Michigan Society of Community Pharmacists recognizes Transcend the Binary co-founder, Darnell Jones, RPh, with distinguished honors for his dedication to the transgender community. 

Gender Confirming Consultant Pharmacist

by Darnell Jones, R.Ph.

What is gender confirming consultant pharmacy (GCPC)?

GCPC is a self-developed practice setting involving the assistance and education of transgender individuals on the hormone therapies involved with gender transitioning. It also involves removing the obstacles to their care along with connecting and assisting them with the other resources they may need.

What is the role of a gender confirming consultant pharmacist?

In my role, I act on a volunteer basis to assist members of the transgender community as a liaison to their physician when starting or continuing their hormone therapies. I also frequently serve as an information bridge for either patients whose doctors work on informed consent or filling information gaps for patients moving from their gender therapists to physician care. In that capacity, I explain in detail the expected effects, benefits and risks, and possible health interactions of their individual therapies, hormone and otherwise. Because it has been a self-developed role, I have also taken active roles in removing financial- or resource-driven obstacles to their care and have, as of late, also assisted in improving their social support networks if necessary. The patients I take on will usually make me their primary communication hub to ensure smooth communication, problem solving and transition therapy maintenance. In many instances, I will work in collaboration with the patient’s doctor in the dosing and monitoring of the medications, blood lab values and external end points involved in safe, effective transitioning.

How can you prepare for a career as a gender confirming consultant pharmacist?

Though it’s difficult to answer that precisely because I’ve developed this on my own, I can talk about what I’ve done to prepare. I have studied and researched the multiple schools of practice on transition hormone therapy and familiarized myself with their benefits, risks and histories of effectiveness. I also see a strong value in becoming sincerely integrated into the transgender community on some level, as an educator, advocate, supporter, etc. I share this because, sincerely, you must develop trust and cultural competency in order to become effective and because you will gain your greatest education and insight from the community and your experience with them.

What is in the future for gender confirming consultant pharmacy?

It is my vision that the model matures in several areas. 1. It becomes a more formalized and repeated model across the country; 2. The pharmacist ultimately becomes the hub of both entry and communication for all points of the transgender individual’s care. Whether on their own, or from a physician, therapist, support group or even economic group, the patient will see pharmacists as the logical professional to reach out to next to help empower, educate and connect the individual as they seek to strengthen their journey; and 3. I will be able to mature this model into a self-sustaining practice by showing its validity to qualify for funding either by grants, donations or sponsorships.

How long have you practiced as a gender confirming consultant pharmacist, and what interested you about this practice area? 

I began practicing and developing this practice model in June 2013 as a once weekly volunteer

service initiative out of Affirmations LGBTQ center in Ferndale. I was drawn to explore and construct this practice model as a method to better serve and strengthen the transgender community coupled with seeking a method to use pharmacy skill sets to directly impact the health disparities shown as focus points for the transgender population in the Healthy People 2020 initiative. Most notable were the points concerning the lack of educated health professionals available, the lack of safety and comfort in practice settings, and the lack of trust inherent in the transgender community regarding health professionals. I also see this as a way to help increase the overall empowerment and positive self-imaging of those I serve.

How has your role as a gender confirming consultant pharmacist evolved during your career?

Since I’ve begun on this path, I’ve seen my role grow and change immensely. It’s evolved from an information dispersal service to much more of a health navigator model. I now see health information, start-of-care planning assistant, liaison to other health divisions and social support connector among my descriptors. And, most notably in my opinion, serving as an all-important interface between the individual and their transition, allowing them to feel empowered to monitor and question their progress or difficulties without the fear of possible repercussions of having their care altered or stopped. While this may be real or imagined, having that safe space has, I’ve been told time and again, been vital to their peace of mind and overall well-being.

What motivates you to continue practicing in this area?

I’m motivated primarily by my recognition of the intense need to reduce the health and social inequities of the transgender community and my ability to assist in this. I’m also drawn to the intense satisfaction of seeing this branch of pharmacy as being one of such positive power in the fulfillment of many patient needs. It has become one more aspect in my continuing service to this and the LGBT community at large. As an ally, I seek to do all I can daily and this form of practice and service fits that desire well.

What is one thing that you would want student pharmacists and other pharmacy professionals to know about gender confirming consultant pharmacy?

I have no idea if others are in the practice phase of this model but I would like to share that it is a model in its infancy and I currently practice it as a volunteer service. I have, however, been immensely rewarded many times over by the sense of satisfaction I feel from this proud pharmacy model. I would hope that any who would like to see this area become more real and sustainable would contact me. I would only ask that you be the caliber of person and pharmacist who sees the increase in the human condition as a primary return on investment, and I know the rest will follow from that.

I have [sic] been immensely rewarded many times over by the sense of satisfaction I feel from this proud pharmacy model.

 

[To those who wish to support this model], I would only ask that you be the caliber of person and pharmacist who sees the increase in the human condition as a primary return on investment, and I know the rest will follow from that.

MSCP Pharmacist of the Year Recipient: Darnell Jones 

Darnell Jones is a 1984 graduate of the University of Illinois who has practiced in the retail/community setting for his entire career. He began giving back to his profession as a pharmacy preceptor at CVS. Early on, he was given the opportunity to attend a meeting of Affirmations, a support group for lesbian, bisexual, gay and transgender (LBGT) individuals as well as their allies, at the Metro Detroit Community Center. This meeting is what Darnell credits as having “opened his eyes” to the medical needs unique to the transgender community.

When caring for transgender patients, Darnell emphasizes that it isn’t just about the medications and prescribing. Health care for these individuals is far more immersive, and has significant cultural implications. Gender reassignment is an intricate procedure involving a series of surgeries and a specific prescribing format of hormones and other therapies to successfully complete the transition. He notes that many times the patients actually know more than the providers about their specific health care needs. This is why Darnell serves as an educational liaison for the transgender community, seeking to ensure that these patients have at least one provider who is knowledgeable about their health care needs. “Healthy People 2020 indicates this population as having one of the greatest health disparities,” he notes.

Additionally, Darnell recognizes the medications taken by these individuals as being “different from any other therapy.” The transgender populations have a highly disproportionate rate of anxiety and suicide due to societal and economic pressures.

To ease the tensions of this community, Darnell notes that it takes more than providers just being familiar with the medications. Additionally, he recommends that providers commit extra effort to communicate that their practice is “trans-friendly.” Some steps that can be taken in the retail setting include:

• Distribution of publications that are LBGT friendly
• Implementation of (gender-neutral) rather than gender-specific facilities
• Support and advertising for local LBGT friendly organizations

Darnell actively encourages his fellow practitioners to get involved with the community, and  encourages anyone with questions to reach out to him by e-mail at labofvlad@sbcglobal.net. “To respond to the patient community, you must be part of the community,” he states. “You learn by experience, especially when the education in these areas is still being written.”

by Eric Roath, Pharm. D, director of professional practice, Michigan Pharmacists Association