I receive my HRT medication by post and am considering transferring HRT medication to local pharmacy just so I can collect faster and save on post.
Whereas it is always safe to talk about any medication with a doctor as they bound by oath and should be discreet also, I am concerned that the same may not necessarily apply to a pharmacy. I believe the Pharmacist/Manager/Owner would be trained to be discreet but I wonder about the assistants.
In your experience if you collect your HRT from pharmacy, have you ever been asked "Is this for you?" or "Why has this been prescribed?" and hence suffered embarrassment if other people there waiting please? Would a good practice call you aside and ask a query in private? Would the average pharmacy care about discretion please?
Thanking you
Pamela
All people who work in a Pharmacy are trained on patient privacy issues. Under the Health Insurance Portability and Privacy Act (HIPPA) here in the US, revealing any patient information is a crime punishable by monetary fines or imprisonment. Your privacy is just as safe with a pharmacy as it is with your doctor.
I have never been asked anything about my meds and I get them in a small town pharmacy right behind my house, so they pretty much know every single person with a regular prescription. They know our names, family status and I am sure they know I am trans. They saw me change in the last 2 Years.
I know others have been asked.
In the end the pharmacist and all the staff is also bound by similar rules than doctors and if they ask anything they have to use the same discretion than a doctor to protect your privacy.
Not all pharmacists are as confidential as doctors.
A friend of mine was doing a one-off shift at the local pharmacy I went to as they were low on staff. Of course that was the day I went to fill my prescription. I said hello to my friend and we had a conversation for a while, but she was really more of an acquaintance at that stage.
Once I left the pharmacist outed me to said friend, who I hadn't actually come out to at the time. When she told me the whole story after I eventually came out to her of my own accord (she knew the whole time but was being respectful and pretending not to) I was gobsmacked. So unprofessional.
Another time I had another pharmacist frown at my prescription then ask me rather loudly "Are you transitioning or something?" while there were other people waiting behind me.
Be careful. I want to note these are isolated incidents and the countless other times I've been to have my prescription filled I haven't had bad experiences. But it can and does happen.
In the UK, I've collected my prescription from boots, Lloyds, sainsburys, Asda...
I walk in give them my prescription with a smile and expect good service. They can lose their license/job very quickly if they are not accurate or professional.
Boots messed up one time and gave me a different estradiol formulation, I had to go back and tell them they messed up, they were very apologetic!
You're a woman collecting some medication, simple. X
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Quote from: Ellement_of_Freedom on April 05, 2018, 06:32:55 AM
Not all pharmacists are as confidential as doctors.
A friend of mine was doing a one-off shift at the local pharmacy I went to as they were low on staff. Of course that was the day I went to fill my prescription. I said hello to my friend and we had a conversation for a while, but she was really more of an acquaintance at that stage.
Once I left the pharmacist outed me to said friend, who I hadn't actually come out to at the time. When she told me the whole story after I eventually came out to her of my own accord (she knew the whole time but was being respectful and pretending not to) I was gobsmacked. So unprofessional.
Another time I had another pharmacist frown at my prescription then ask me rather loudly "Are you transitioning or something?" while there were other people waiting behind me.
Be careful. I want to note these are isolated incidents and the countless other times I've been to have my prescription filled I haven't had bad experiences. But it can and does happen.
You should have asked the pharmacist, do they understand HIPPA?
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Pharmacists and any employee that deals with patient health information (PHI) are bound by HIPPA as far as privacy goes. Definitely a violation for the one that outed someone to their friend. Sharing PHI is a definite no no and that is rare that someone would do that.
The biggest privacy issue is that pharmacies are usually fairly open public areas and even when trying to be discreet things can be overheard. HIPPA has been around long enough that pharmacists should not be yelling out medical questions if they need more information to fill a prescription.
For the OP, you can go to the pharmacy and ask to speak to the pharmacist in charge and explain your situation and ask for assurance of extra discretion. It's the law so they ought not to have a problem with it.
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Although I am not currently on HRT, I have been dealing with the pharmacy my whole life, being type 1 diabetic. Every prescription I've ever had - be it insulin, birth control, Zoloft, antibiotics - just needed a 'Hi, I need to pick up a prescription for so-and-so' and there are never any questions asked, and I've been through three pharmacies. Unless they're disrespectful or don't care, they don't ask questions and it's a very quick process.
HIPPA should protect you here in the states. I don't know what other countries have that may be similar. One reason I picked the pharmacy I currently use is because it has a drive thru window. That saves me when I'm not in a peopling mood.
I have used the pharmacy at WalMart and at an Army Hospital for HRT. The first time at WalMart the Pharmacist questioned me discreetly to be sure the prescription was correct. After that nothing was ever said and the experience was uneventful. At the Army Hospital nobody has ever said anything other than the usual asking if I had any questions about the dose. They often ask that about any meds there.
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My health care team know I am on Medical transition so to them I just another woman going on on my business.
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Quote from: Gertrude on April 05, 2018, 07:45:57 AM
You should have asked the pharmacist, do you understand HIPPA?
I live in Australia.
Elle,
You need to and should complain to AHPRA
https://www.ahpra.gov.au/
They have teeth, are independent and act on such complaints. Such behaviour is illegal and abhorrent and needs to be tackled.
Quote from: Cindy on April 05, 2018, 06:08:04 PM
Elle,
You need to and should complain to AHPRA
https://www.ahpra.gov.au/
They have teeth, are independent and act on such complaints. Such behaviour is illegal and abhorrent and needs to be tackled.
I would but the pharmacist no longer practices anyway.
I get my estrogen from a different pharmacy than my other meds as it's in the same building as my hormone doctor. I was asked why I was getting it the first time I picked it up. Being a smart ass I just opened my jacket and said I wanted bigger breasts. End of conversation and I left with my prescription. No more questions since then.
Aussie here so experiences maybe different.
I have a regular pharmacy (diabetic) that I go to... Over here it is pretty much standard for a pharmacist to ask if "you have taken it before" and if you haven't verify that you know what your taking, dosage and possible side effects ect.. well at least in my experience that's seems to be the case with the ones iv been to.
The first time I went in to collect my scrip I was picking up Spiro and E in man mode.. wasn't out..
It's the first and only time iv had a scrip handed to me that iv never taken before and the pharmacist just looked at me and said "you know exactly what this will do right" (or something close to that I can't remember the exact wording) then paid walked out and nothing was said.
I was sooo thankful that he obviously put it together and chose not to go through the whole explanation and questions that normally happens.
So good pharmacists do exist :)
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Quote from: Donna on April 05, 2018, 10:09:03 PM
I get my estrogen from a different pharmacy than my other meds as it's in the same building as my hormone doctor. I was asked why I was getting it the first time I picked it up. Being a smart ass I just opened my jacket and said I wanted bigger breasts. End of conversation and I left with my prescription. No more questions since then.
Donna,
I like your response; I'll give it a try if the opportunity ever arises. Do know why they don't send Donkey's to college? On one of my smart ass trips I landed in jail; some cops just can't take a joke. Ironically I became one and was the joke.
I recently went on HRT; the med cost me $70.00 for 4 weeks of transdermal patches. Afterwards I found I could have obtained them for half that amount by using GoodRX.com. It's worth looking into and it's free. I went to my dermatologist yesterday and he gave me a GoodRx coupon. I used it at a Kroger pharmacy and saved 50%. I don't know how this works, just that it does.
Best Always,
Christine
Christine,
GoodRx was a lifesaver. I picked my pharmacy as Walmart because patches only cost about $35 compared to the $100 or so the box said.
I eventually switched to pills and insurance covers it.
The only problem I ever had with a pharmacy was the pre authorization crap [emoji35]
Take care
Kitty
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One can easily call the pharmacist that they saw you come out of and pretend to be you. All they have to do is know your name and birthdate....
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I pick up my prescriptions in person at a local drugstore. The first few times, I was presenting male. Since then, I have presented as female. I have had no problems.
Pharmacists are trained to be discrete, and as others have pointed out, there are legal protections in many places requiring them to be discrete. When I started out, I had my doctor list my name on the prescription as "<deadname> (Kathleen) <lastname>". It was fairly obvious what the prescription was for. The only awkward question was which name I wanted them to use. Now, my prescriptions are written out just for Kathleen.
They do ask if you have taken the meds before. That is a requirement, because they have to ensure that you know how to take them.
I resolved when I transitioned that I would have no more secrets. So, if a pharmacist had asked me the purpose of the prescription back when I was presenting male, I would have told them: gender transition. I am not ashamed of who I am. Knowing the purpose helps them to be confident that I am getting the right meds. Nowadays, I don't worry about it at all. I am just a [possibly trans, possibly post-menopausal] woman picking up her HRT meds. Happens all the time. Nothing to see here, folks.
I am not worry much about Pharmacist ask questions. Staff at Medical Center knew about my Medical transition so when I visit my Endocrine sit in waiting room with all women, and nobody even though about the why I am there. Maybe because I live in San Jose California.
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Quote from: Kitty June on April 06, 2018, 02:11:19 AM
Christine,
GoodRx was a lifesaver. I picked my pharmacy as Walmart because patches only cost about $35 compared to the $100 or so the box said.
I eventually switched to pills and insurance covers it.
The only problem I ever had with a pharmacy was the pre authorization crap [emoji35]
Take care
Kitty
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Hi Kitty,
The $70.00 I paid was less than normal; the druggist gave me a break. It wasn't till I returned home and looked up Estradiol on the web and found GoodRx and $35.00 for it. When I refill the script in a week or so, I'll go where GoodRx gives the best price.
When I walked into the pharmacy my friendly "Drug Dealer" asked: "What's going on?" I told him "Just what it seems. Making a change in direction." That was an easy outing. I went to my dermatologist Tuesday and Primary Thursday. I asked both of them to discuss my transition with their staff so there won't be any misunderstandings.
My insurance refused coverage... thank you Medicare Part D. I can probably cut back on my junk food for a day and save enough for a months script. Actually, if I cut out all the junk food for a month it will cover the $35.00 and be a lot healthier. I need to get rid of some fat before it redirects to the wrong place. Since it has only been 2 weeks of HRT there has been no noticeable redirection. I keep hoping a couple speed bumps start forming on my chest soon. I'm sure it's kind of like watching a pot of water on the stove waiting for it to boil. Momentarily look away and it'll be boiling.
I do have one regret with my transition; I should have done this years ago. Advice to those of you who are wavering: Get on with it; don't wait until you are a "Seasoned Citizen." If you do wait, it's never too late. I see my transition as the greatest adventure of my life.
Best Always,
Christine
Quote from: Tammy Jade on April 05, 2018, 11:15:37 PM
It's the first and only time iv had a scrip handed to me that iv never taken before and the pharmacist just looked at me and said "you know exactly what this will do right" (or something close to that I can't remember the exact wording) then paid walked out and nothing was said.
He was probably glad that he didn't have to explain it to you if you didn't know what they were for.
Quote from: Tammy Jade on April 05, 2018, 11:15:37 PM
So good pharmacists do exist :)
Most of us are, thanks. People tend not to make a fuss when someone does their job properly.
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I rarely have to go into the pharmacy I use, my Dr. places the order from his office and the pharmacy has free delivery
The delivery person has no idea about what my prescription is other than to make their deliveries and get a signature and they are always politely in a hurry to finish their deliveries
My first experience:
I give the pharmacist the script and came back in 30 minutes to pick it up.
She asks me to go over to the window and then proceeds to ask me if I know it is estrogen.
I say, "Yep".
She asks again. I say "yep" again. Then she asks a third time, and I say "yep" again!
At that point, apparently, she was able to put it together. I was presenting as a man at the time.
She did ask rather loud, but I was done with secrets at that point so I didn't care.
Since then, I present as myself, and haven't had any issues.
My first script for E I went to CVS. My prescription card is for CVS only. The pharmacist came to the counter and said loudly, Do you know what this will do to you? I said yes and she said it again. I looked at her and people looked at me. I was embarrassed.
For my refill I picked up my meds at the counter and a young clerk looked at me and as I walked away started laughing. I was embarrassed again. That was 4.5 years ago and I was pretty fragile at that point.
I then picked up my scripts at the Mazzoni pharmacy adjacent to the Mazzoni canter where I get my trans care and primary care and go to group. They are awesome.
I am a different person now. I get Truvada as an HIV prophylactic (perhaps some day I will find someone). The CVS pharmacist had to ask me questions as per protocol. I was descriptive about why I was going on the drug and the side effects. He was like ok, you know what you are doing and the side effects. Do you have any questions? Maybe it is me or that I handle myself differently, with confidence or maybe they have changed.
I was prescribed T (very small dose every other day). I picked it up at the Mazzoni Pharmacy. The pharmacist asked what am I doing with this. I just stated I am post op and taking a dab every other day for bone health. She said Ok, OK.
There is a difference between being asked questions and being disrespected. 4.5 years ago I should have complained to CVS for being disrespected and lack of privacy protocol. I am a different person now and much stronger. I can handle myself and am not embarrassed about who I am.
In my medical records acknowledge I am a transgender female. So when the pharmacy members call me questions about medication and they're always call me Miss when they are talking to me either in English or Vietnamese.
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I go to a Walgreens by my house. I have newer had anyone question it or say anyehing.
Quote from: Rachel on April 10, 2018, 03:00:55 PM
There is a difference between being asked questions and being disrespected. 4.5 years ago I should have complained to CVS for being disrespected and lack of privacy protocol. I am a different person now and much stronger. I can handle myself and am not embarrassed about who I am.
Rachel, 10 Apr 2018
Congratulations, you are one tough lady. You ARE my hero. I used to think I was a pretty tough nut; I can't hold a candle to you. I have been reading your blog and I am amazed by your tenacity, fortitude, perseverance and courage.
All the Best to you always,
Christine
Thank you Ladies for all your responses.
I am sorry to hear a couple of sad stories here but thankfully they seemed to have happened some time ago rather than of late.
I am confident most pharmacies are discreet, professional and respectful.
Pamela
I had pharmacists inquire why I was taking so much estrogen or progesterone as those doses were far above those recommended for ciswomen. I told them it was between me and my doctor and that everything was fine, not to worry. ;) Annoying though...one girl in the back even shouted: "She's pregnant!". If she only knew...I told them I wasn't.
Quote from: Danielle M on April 10, 2018, 05:31:23 PM
I go to a Walgreens by my house. I have newer had anyone question it or say anyehing.
I use Walgreens also. I still present male and the first time I went the pharmacist showed me the prescription names and said "are these the correct medications for you?" I said "yes that's me alright" :laugh: I have only been two times total so far but no problems with them yet.
Hugs,
Chelsea
After 14 years of DIY, I recently contacted a doctor online who prescribed injectable EV for me.
I had him call the script into Walmart since they list it online as something they carry.
Had an assistant and the Pharmacist both speak to me, now imagine the scenario....
6'8" person who will NEVER be able to pass, dressed in regular guy clothes, picking up that particular drug....
Neither seemed overly curious, they just wanted to know if I was ok with self administering an injectable.
I told them I'd been doing it for 14 years already.
They did give me the wrong needled syringes though and will be told when it's refill time.
Quote from: KayXo on April 11, 2018, 08:08:57 AM
I had pharmacists inquire why I was taking so much estrogen or progesterone as those doses were far above those recommended for ciswomen. I told them it was between me and my doctor and that everything was fine, not to worry. ;) Annoying though...one girl in the back even shouted: "She's pregnant!". If she only knew...I told them I wasn't.
Well that would be way uncomfortable for them to explain that miracle of nature.
Pregnant and loving it. Lol
Quote from: KayXo on April 11, 2018, 08:08:57 AM
I had pharmacists inquire why I was taking so much estrogen or progesterone as those doses were far above those recommended for ciswomen. I told them it was between me and my doctor and that everything was fine, not to worry. ;) Annoying though...one girl in the back even shouted: "She's pregnant!". If she only knew...I told them I wasn't.
LOL! But I don't understand how being pregnant could explain being placed on high doses of oestrogen..
Quote from: Ellement_of_Freedom on April 20, 2018, 10:05:47 PM
LOL! But I don't understand how being pregnant could explain being placed on high doses of oestrogen..
That was when I was getting my progesterone prescription and some women are prescribed high doses of progesterone to prevent miscarriage in the beginning of pregnancy. Also, women undergoing IVF (in-vitro fertilization) take both high doses of estrogen and progesterone in the beginning, until the placenta takes over.
Quote from: Ellement_of_Freedom on April 20, 2018, 10:05:47 PM
LOL! But I don't understand how being pregnant could explain being placed on high doses of oestrogen..
There is a school of thought in the medical community that high doses of estrogen during pregnancy will reduce the risk of miscarriage. I don't know how much truth there is in this, but I am pretty sure the theory is still out there.
That theory was the reason for prescribing high doses of DES, a synthetic estrogen, to women in the 1950s and 1960s, which probably resulted in many of us being MTF trans.
I switched my medical insurance to Kaiser Permente because I heard they had the best Trans Care and when I was on another I was having trouble finding a Endo to prescribe HRT. So I made the decision to wait about 2 months for open enrollment so i could switch to Kaiser and start treatment.
It has been overall a been great decision, at the start of everything i was nervous about talking to anyone including health professionals about transitioning which i think most people are.
So after seeing the Therapist for the first time she recommended me immediately to schedule with the endo so i could start HRT. I had been trying for over a year with the other insurance and there therapist so this was happening really fast which excited me also terrified at the same time.
Within a week i had a appointment with the endo at one of the larger Kaiser Hospitals in the Los Angeles area.
I dressed for the appointment androgynous womens jeans just a plain T shirt , I'm 51 so i was not passing or trying to pass at this time. So get to the appointment and walking down the hall looking for the right room. I spot the room # and open the door to walk in and there is female Kaiser employee on here way out, She stops in the doorway looks me up from head to toe then back toe to head and just really loudly makes the PFFFT so everyone in the waiting room hears. Shakes her head and struts out.
This is my first experience like this i was fairly embarrassed for a little while sitting there until everyone went back to what they were doing.
I get called to see the endo went in had the appointment and she prescribes the Estradiol and asked me i wanted to go downstairs and get my prescription right now. I was surprised i was used to having to get it called into a local pharmacy and waiting for it to filled, figured it would be a few days at least. So was really surprised since i was new to Kaiser that you can walk out the office right to the pharmacy and get the prescription.
I said yes i will get it here and now excited and a bit apprehensive since i have bee trying for so long and its happening really fast.
I go down the pharmacy downstairs , this is one of the bigger Kaiser location so there was probably 30 people in pharmacy to pick up prescriptions. This pharmacy was tiny thou, crammed in there like sardines and NO privacy whatsoever. When i was called to come up and collect the prescription it was a young male in his mid twenties , at first he was all business here it is pay this to each customer and he is the same with me at the start of the transaction, then he looks at what the prescription is , he pauses his lips scrunch up and every word from is mouth at this point everyone can hear.
Who are you picking this up for ? me
You do know this is estrogen right? yes
Do you need the pharmacist to go over how to take it? no
Now I'm sweating its the first time getting HRT, already had the experience upstairs with the women, now this
I walked out of there and back to my car so fast already questioning my decision if it is going to be like this the whole way if this is what its like the first day.
At the start of traveling home my emotions were embarrassment, fear, then some anger
Then i started laughing the more i thought about it, if I'm going to let a couple people i don't know and will never see again dictate how i live my own life then I'm really destined to be sad and miserable for the rest of life. So decided then to just smile and move on with my life and not let these small and yes they may feel embarrassing at the time but those people didn't think about me the moment i was out of their sight. Why would i think about them any longer than they thought about me and let them control me.
When i arrived home went straight in and took my first dose and its been almost a year now
Those were the only experiences like that i have had to date and almost let those stop me yet again.
I'm glad i did not, transition is hard enough without letting small blips take more control of you then they should
I have been getting my RX now online from the Kaiser mail-order most of the time but i have been into the local one on a few occasions now to pick up the RX and there has never been an issue since
I have to agree Kathy. Those high doses my mom got caused this. Thank you mom💗💗💗💗 for taking your meds as needed
Quote from: Brie B on April 21, 2018, 09:07:55 AM
> I spot the room # and open the door to walk in and there is female Kaiser employee on here way out, She stops in the doorway looks me up from head to toe then back toe to head and just really loudly makes the PFFFT so everyone in the waiting room hears. Shakes her head and struts out.
>
then he looks at what the prescription is , he pauses his lips scrunch up and every word from is mouth at this point everyone can hear.
Brie I admire your ability to laugh this off later on. You did the right thing - placing your future first, regardless of people who don't matter. This was their failure, not yours, although at the moment it happens we tend to blame ourselves.
As we gain confidence it becomes easier to know where the line was crossed and in some cases do something about it on the spot. For the employee whose brain went PFFFT, asking her "excuse me, is there a problem?" would have thrown this back on her to explain. She probably wouldn't have answered much, but point made.
The pharmacy is in the US so it must follow HIPAA. Although that was a year ago, if they haven't changed procedures and the setup of that room you could contact management and let them know some of their employees have been unintentionally breaking the law. I would do it in writing.
It does sound like there are also a lot of good people and practices at that facility.