Delivering Holistic Transgender and Nonbinary Care in the Age of Telemedicine and COVID-19

Ng, Henry; Zimmerman, Lyndsay; Ferguson, Bailey; Dimmock, Elizabeth; Harlan, Richard E.; Hekman, James; Obeid, Hiba

doi:10.1016/j.pop.2021.02.008

Cited by 10 publications

(8 citation statements)

References 36 publications

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“…Pre‐ and early pandemic telehealth guidelines were limited in scope and did not fully address the increasing demands of interprofessional collaboration and increasing range of virtual care that was required under the tight restrictions of the pandemic (Shaver, 2022). More recently, nurses and their health teams have created guidelines that support telehealth under COVID‐19 conditions (Ng et al, 2021; Smith & Raskin, 2021).…”

Section: Discussionmentioning

confidence: 99%

“…Telehealth is the use of any telecommunication and information technology in the provision of care, the collection of patient data, and the dissemination of information between patient and practitioner across a distance (College of Nurses of Ontario, 2020; Kichloo et al, 2020). When telehealth was used to good effect, practitioners found encouraging results with early experiences suggesting improved health outcomes (Lock et al, 2022; Ng et al, 2021). For example, Grasso et al (2022) found that their US federally qualified gender affirming clinic was able to care for nearly as many new transgender patients from during the first 6 months of the pandemic as they do annually despite the patients hailing from across 24 states.…”

Section: Introductionmentioning

confidence: 99%

“…When telehealth was used to good effect, practitioners found encouraging results with early experiences suggesting improved health outcomes (Lock et al, 2022;Ng et al, 2021). For example, Grasso et al (2022) found that their US federally qualified gender affirming clinic was able to care for nearly as many new transgender patients from during the first 6 months of the pandemic as they do annually despite the patients hailing from across 24 states.…”

Section: Introductionmentioning

confidence: 99%

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Primary care in Northern Ontario for transgender people in the context of the COVID‐19 pandemic: A qualitative secondary analysis

Ziegler

Carroll

2023

J of Nursing Scholarship

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PurposeTo examine changes to primary care practice for transgender clients resulting from government mandated public health measures in response to COVID‐19 in Northern Ontario.DesignSecondary analysis of qualitative data using interview transcripts from a dataset that included 15 interviews conducted between October 2020 and April 2021.MethodsThe dataset came from a convergent mixed method study exploring the delivery of primary care services to transgender individuals in Northern Ontario. Qualitative interviews with primary care practitioners including nurse practitioners, nurses, physicians, social workers, psychotherapists, and pharmacists providing care for transgender people in Northern Ontario were included in the secondary analysis.ResultsFifteen primary care practitioner providing care to transgender individuals in Northern Ontario participated in the parent study. Practitioners described their understanding of the effect of the early stages of the COVID‐19 pandemic changes on their practice and the care experience for their transgender patients. Two themes were identified and described by participants: (1) a change in the delivery of care; and (2) barriers and facilitators to care.ConclusionsPractitioners' primary care experiences in the early waves of COVID suggest the integral use of telehealth in Northern Ontario transgender care. Nurses working in advance practice and nurse practitioners are essential in providing continuity of care for their transgender clients.Clinical relevance/SignificanceIdentification of initial practice changes for the primary care of trans people will illuminate avenues for further research. The urban, rural, and remote practice settings in Northern Ontario provide an opportunity for increasing access for gender diverse people in these areas and for developing increased understanding of uptake of telemedicine practice. Nurses are integral to primary care for transgender patients in Northern Ontario.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Primary care in Northern Ontario for transgender people in the context of the COVID‐19 pandemic: A qualitative secondary analysis

Ziegler

Carroll

2023

J of Nursing Scholarship

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“…Virtual connections could serve to bypass transportation issues and avoid misgendering from clinic staff. When used with an interprofessional approach and with providers that have gender-affirming care experience, telehealth has the potential to help reduce anxiety among these patient populations ( Ng et al, 2021 ). However, 21.0% of participants who avoided primary care in this study also reported avoiding virtual care.…”

Section: Discussionmentioning

confidence: 99%

Avoidance of primary healthcare among transgender and non-binary people in Canada during the COVID-19 pandemic

Tami

Ferguson

Bauer

et al. 2022

Preventive Medicine Reports

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“…Telemedicine during the COVID-19 pandemic offered many benefits for TGD patients beyond a reduction in coronavirus transmission risk, including not needing to arrange transportation, navigate the use of public restrooms, and avoidance of negative interactions while in public and in clinical settings [ 60 ]. On the other hand, use of telemedicine can be challenging for those who are older or less computer literate, lack of broadband access or computer hardware, or a safe and confidential space to conduct telehealth visits [ 61 ].…”

Section: Telemedicinementioning

confidence: 99%

Transgender Individuals and Digital Health

et al. 2022

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Purpose of review The goal of this review is to assess the use of digital technologies to promote the health and well-being of transgender and gender diverse (TGD) people. Recent findings TGD individuals experience numerous health disparities, including low uptake of HIV prevention strategies, such as pre-exposure prophylaxis, increased HIV incidence, and suboptimal HIV-related outcomes. These health disparities are the result of widespread intersectional stigma on the basis of gender identity, gender expression, socioeconomic class, race, and ethnicity, which negatively impact access to general medical and transgender-specific health care. TGD individuals often delay or avoid essential medical services due to fear of discrimination. Clinicians frequently lack training, competence, and skills in transgender medicine, further exacerbating the health disparities faced by TGD people. Digital technologies have been used to improve research and clinical care for TGD populations through various modalities; telemedicine, telehealth and mHealth. Summary Digital health technologies, including HIT-enabled clinical decision support, telehealth, telemedicine, and mHealth, offer innovative ways to improve health care access, improve quality of care, and reduce health disparities for TGD populations, including and beyond HIV outcomes, through enhanced care delivery, clinician education, and enhancing social support networks.

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Delivering Holistic Transgender and Nonbinary Care in the Age of Telemedicine and COVID-19

Cited by 10 publications

References 36 publications

Primary care in Northern Ontario for transgender people in the context of the COVID‐19 pandemic: A qualitative secondary analysis

Primary care in Northern Ontario for transgender people in the context of the COVID‐19 pandemic: A qualitative secondary analysis

Avoidance of primary healthcare among transgender and non-binary people in Canada during the COVID-19 pandemic

Transgender Individuals and Digital Health

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