JMIR Publications

ABSTRACT

Background:

Access to virtual care has increased since the beginning of the COVID-19 pandemic, yet little is known about transgender and gender diverse (TGD) youth’s experiences and perspectives on receiving care via telemedicine.

Objective:

The purpose of this study was to explore these experiences to 1) inform necessary changes to the provision of pediatric gender-affirming care and 2) help providers and health systems determine if and how telemedicine should be made available post-pandemic.

Methods:

Youth (14-17) who completed a telemedicine visit in the Seattle Children’s Gender Clinic were invited to participate in a semi-structured interview exploring perceived advantages/disadvantages of telemedicine and preferred visit modalities. Interview transcriptions were analyzed by two research team members using an inductive thematic analysis framework.

Results:

Fifteen TGD youth completed an interview. Commonly cited advantages of telemedicine were convenience and comfort with having visits in their own environments. Reported disadvantages included technical issues, discomfort with the impersonal nature, lack of familiarity with the platform, and privacy concerns. Overall, slightly more youth preferred in-person visits over telemedicine, referencing both specific characteristics of the clinical visit (i.e., initial vs. return, complexity) and proximity to the clinic as reasons for this preference. Although a plurality of TGD youth preferred in-person visits, they also recognized the value of telemedicine and the impact it may have in facilitating access to care.

Conclusions:

Given variations in needs and visit complexity, our study supports the provision of both in-person and telemedicine modalities as options for pediatric gender-affirming care.