The burden of an identity: Coping strategies for sexual and gender minority individuals in pharmacy practice.

Abstract

Sexual or gender minority (SGM) individuals are known to experience stigma and discrimination in pharmacy settings. It is also known that SGM individuals may delay or avoid care in pharmacies due to the stress associated with these experiences. Aside from avoidance, however, little is known about how SGM individuals cope with stigma and discrimination and how their coping strategies may influence their healthcare behaviors. Therefore, this study aimed to characterize how SGM individuals cope with stigma and discrimination associated with their SGM identity in pharmacy settings. This was a qualitative study conducted using semistructured interviews. A total of 31 SGM individuals were recruited across 2 Canadian provinces. Interviews followed a topic guide designed according to the minority stress model to elicit participants' lived experiences in community pharmacies. Thematic analysis was used to identify and interpret themes. Five themes were identified that described coping strategies used by SGM individuals when encountering minority stress processes in pharmacy settings: avoidance (avoiding or withdrawing from care), seeking support (from people or settings), perseverance (when faced with no other option), concealment (of SGM identity), and lowering expectations (of pharmacist knowledge and competence). Our findings support the notion that individuals cope in different ways and across a wide spectrum of behaviors. Those who avoid care, conceal their SGM identity, or are forced to persevere through interactions may be at increased risk for both physical and mental health disparities. Those who seek support or lower expectations may also be at risk for reduced access to quality care.