Community pharmacists’ knowledge, attitudes, and educational needs regarding LGBTQ+ healthcare: a cross-sectional study

Background LGBTQ+ individuals continue to experience persistent healthcare inequalities, partly due to limited training of healthcare professionals in LGBTQ+-specific healthcare needs. Community pharmacists (CPs), given their accessibility and role in frontline healthcare delivery, are well-positioned to provide inclusive and competent care. This study aimed to describe participating CPs’ self-reported knowledge and awareness, attitudes, professional experiences, educational exposure, and educational needs regarding LGBTQ+ healthcare, and to explore whether responses to selected items on difficulty providing care and participation in LGBTQ+ advocacy differed by demographic and professional characteristics.Methods We conducted a quantitative cross-sectional study in Thessaloniki, Greece, between October 2023 and January 2024, involving 305 CPs (59.8% of the 510 pharmacists invited). Data were collected using a 35-item questionnaire covering self-reported knowledge and awareness, educational exposure and preparedness, ethical perceptions, professional experiences and behaviours, advocacy and awareness activities, and demographic and professional characteristics. Descriptive statistics and unadjusted subgroup comparisons were performed using SPSS, applying independent-samples t-tests and one-way ANOVA, as appropriate. Statistical significance was set at p < 0.05.Results Participants reported generally positive attitudes toward LGBTQ+ patients; however, only 43.0% reported adequate training in LGBTQ+-specific healthcare needs. Participation in LGBTQ+ advocacy and awareness activities differed significantly across age groups (F(3,301) = 7.058, p < 0.001), with younger pharmacists reporting higher engagement. Advocacy participation also differed significantly across professional-experience groups (F(2,302) = 9.146, p < 0.001), with pharmacists with fewer than 10 years of experience reporting greater involvement than those with >10 years. Female pharmacists reported significantly higher advocacy engagement than males (t(303) = −4.089, p < 0.001). No robust statistically significant group differences were identified in self-reported difficulties in providing care across the demographic and professional characteristics examined.Conclusions While attitudes are positive, important educational gaps persist. This highlights the need for structured LGBTQ+ inclusive undergraduate pharmacy curricula and continuing professional development to ensure competent, respectful, and inclusive care for LGBTQ+ individuals.