swidrovich, she highlighted her experiences accessing healthcare, the importance of comprehensive gender-affirming care and how pharmacists can support trans people—which is not only about providing medications.“For me, gender affirmation isn’t only about hormones. It’s also about how I dress, how I do my hair, how I wear makeup and how I present myself every day. Those are all affirming practices. Even though I’m not medically transitioning, there are still many ways I can feel affirmed,” she said.“Healthcare providers are often helping people who may not even know what kind of care they need. Providers need to be educated so they can guide people toward the support that’s available and help them in the best way possible.”Awareness of patients’ intersectional identities helps ensure equitable care. Thompson said that the conversation between Wolfe and Swidrovich was a respectful and meaningful learning experience for students that highlighted the importance of considering the complexity of each individual and how pharmacists can support patients in different ways.“Pharmacists are experts in medications, but they are also information providers, educators and connectors to community resources,” said Thompson. “Whether it’s helping patients access gender-affirming products, connecting them with support services, or simply providing reliable information, pharmacists have an important role in making care more accessible.”She hopes that the session helps students develop a greater awareness of the diversity of patients they will see in their future practices, with different intersectional identities, social determinants of health, beliefs and experiences—and understanding that complexity is essential to providing effective, equitable care.“Pharmaceutical care is ultimately about caring for human beings who have rich, complex lives. Patients are never simply their diagnosis or disease,” said Thompson. “We want students to understand that patients have beliefs, values, preferences, goals and autonomy. Good care requires understanding how treatment aligns with those factors.”Eileen Hoftyzer is a freelance editor and writer based in Toronto, Ontario. This article is republished from the Leslie Dan Faculty of Pharmacy’s news site.

‘Support doesn’t always come in the form of a prescription’: U of T students hear from Two-Spirit trans advocate

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