Providing equitable care to all patients requires an understanding of the unique health disparities faced by sexual and gender minority (SGM) populations, often referred to as LGBTQ+. These disparities are driven by systemic factors like stigma, discrimination, and barriers within the healthcare system itself. For pharmacists, creating a welcoming and affirming environment and providing culturally competent care is a professional and ethical imperative. This quiz will test your knowledge of the health challenges and patient care principles for this diverse community.
1. A “health disparity” affecting a sexual minority group is a difference in health that is primarily driven by:
- A biological certainty linked to their sexual orientation.
- Their personal lifestyle choices alone.
- Social, economic, or environmental disadvantage.
- A preference for alternative medicine.
Answer: Social, economic, or environmental disadvantage.
2. A patient who identifies as a transgender man tells you he was born female. The term “transgender” refers to a person’s:
- Sexual orientation.
- Gender identity.
- Biological sex.
- Intersex status.
Answer: Gender identity.
3. A primary structural driver of health disparities among LGBTQ+ populations is:
- A lower prevalence of chronic disease.
- Widespread access to inclusive health insurance.
- Stigma and discrimination in healthcare settings and society at large.
- A genetic predisposition to better health outcomes.
Answer: Stigma and discrimination in healthcare settings and society at large.
4. A pharmacist can create a more affirming and welcoming environment for LGBTQ+ patients by:
- Making assumptions about a patient’s gender or partner based on their appearance.
- Using gender-neutral language and asking for a patient’s pronouns.
- Avoiding all conversation about a patient’s personal life.
- Displaying political signs in the pharmacy.
Answer: Using gender-neutral language and asking for a patient’s pronouns.
5. Compared to the heterosexual and cisgender population, LGBTQ+ youth report significantly higher rates of:
- Hypertension and high cholesterol.
- Suicidal ideation, depression, and anxiety.
- Type 2 diabetes.
- Osteoporosis.
Answer: Suicidal ideation, depression, and anxiety.
6. The “minority stress” model suggests that the higher prevalence of mental health and substance use disorders in SGM populations is a result of:
- A biological weakness.
- The chronic stress of dealing with prejudice and discrimination.
- A lack of interest in being healthy.
- A side effect of medication.
Answer: The chronic stress of dealing with prejudice and discrimination.
7. A key health service for preventing HIV transmission, particularly relevant for men who have sex with men (MSM) and transgender women, is:
- Annual influenza vaccination.
- Cholesterol screening.
- Pre-exposure prophylaxis (PrEP).
- A daily multivitamin.
Answer: Pre-exposure prophylaxis (PrEP).
8. A pharmacist’s role in PrEP therapy includes:
- Counseling on the importance of adherence.
- Discussing risk reduction strategies.
- Monitoring for potential side effects and drug interactions.
- All of the above.
Answer: All of the above.
9. A patient’s fear of disclosing their sexual orientation or gender identity to a healthcare provider due to fear of judgment is a major:
- Sign of a good therapeutic relationship.
- Barrier to receiving appropriate and comprehensive care.
- Indication that the patient is healthy.
- Reason to avoid all healthcare.
Answer: Barrier to receiving appropriate and comprehensive care.
10. When taking a medication history for a transgender woman (assigned male at birth), it is important for the pharmacist to ask about:
- Only the medications prescribed by her current doctor.
- Her dietary preferences.
- The use of any hormone therapies, as they can have drug interactions and impact health.
- Her preferred pharmacy.
Answer: The use of any hormone therapies, as they can have drug interactions and impact health.
11. A pharmacist can be a patient advocate for a transgender patient by:
- Questioning their identity.
- Respectfully using their correct name and pronouns, even if it differs from their insurance information.
- Telling them where to find the best sales on clothing.
- Ignoring their presence in the pharmacy.
Answer: Respectfully using their correct name and pronouns, even if it differs from their insurance information.
12. The lack of data collection on sexual orientation and gender identity (SOGI) in many EHR systems is a structural problem that:
- Helps to protect patient privacy.
- Makes it difficult to identify and address LGBTQ+ health disparities.
- Is the preferred method for data management.
- Ensures all patients are treated the same.
Answer: Makes it difficult to identify and address LGBTQ+ health disparities.
13. Which of the following is an example of using inclusive language on a pharmacy intake form?
- Having a checkbox for “Marital Status: Married / Single / Divorced.”
- Having a line for “Relationship Status” with a blank space to fill in.
- Asking for “Mother’s Name” and “Father’s Name.”
- Assuming the patient’s gender based on their name.
Answer: Having a line for “Relationship Status” with a blank space to fill in.
14. A pharmacist providing care to an LGBTQ+ older adult must be sensitive to the fact that this individual may have:
- Experienced a lifetime of discrimination, leading to heightened mistrust of the healthcare system.
- No unique health concerns.
- Fewer chronic conditions than their heterosexual peers.
- A large and supportive biological family.
Answer: Experienced a lifetime of discrimination, leading to heightened mistrust of the healthcare system.
15. A pharmacist providing non-judgmental counseling on harm reduction to a patient who uses substances is practicing a key principle that is vital for:
- Increasing drug use.
- Building trust and engagement with marginalized patients.
- Stigmatizing the patient.
- Violating the law.
Answer: Building trust and engagement with marginalized patients.
16. Higher rates of tobacco and alcohol use in some sexual minority populations are often linked to:
- A biological need for these substances.
- Their use as coping mechanisms for stress related to discrimination.
- A lack of knowledge about the health risks.
- A preference for these substances.
Answer: Their use as coping mechanisms for stress related to discrimination.
17. A patient who is a transgender man is prescribed testosterone therapy. The pharmacist should counsel on the need to monitor for:
- A decrease in muscle mass.
- An increase in bone density.
- Changes in mood and libido.
- Erythrocytosis (increased red blood cell count) and changes in lipid profile.
Answer: Erythrocytosis (increased red blood cell count) and changes in lipid profile.
18. A key leadership practice for a pharmacy manager seeking to reduce disparities is to:
- Ignore staff complaints about difficult patients.
- Implement mandatory staff training on cultural competence and caring for LGBTQ+ patients.
- Assume their staff is already competent in this area.
- Create a policy that prohibits discussing LGBTQ+ health issues.
Answer: Implement mandatory staff training on cultural competence and caring for LGBTQ+ patients.
19. When a pharmacist uses “person-first” language, they are demonstrating respect. This can be adapted for SGM populations by:
- Using labels to define a person (e.g., “the lesbian patient”).
- Referring to a patient by their diagnosis.
- Using the language and labels a patient uses to describe themselves.
- Avoiding any discussion of identity.
Answer: Using the language and labels a patient uses to describe themselves.
20. A pharmacist can advocate for LGBTQ+ health equity at a systemic level by:
- Supporting policies that protect against discrimination in healthcare.
- Remaining silent on all political and social issues.
- Advocating for the exclusion of SOGI data from health records.
- Joining organizations that oppose LGBTQ+ rights.
Answer: Supporting policies that protect against discrimination in healthcare.
21. A patient may be hesitant to disclose their use of PrEP to a new provider. A sensitive pharmacist can normalize this by:
- Asking all patients about their sexual health history in a routine, non-judgmental way.
- Only asking patients who they assume are at risk.
- Waiting for the patient to volunteer the information.
- Refusing to fill the prescription.
Answer: Asking all patients about their sexual health history in a routine, non-judgmental way.
22. Which of the following is a potential health disparity for lesbian and bisexual women?
- Lower rates of breast and cervical cancer due to better screening access.
- Higher rates of obesity and cardiovascular disease.
- Lower rates of smoking.
- Better mental health outcomes compared to heterosexual women.
Answer: Higher rates of obesity and cardiovascular disease.
23. The pharmacist’s patient care process (Collect, Assess, Plan, Implement, Follow-up) for an LGBTQ+ patient should include:
- An assessment of health risks and needs that may be unique to their identity and experiences.
- The exact same assessment as for a cisgender, heterosexual patient, with no modifications.
- A focus only on their prescription medications.
- A plan to change their sexual orientation.
Answer: An assessment of health risks and needs that may be unique to their identity and experiences.
24. The concept of “intersectionality” is important because a Black transgender woman may face health disparities related to:
- Racism only.
- Transphobia only.
- An intersection of racism, transphobia, and misogyny.
- Her socioeconomic status only.
Answer: An intersection of racism, transphobia, and misogyny.
25. Forging ahead in pharmacy practice means creating a healthcare environment that is:
- Inclusive, affirming, and equitable for all patients, regardless of sexual orientation or gender identity.
- Standardized to a single, majority perspective.
- Focused only on the most profitable services.
- Unaware of patient diversity.
Answer: Inclusive, affirming, and equitable for all patients, regardless of sexual orientation or gender identity.
26. A pharmacist who dismisses an LGBTQ+ patient’s health concern as being “all in their head” is engaging in a form of:
- Good clinical practice.
- Empathy.
- Diagnostic overshadowing and displaying implicit bias.
- Patient advocacy.
Answer: Diagnostic overshadowing and displaying implicit bias.
27. A key to providing effective care to a gender-diverse patient is:
- To understand that gender identity is a choice.
- To recognize that gender identity is a core part of a person’s sense of self and to use their affirmed name and pronouns.
- To focus on the sex they were assigned at birth for all aspects of care.
- To avoid any physical assessment.
Answer: To recognize that gender identity is a core part of a person’s sense of self and to use their affirmed name and pronouns.
28. An important counseling point for a transgender woman on estrogen therapy is the increased risk of:
- Venous thromboembolism (VTE).
- Osteoporosis.
- Hair loss.
- Weight loss.
Answer: Venous thromboembolism (VTE).
29. The ultimate goal of addressing health disparities among sexual and gender minorities is to:
- Provide special, separate care for this population.
- Ensure they have the same opportunity to achieve optimal health as everyone else.
- Encourage them to conform to majority norms.
- Eliminate all differences between people.
Answer: Ensure they have the same opportunity to achieve optimal health as everyone else.
30. Which skill, emphasized in leadership and communication courses, is most critical for interacting with a patient from a marginalized community?
- The ability to speak loudly.
- Empathy.
- Financial management.
- Speed reading.
Answer: Empathy.
31. A pharmacist can use their knowledge of “gerotechnology” to help an older LGBTQ+ adult by:
- Recommending online support groups or telehealth services that are known to be affirming and inclusive.
- Assuming they are not capable of using technology.
- Ignoring their need for social connection.
- Providing them with a standard, non-customized health app.
Answer: Recommending online support groups or telehealth services that are known to be affirming and inclusive.
32. “Post-exposure prophylaxis” (PEP) for HIV is a harm reduction strategy that involves:
- A vaccine to prevent HIV.
- Taking a course of antiretroviral therapy after a potential exposure to prevent infection.
- A daily pill to prevent HIV before exposure.
- A treatment to cure HIV.
Answer: Taking a course of antiretroviral therapy after a potential exposure to prevent infection.
33. The lack of family acceptance is a major social determinant of health for many LGBTQ+ youth, contributing to higher rates of:
- Academic success.
- Homelessness and substance use.
- Financial stability.
- Physical activity.
Answer: Homelessness and substance use.
34. A pharmacist’s patient-centered communication should involve:
- Using open-ended questions to allow the patient to share their story.
- Making assumptions to save time.
- Focusing only on the questions on the intake form.
- Interrupting the patient frequently.
Answer: Using open-ended questions to allow the patient to share their story.
35. A “trauma-informed” approach recognizes that LGBTQ+ individuals may have experienced trauma related to:
- Bullying or violence.
- Family rejection.
- Negative healthcare experiences.
- All of the above.
Answer: All of the above.
36. A key component of “geriatric sensitivity” when caring for an older gay man is to:
- Assume he is not sexually active.
- Use inclusive language that does not assume his partner is a woman.
- Ask his children about his health instead of him.
- Focus only on his age-related health issues.
Answer: Use inclusive language that does not assume his partner is a woman.
37. When a pharmacist advocates for their institution to add “gender identity” as a standard field in the patient demographic record, they are promoting:
- A systemic change to improve care for transgender and gender-diverse patients.
- A violation of patient privacy.
- An unnecessary complication to the EHR.
- A way to slow down the registration process.
Answer: A systemic change to improve care for transgender and gender-diverse patients.
38. The “P” in the PICO question format can be used to specifically study health disparities by defining the “Population” as:
- All patients in the hospital.
- A specific sexual or gender minority group.
- Only patients with a certain disease.
- Only patients of a certain age.
Answer: A specific sexual or gender minority group.
39. A pharmacist’s professional obligation to “do no harm” (non-maleficence) includes:
- Actively working to avoid the harm caused by discrimination and lack of culturally competent care.
- Refusing to care for patients who are different from them.
- Following all instructions from a physician without question.
- Focusing only on preventing dispensing errors.
Answer: Actively working to avoid the harm caused by discrimination and lack of culturally competent care.
40. A forward-thinking pharmacy leader would view creating an inclusive environment as:
- A business imperative and an ethical obligation.
- A distraction from the pharmacy’s financial goals.
- A task for the human resources department only.
- An optional activity.
Answer: A business imperative and an ethical obligation.
41. Higher rates of certain cancers (e.g., anal cancer in MSM, breast cancer in lesbians) are disparities often linked to:
- A combination of behavioral risk factors, viral co-infections (like HPV), and barriers to screening.
- A genetic certainty.
- A lack of any effective screening methods.
- The side effects of medications.
Answer: A combination of behavioral risk factors, viral co-infections (like HPV), and barriers to screening.
42. A pharmacist’s self-awareness of their own biases is a critical first step towards:
- Reinforcing those biases.
- Providing more equitable and objective patient care.
- Ignoring cultural differences.
- Making faster clinical decisions.
Answer: Providing more equitable and objective patient care.
43. The curriculum on “Advocacy” is relevant to this topic because pharmacists should advocate for:
- The needs and rights of their individual LGBTQ+ patients.
- Broader public policies that promote health equity for all.
- The advancement of their own careers only.
- Both A and B.
Answer: Both A and B.
44. A pharmacist ensuring a transgender man on testosterone therapy is offered a cervical cancer screening (if he has a cervix) is an example of:
- Providing clinically appropriate, anatomy-based preventive care regardless of gender identity.
- A violation of the patient’s identity.
- An unnecessary screening.
- A task outside the pharmacist’s role.
Answer: Providing clinically appropriate, anatomy-based preventive care regardless of gender identity.
45. Which of the following is a structural barrier, not an individual one?
- A patient’s lack of motivation.
- An insurance policy that explicitly excludes coverage for gender-affirming care.
- A patient’s choice of diet.
- A patient’s refusal to take a medication.
Answer: An insurance policy that explicitly excludes coverage for gender-affirming care.
46. The use of “difficult conversations” skills may be necessary when:
- A patient’s family member is not affirming of their identity.
- A colleague makes a discriminatory remark.
- A pharmacist needs to discuss sensitive topics like sexual health.
- All of the above.
Answer: All of the above.
47. A key challenge in researching LGBTQ+ health is:
- The lack of funding and historically small sample sizes.
- The refusal of this population to participate in research.
- The simplicity of the health issues involved.
- The fact that there are no health disparities to study.
Answer: The lack of funding and historically small sample sizes.
48. An effective leader in a diverse community fosters a team culture of:
- Silence and conformity.
- Trust, psychological safety, and respect for diversity.
- Competition and conflict.
- Ignoring differences between people.
Answer: Trust, psychological safety, and respect for diversity.
49. Providing care that is affirming of a patient’s gender identity is directly linked to:
- Better mental health outcomes and engagement in care.
- Worsening health disparities.
- An increase in healthcare costs.
- A violation of the pharmacist’s professional ethics.
Answer: Better mental health outcomes and engagement in care.
50. The ultimate reason to learn about health disparities among sexual and gender minorities is to:
- Fulfill a course requirement.
- Become a better, more effective, and more equitable healthcare provider for all patients.
- Be able to label patients correctly.
- Focus only on the needs of this specific population.
Answer: Become a better, more effective, and more equitable healthcare provider for all patients.
I am a Registered Pharmacist under the Pharmacy Act, 1948, and the founder of PharmacyFreak.com. I hold a Bachelor of Pharmacy degree from Rungta College of Pharmaceutical Science and Research. With a strong academic foundation and practical knowledge, I am committed to providing accurate, easy-to-understand content to support pharmacy students and professionals. My aim is to make complex pharmaceutical concepts accessible and useful for real-world application.
Mail- Sachin@pharmacyfreak.com