Acceptance, Use, and Barriers of Telemedicine in Transgender Health Care in Times of SARS-CoV-2: Nationwide Cross-sectional Survey.
COVID-19
Germany
acceptance
barrier
cross-sectional
framework
gender
health services research
identity
implementation
survey
telehealth
telemedicine
transgender
transgender health care
usage
Journal
JMIR public health and surveillance
ISSN: 2369-2960
Titre abrégé: JMIR Public Health Surveill
Pays: Canada
ID NLM: 101669345
Informations de publication
Date de publication:
03 12 2021
03 12 2021
Historique:
received:
08
05
2021
accepted:
19
09
2021
revised:
02
07
2021
pubmed:
1
10
2021
medline:
15
12
2021
entrez:
30
9
2021
Statut:
epublish
Résumé
The global incidence in the treatment of transgender people is increasing. During the COVID-19 pandemic, many consultations had to be cancelled, postponed, or converted to a virtual format. Telemedicine in the management of transgender health care could support physicians. The aim of this study was to analyze the acceptance, use, and barriers of telemedicine in transgender health care in times of SARS-CoV-2 in Germany. This prospective cross-sectional study was based on a survey of gynecological endocrinologists and transgender patients undergoing gender-affirming hormone treatment in Germany during the COVID-19 pandemic. Descriptive statistics were calculated, and regression analyses were performed to show correlations. We analyzed responses of 269 transgender patients and 202 gynecological endocrinologists treating transgender patients. Most believed that telemedicine was useful. Physicians and patients rated their knowledge of telemedicine as unsatisfactory. The majority of respondents said they did not currently use telemedicine, although they would like to do so. Patients and physicians reported that their attitudes toward telemedicine had changed positively and that their use of telemedicine had increased due to COVID-19. The majority in both groups agreed on the implementation of virtual visits in the context of stable disease conditions. In the treatment phases, 74.3% (150/202) of the physicians said they would use telemedicine during follow-ups. Half of the physicians said they would choose tele-counseling as a specific approach to improving care (128/202, 63.4%). Obstacles to the introduction of telemedicine among physicians included the purchase of technical equipment (132/202, 65.3%), administration (124/202, 61.4%), and poor reimbursement (106/202, 52.5%). Telemedicine in transgender health care found limited use but high acceptance among doctors and patients alike. The absence of a structured framework is an obstacle for effective implementation. Training courses should be introduced to improve the limited knowledge of physicians in the use of telemedicine. More research in tele-endogynecology is needed. Future studies should include large-scale randomized controlled trials, economic analyses, and the exploration of user preferences.
Sections du résumé
BACKGROUND
The global incidence in the treatment of transgender people is increasing. During the COVID-19 pandemic, many consultations had to be cancelled, postponed, or converted to a virtual format. Telemedicine in the management of transgender health care could support physicians.
OBJECTIVE
The aim of this study was to analyze the acceptance, use, and barriers of telemedicine in transgender health care in times of SARS-CoV-2 in Germany.
METHODS
This prospective cross-sectional study was based on a survey of gynecological endocrinologists and transgender patients undergoing gender-affirming hormone treatment in Germany during the COVID-19 pandemic. Descriptive statistics were calculated, and regression analyses were performed to show correlations.
RESULTS
We analyzed responses of 269 transgender patients and 202 gynecological endocrinologists treating transgender patients. Most believed that telemedicine was useful. Physicians and patients rated their knowledge of telemedicine as unsatisfactory. The majority of respondents said they did not currently use telemedicine, although they would like to do so. Patients and physicians reported that their attitudes toward telemedicine had changed positively and that their use of telemedicine had increased due to COVID-19. The majority in both groups agreed on the implementation of virtual visits in the context of stable disease conditions. In the treatment phases, 74.3% (150/202) of the physicians said they would use telemedicine during follow-ups. Half of the physicians said they would choose tele-counseling as a specific approach to improving care (128/202, 63.4%). Obstacles to the introduction of telemedicine among physicians included the purchase of technical equipment (132/202, 65.3%), administration (124/202, 61.4%), and poor reimbursement (106/202, 52.5%).
CONCLUSIONS
Telemedicine in transgender health care found limited use but high acceptance among doctors and patients alike. The absence of a structured framework is an obstacle for effective implementation. Training courses should be introduced to improve the limited knowledge of physicians in the use of telemedicine. More research in tele-endogynecology is needed. Future studies should include large-scale randomized controlled trials, economic analyses, and the exploration of user preferences.
Identifiants
pubmed: 34591783
pii: v7i12e30278
doi: 10.2196/30278
pmc: PMC8647970
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e30278Informations de copyright
©Stefan Hertling, Doreen Hertling, David Martin, Isabel Graul. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 03.12.2021.
Références
Am J Psychiatry. 2020 Aug 1;177(8):727-734
pubmed: 31581798
J Health Serv Res Policy. 2000 Oct;5(4):219-21
pubmed: 11184958
BMC Musculoskelet Disord. 2016 Aug 24;17(1):362
pubmed: 27553253
J Med Internet Res. 2018 Nov 23;20(11):e10971
pubmed: 30470678
Facts Views Vis Obgyn. 2020 Apr 1;12(1):3-7
pubmed: 32259155
Semin Arthritis Rheum. 2016 Dec;46(3):380-385
pubmed: 27395561
J Sex Med. 2021 May;18(5):900-907
pubmed: 33903046
Lancet. 2020 Mar 14;395(10227):859
pubmed: 32171399
PLoS One. 2020 Dec 31;15(12):e0244421
pubmed: 33382752
RMD Open. 2021 Feb;7(1):
pubmed: 33622673
Asian J Psychiatr. 2020 Oct;53:102234
pubmed: 32585636
J Med Internet Res. 2018 Jan 23;20(1):e24
pubmed: 29362206
J Clin Epidemiol. 2005 Jan;58(1):103-5
pubmed: 15649678
Evid Based Ment Health. 2020 Nov;23(4):e1
pubmed: 33033058
Lancet Diabetes Endocrinol. 2020 Jul;8(7):564-565
pubmed: 32445629
J Med Internet Res. 2004 Sep 29;6(3):e34
pubmed: 15471760
AIDS Behav. 2020 Sep;24(9):2477-2479
pubmed: 32338329
Obstet Gynecol Clin North Am. 2020 Jun;47(2):215-225
pubmed: 32451013
J Med Internet Res. 2020 Jun 2;22(6):e19361
pubmed: 32452816
Lancet Diabetes Endocrinol. 2018 Jun;6(6):427
pubmed: 29803259
BMJ. 2020 Nov 10;371:m4348
pubmed: 33172855
Dtsch Arztebl Int. 2020 Oct 23;117(43):725-732
pubmed: 33559593
Arch Sex Behav. 2020 Jul;49(5):1395-1399
pubmed: 32519279
J Adv Nurs. 2000 Oct;32(4):1008-15
pubmed: 11095242
Minerva Stomatol. 2020 Aug;69(4):251-255
pubmed: 32945634
Lancet. 2016 Jul 23;388(10042):390-400
pubmed: 27323925
Neurol Sci. 2020 Aug;41(8):1977-1979
pubmed: 32556746
JMIR Public Health Surveill. 2020 Apr 2;6(2):e18810
pubmed: 32238336
Z Evid Fortbild Qual Gesundhwes. 2019 May;141-142:76-88
pubmed: 30910624
Int J Med Inform. 2010 Nov;79(11):736-71
pubmed: 20884286