Opening doors to inclusive sexual health care

Pictured above: Pharmacist/Owner – Greg Richard

At Boyd’s Pharmasave in downtown Halifax, gender-affirming and sexual health services are at the core of community care—not at the margins. The administration of gender- affirming hormones (e.g., testosterone and leuprolide injections) is as accessible as a medication review. On intake forms, all patients are asked their pronouns and gender identity.

Originally profiled in CFP’s 2025 Changing Face of Pharmacy report, the emphasis is on “creating a space free of discrimination and stigma,” says pharmacist/owner Greg Richard, himself a member of the LGBTQ+ community. “It’s an environment where we treat everyone the exact same way.”

Growing up in Miramichi, New Brunswick, Richard worked in community pharmacies before moving to Halifax with his partner and opening his own pharmacy. He deliberately chose a queer-friendly neighbourhood on a major bus route, making the space as accessible as possible for all. “For me, the neighbourhood is really such a great representation of what a community should be,” he says. “There’s a ton of diversity, and I think we really lean into that and try and make it a part of our pharmacy practice.”

Richard recalls a situation back in Fredericton during the pandemic when he was working in a community setting. A trans patient on opioid agonist therapy needed a testosterone injection but his usual provider had shut down. Richard couldn’t help. “Our pharmacy wasn’t set up for that, yet I knew it was a moment when saying ‘no’ would have a profound effect on someone who was obviously struggling,” he says. “It really lit a fire under me around the potential of what I could be doing as a pharmacist.”

The transition journey

Since opening his pharmacy in 2021, Richard says it’s incredibly rewarding to be able to provide these kinds of services and be part of a patient’s transition journey, from that very first hormone injection. “In creating this safe space and advocating for better healthcare services in our community, I’ve realized that we can make huge changes in our patients’ lives,” he says.

Boyd’s provides a variety of hormone injection services, as well as training on proper injection administration. Members of the pharmacy team also act as advocates for patients, whether that be in finding appropriate paths for gender-affirming surgeries or instructing on how to legally change names and gender. “We also offer free injection supplies for intramuscular and subcutaneous injections in pre-made kits, no questions asked,” says Richard, noting that this minimizes patients’ apprehension.

Outside of the pharmacy, he and his team (which includes two other pharmacists) are often called on as experts in the field of gender-affirming care. “If a physician is looking to make a dose adjustment or therapy change, they can lean on us,” he says. “I’ve had questions from practitioners across the entire province.”

In building Boyd’s reputation as a safe space for gender-diverse patients, Richard says he initially connected with community members about what they needed most. “I reached out to more than a dozen community organizations to ask about their perceptions of health inequities and the challenges faced by gender and sexually diverse patients,” he says. “That was really important as it set the stage for our intentions going forward.”

While the focus was always on improving access rather than profitability, Richard notes that business growth followed naturally. In the early days, he provided expanded pharmacy services in between core dispensing duties. Starting in 2023, as part of Nova Scotia’s Community Pharmacy Primary Care Clinic (CPPCC) project, the pharmacy’s onsite primary care clinic improved efficiencies and added capacity.

Services for high-risk patients

With the addition of the clinic, the pharmacy was able to introduce new services such as HIV assessments to determine if patients were at high risk for HIV and could benefit from pre-exposure prophylaxis (PrEP) medication, which quickly gained traction. “I would say we’re doing at least two or three HIV PrEP appointments a day,” Richard reports.

As a CPPCC, Richard could also bill the government’s drug plan for hormone injections that the pharmacy had provided at no cost to patients for years. “HIV PrEP prescribing is not covered and so we don’t charge for that but we’re hoping that will change in the near future.”

The growing popularity of HIV PrEP and other services is a testament to the need for more pharmacies to provide services that equalize access to care for sexually diverse patients, says Richard. He points to numerous cases of patients who have come to him with health-related questions they didn’t feel comfortable asking their primary care provider. “I’ve had patients come for HIV PrEP prescribing because they’ve been refused it by their primary care provider, who either doesn’t understand it or doesn’t agree with it,” he adds. “It’s a shame but it also lights a fire under pharmacists to actually get out and do something about this.”

Richard teaches the gender-affirming care section of the curriculum at Dalhousie University’s College of Pharmacy and was involved in developing the “Gender-Affirming Care for Transgender and Gender-Diverse Individuals” chapter for the latest edition of the Compendium of Pharmaceuticals and Specialties. His greatest hope? That more pharmacies will use his practice as a model for what’s possible in caring for their sexually diverse patients.

“I can’t open a pharmacy in every rural community in Nova Scotia, but I hope to empower others to do the same thing I’m doing,” he says.

This article is reprinted from CFP’s 2025 Changing Face of Pharmacy report, mailed to more than 14,000 community pharmacies in Canada in November 2025. A pdf version is also available.