A survey study on knowledge, comfort, and confidence in gender-affirming care among pharmacy students following a two-phased educational intervention

Transgender and gender-diverse individuals continue to experience significant health disparities, often exacerbated by healthcare providers' lack of preparedness in delivering gender-affirming care (GAC). To address this gap in pharmacy education, a two-phase instructional intervention was implemented at a school of pharmacy with the objective of improving pharmacy students' perceived knowledge, comfort, and confidence in providing GAC. Educational activity: The intervention included a required 2-h didactic lecture on lesbian, gay, bisexual, transgender, queer/questioning and other cultural competence and pharmacotherapy, followed by a small-group case conference one week later. A 16-item survey assessing perceived knowledge, comfort, and confidence in providing GAC was administered to students at three timepoints: pre-lecture, post-lecture, and post-case discussion. Responses were analyzed using the Friedman test. Survey reliability was assessed using intraclass correlation coefficients (ICC) and Cronbach's alpha. Evaluation of findings: A total of 141 students underwent the educational activity, with 24 completing all surveys. All knowledge and confidence items showed significant improvement across timepoints. Three of six comfort items demonstrated significant gains. The ICC for all items exceeded 0.50, and Cronbach's alpha values were consistently >0.80. Analysis of educational activity: A brief, two-phase educational intervention significantly improved pharmacy students' perceived knowledge and confidence, and modestly improved comfort, in providing GAC. These findings support the use of spaced, multimodal instruction grounded in adult learning theory to enhance student preparedness in caring for transgender and gender-diverse individuals. Integration of GAC content into pharmacy curricula may address gaps in training, align with accreditation standards, and promote health equity.