Beyond neutrality in LGBTQIA+ cancer care: Optimising outcomes through inclusive and culturally competent pharmacy practice.

ObjectiveTo examine the pharmacological and psychosocial complexities in LGBTQIA+ cancer care and to highlight the role of pharmacists in delivering inclusive, culturally competent care to optimise treatment outcomes.Data sourcesA comprehensive literature search was conducted using PubMed, Scopus, Web of Science, and Google Scholar databases. Search terms included combinations of "LGBTQIA+", "transgender", "sexual and gender minorities", "cancer", "oncology", "gender-affirming hormone therapy", "antiretroviral therapy", "drug interactions", "pharmacokinetics", "pharmacodynamics", "culturally competent care", "minority stress", "pharmacist", and "practitioner positioning". Peer-reviewed articles, systematic reviews, clinical reports, and position statements published in English were included. Reference lists were hand-searched, and relevant grey literature and clinical guidelines were consulted.Data summaryLGBTQIA+ cancer patients often require concurrent therapies, including gender-affirming hormone therapy (GAHT), antiretroviral therapy (ART), and oncology treatments, which create risks of drug interactions, cumulative toxicities, and altered pharmacokinetics and pharmacodynamics. Comorbidities and polypharmacy may further complicate management. These challenges are compounded by minority stress, healthcare disparities, and gaps in provider knowledge. Evidence shows that healthcare professional positioning influences patient disclosure, treatment engagement, and outcomes. Inclusive approaches facilitate accurate medication histories and safer care, while egalitarian or non-inclusive practices may lead to missed interactions and unmet needs, particularly for transgender patients.ConclusionsPharmacists must adopt inclusive, culturally competent practices alongside pharmacological expertise to optimise medication safety, improve adherence, and reduce disparities in LGBTQIA+ oncology care.