Expert: Advocacy, Support for LGBTQ+ Pharmacy Colleagues Is Crucial to Improving Representation

In an interview with Pharmacy Times, Liam Volk, MPharm, president-elect of the Pharmacists’ Defence Association LGBT+ Network, discussed how pharmacists can support their LGBTQ+ colleagues. Additionally, Volk discussed the recent end of the FDA’s ban on gay and bisexual men donating blood, saying it’s a good step, although more must be done.

Q: How can pharmacists provide support for their LGBTQ+ colleagues?

Liam Volk, MPharm: From what I can gather, the main things you could probably do is support them on a social level, because social transition is a really big indicator of someone's wellbeing. A lot of studies have shown—by social transition, I mean things like using a person's preferred pronouns, using a person's preferred name, allowing people to use the same sex facilities that match their gender identity—stuff like that, quite often can support someone to the point where, I think there's a study cited here in my notes, that says that children who are transgender, who were supported through social transition showed mental health at the same level as cisgender peers or siblings, whilst those who weren't supported in social transition didn't show as positive mental health as their peers and siblings. So it obviously makes a difference. I think it's really important to, on a personal level, press the social transition kind of support, because there's obviously a lot of issues getting access to the medical treatment and care that you need. So in some respects, it's a little bit of a band-aid or a plaster to put over the wound. I think it's a good first step to kind of always ensure that you're being mindful about someone's pronouns and preferred name.

Second thing I would say is—obviously because that’s not enough—would be to advocate on a local basis to make sure that local government and national and international and in America as well, federal government and state government, I would say, it's important to speak to your representatives in government to ensure that they're aware, and make sure that it doesn't go away, essentially. Make sure that we all stick up for our friends and allies, and know that this situation, which is fraught for particularly transgender people in the US and the UK, and the West in general, at the moment, try and improve it a bit. And I think we won't get there by being quiet, to say the least.

Q: The FDA just recently ended its ban on gay and bisexual men donating blood, instead implementing questionnaires for all potential donors, regardless of gender or sexual orientation. Can you discuss what this change means for gay and bisexual men, or others impacted by the ban?

Liam Volk, MPharm: First off, it's really good that it's more equal, and it's going to be the same forms for people regardless of their sexuality or gender identity, because I think being on the equal footing, is brilliant; it doesn't single out gay or bisexual men. It kind of is a bit of a departure from some of the old rules, which came about during the AIDS crisis in the 80s, where people like Thatcher in the UK and Reagan in America were very much sweeping AIDS and HIV under the rug, they didn't want to address it, they didn't want to talk about it. And there was kind of a general idea that gay and bisexual men in particular, but just the LGBT community in general, including transgender people, were undesirable. It was sort of, that blanket ban was kind of in place against everyone, and it kind of fostered an environment where people could justify discrimination against LGBT people. They sort of legitimized it in a way; it's very much, “Oh, the government sees them as undesirable, we shouldn't have their blood, they’re different to us.” I think it's very invalidating, because I've been in situations, I remember at the start of COVID, I was a really early person to catch COVID in the UK. And yet, there was all these ideas of like, “Oh, can we maybe click donate people's blood who have had COVID, for antibodies, blah, blah, blah.” I was kind of exempt from all that, because at the time, the laws were the same as in the US, which was that if you were a gay or bisexual man, it was really hard to donate blood, which in itself was quite invalidating. Again, you kind of feel a bit like a second-class citizen, and they kind of make you feel quite dirty and sort of undesirable.

So there's still a long way to go when it comes to this because I think, obviously, it's not perfect—the new changes for the FDA, same as in the UK—but I think it is a good step in the right direction. And I think we do need to address what we do next because it should be, the next step should be, how can we make it even more accessible for everyone to donate blood who physically can? I think technology will help a lot with that. And I think improvements to sexual health or health to that as well. I think PrEP is obviously going to be a really big help for dealing with HIV and other blood-borne illnesses as time goes on. There’s national shortages and international shortages of blood quite a lot at the moment. So I think it's really good that they've opened up these new supplies of blood. In the UK, we had our first ever amber alert last year, which meant that we had less than two days supply nationally of all blood types. So that's never happened before, and I think COVID kind of affected, obviously, the amount of healthcare workers who could actually be taking the blood, and it also affected the systems in place to allow people to donate blood. So I think that's caused a lot of issues. I think we need to be encouraging everyone we can to donate blood.

Q: Could this ban signal other changes in the health care landscape to better support and empower LGBTQ+ patients?

Liam Volk, MPharm: I would hope so. I would say, I'd like to think that this isn't just, like I said, that this isn’t a one-and-done for the FDA blood changes. I would say they need to re-investigate again in a couple of years time. I'd also think we need to think about speaking out about blood borne illnesses. I did touch on it just then I think, about PrEP being more readily available around the world, because I think we definitely should work towards eradicating HIV. And I think it would be amazing if we did that, considering it's only been a disease known to the public for about 40 or so years. So I think that would be amazing. And I don't think if we put our minds to it, it wouldn't be an unrealistic thing to aim for an HIV-free world by some point. And there's developments for that constantly, which is really enlightening and quite enjoyable to see, and quite nice to see some good news for that. I'd say there's a lot of things for which I don't see a positive change on unfortunately, at the moment. It's in the UK and the US—I know there's been a lot of shifts with certain political figures and pressure groups that have sort of encouraged an environment that's unsafe for LGBT people, particularly things like drag bans, and bans on gender affirming care for minors, or adults. Similarly, I think we need to be of mind of intersectional issues that can come into play. Things like access for women's health and reproductive rights. And similarly, rights for people of color as well, because these groups are intersectional; there’s queer people of color, there's queer women, obviously, as well, and queer people who need all these access to all these different services. So I think it'd be useful to keep that in mind.

And there's lots of attacks on the gender affirming care; in the UK, there's a big push to ban LGBT conversion therapy. This has been in the pipeline for a number of years now, it's been about four or five years. And since that initial announcement, with a right-wing conservative prime minister who said she wanted to ban all conversion therapy because it was upsetting, it was abusive, the Overton Window, unfortunately, in that time has kind of shifted quite far to the right in the UK, on transgender issues and transgender healthcare. We're in a situation where it's kind of been kicked down the corridor quite a lot, and it's been kind of delayed. There's a lot of speculations now, they might end up putting in exemptions for religious groups, and also remove transgender people from that conversion therapy bill entirely. Which obviously almost defeats the point; when you have all these holes in it, it's going to be very easy for people to get anyway. I think there's some very positive changes from the FDA’s blood ban being lifted and changes, but I think there's still quite a lot that needs to be done. I think the only way we can really work to achieve that is LGBT+ members and allies in the healthcare community advocating in our organizations and with government about getting that changed, and kind of getting people on the side of supporting each other, I'd say.

Q: Is there anything you’d like to add?

Liam Volk, MPharm: I was going to say as well, it is Pride Month at the moment, isn't it? Which is always good. I was just going to say that I think it’d be really good if, my personal opinion is that pharmacy professionals should probably get more involved in Pride Month if they can. I know that historically in the UK, we haven't really engaged in it that much outside of a couple of different places, but I think we kind of need at this point in particular, all around the world, to kind of show the people who do want to silence us and oppress us that we're here, we're proud, and we're not going to go anywhere.