Telehealth in Trans and Gender Diverse Communities: the Impact of COVID-19

Abstract

Purpose of Review This paper synthesizes current knowledge regarding telehealth and the impact of the SARS-COV2 pandemic on transgender and gender diverse (TGD) patients. We discuss the benefits and challenges of telehealth for patients, providers, and trainees. Recent Findings Mental health of TGD populations has been disproportionately challenged in the context of SARS-COV2, and telehealth interventions focused on gender affirmation and mental health are desired and acceptable by TGD populations. Summary Telehealth in the era of SARS-COV-2 has a mixed impact on TGD patients and families, increasing access, decreasing travel time, and allowing for comfort and safety during care while also leaving gaps in care for patients without web/phone access and/or without a confidential place to participate in appointments, or to manage health concerns that require in-person evaluation. Providers have benefitted from the ability to reach TGD patients that are far from practice sites and to provide remote consultation for procedures and other interventions. Trainees have challenges as a result of telehealth practice which can impair the ability to learn in-person care, but have benefitted from remote training opportunities, including surgical training. Alterations in compensation structures have allowed sustainable telehealth practice to be an option for providers and health systems. As telehealth evolves, quality improvement and research efforts aimed at resolving known challenges and expanding beneficial uses of telehealth should consistently include and consider not only the beneficiaries of telehealth but also those who may struggle with access.

Patient and parent perspectives on the utility of telemedicine for initial surgical gender care consultations: A cross-sectional survey

“…Adopting telemedicine as an alternative for some in-person gender care visits may also facilitate the clinician–patient relationship by minimizing the potential for patient stress caused by anxiety and stigmatization during in-person visits. 42 , 43 The patients in this study described feeling more comfortable in a telemedicine setting where they could avoid harmful office interactions, a finding that is in line with existing literature on the stigma that TGD patients face in medical settings and that leads many to delay medical visits or avoid them entirely. 44 , 45 Increased availability of telemedicine for GAC could allow TGD patients to have more autonomy over their care, empowering them to be more comfortable and engaged in subsequent visits.…”