Breaking the ice: Creating and maintaining an affirming practice setting for LGBTQIA plus pharmacy trainees

Learners who identify as a sexual or gender minority (SGM) may experience anxiety and fear when entering new learning environments, hindering their ability to develop their professional identity. This may be attributed to uncertainty regarding whether the preceptors and practice site will be affirming of their gender identity and/or sexual orientation. Historically, SGM learners may have experienced these stress processes, leading to an unnecessarily poor learning experience. Postgraduate trainees' experiences have an increased and sustained negative impact when training in an "unfriendly" environment, as previous negative encounters have already challenged their professional identity. Preceptors serve as the first step in creating a welcoming and affirming practice site and are instrumental in mitigating stigmatizing encounters. By focusing on effective first impressions and non-assumptive dialogue, a preceptor can help elevate themselves as a trusted individual in that learner's life. This article aims to discuss stigma and discrimination's effects on postgraduate and early-career SGMs and provide a "how-to" guide to mitigate negative experiences for pharmacy learners. Additionally, this guide will utilize case studies to better illustrate stigmatizing encounters in the trainee setting and provide considerations for equitable and affirming learning environments.