Transgender youth supportive of telehealth for ongoing gender care


By Lisa Rapaport

(Reuters Health) - Many transgender youth are open to receiving gender-affirming care via telehealth, and a new study also suggests that this approach may be preferable for ongoing care and for youth who lack parental support.

Researchers surveyed 204 youth aged 12 to 26 years old who were receiving care at a multidisciplinary gender clinic. Overall, 47% of the survey respondents were interested in getting this care via telemedicine.

Transgender youth with low perceived parental support were more likely to be interested in receiving gender care via telemedicine than their counterparts with high perceived parental support (68% v 31%, respectively).

"A young person experiencing lower perceived parental support may also assume that their parent is less likely to go to great lengths to attend these appointments," said lead study author Dr. Gina Sequeira, an acting assistant professor of pediatrics at the University of Washington and co-director of the Seattle Children's Gender Clinic.

"If we are able to develop systems using telehealth to make accessing gender-affirming care less cumbersome, we may be able to reach patients and families we were previously unable to reach by providing only in-person care," Dr. Sequeira said by email.

The majority of the youth in the study identified as transmasculine (59%), were under 18 years old (56%), and traveled more than 30 minutes to the gender clinic (67%), according to the report in the Journal of Adolescent Health.

In addition, most of the youth reported at least one visit in the previous year with a primary care provider outside the gender clinic (59%). Most of these primary care visits were to pediatricians (61%) and involved providers who knew about the participants' gender identity (57%).

While only 44% of participants overall said they were somewhat or very interested in receiving gender care from a primary care provider. However, 85% were willing to receive care from primary care providers who received regular training in transgender health.

In addition, 76% of youth were willing to receive gender care from a primary care provider who could communicate regularly by phone, and 68% would do telemedicine visits with primary care providers who had a gender clinic doctor present for the visit.

Among participants interested receiving gender care via telemedicine, most of them wanted to receive refills for hormones (80%) and laboratory monitoring (72%) via these virtual visits. Only 10% of these participants, however, were interested in using telemedicine for sick visits with gender specialists.

One limitation of the study is that it didn't assess the providers' perceptions about the feasibility or desirability of providing care to transgender youth using telemedicine.

"These findings indicate that providers should explore telehealth options for offering gender-affirming care to trans youth, as well as to trans adults," said Kellan Baker, a health services researcher at the Johns Hopkins Bloomberg School of Public Health in Baltimore who wasn't involved in the study.

"There is a common but incorrect perception that gender-affirming hormone therapy is difficult to provide, but in reality, hormone therapy, including the use of puberty delay medications, is safe and can be easily monitored via telehealth," Baker said by email.

SOURCE: Journal of Adolescent Health, online September 23, 2020.

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