Medically reviewed by Aimee Paik, MD
Written by Apostrophe Team
Last updated 11/4/2022
The U.S. healthcare system often allows people to fall through the cracks. No one is more aware of that than queer and trans patients. Obstacles like obtaining health insurance, traveling to a doctor’s office, or accessing treatment can affect anyone, but you often experience these obstacles on top of discrimination from providers. Just like anyone else, doctors and nurses can be transphobic and homophobic, and this discrimination occurs in conjunction with systemic and institutional barriers to healthcare. However, you may have noticed a trend in healthcare recently: telemedicine. By cutting out travel and removing intermediaries to make treatments more affordable, telemedicine has the potential to expand access for those of us who struggle to find safe, effective, and destigmatized care.
In a system that has medicalized trans bodies both historically and in the present, trans patients often face multiple barriers to accessing healthcare, whether that means routine check-ups from primary care physicians, or more specific treatment related to hormone therapy and gender affirmation. Study after study report both you and your doctors cite socioeconomic factors, lack of cultural competency and experience from providers, and health systems barriers (like records-keeping and adherence to the gender binary) as just some of the obstacles trans patients must overcome to get care. Services like QueerMed and SteadyMD are already using video chat and other telehealth technologies to offer LGBTQ-inclusive care to patients who struggle with access to, or comfort with, providers.
Telemedicine is most often used to treat common ailments that are easily diagnosable and easily treated with safe and effective medicines. For instance, dermatologists typically prescribe finasteride for cis-men to treat male pattern baldness. For trans men who begin hormone therapy, the addition of testosterone can often jumpstart hair loss in those who are genetically predisposed. However, treatment for trans patients can be a balancing act. Finasteride is an anti-androgen, which means it can slow the development of secondary sex characteristics caused by testosterone (notably, beard development, body hair development, and clitoromegaly - “bottom growth”) – changes that may be a priority for those beginning or in the process of transitioning. Our medical director notes, “patients are complex cases. We will need to do a significant job educating our providers about this community. We also need to have providers eager and up to the task of treating this population.”
At Apostrophe, we take customer care seriously starting with education for the providers on our platform so all customers can have fair treatment. Telemedicine providers armed with the resources to take these factors into account can treat their patients holistically by using online platforms to counsel on these considerations. Customers are better informed about their treatments and have increased access to their doctors. We are excited about the potential telemedicine has to increase healthcare access for this community and to change lives!
To ask questions or learn more, tweet us @hi_apostrophe.
1. Bauer, Great R., et al. “‘I Don't Think This Is Theoretical; This Is Our Lives’: How Erasure Impacts Health Care for Transgender People.” Journal of the Association of Nurses in AIDS Care, vol. 20, no. 5, 2009, pp. 348–361., www.sciencedirect.com/science/article/abs/pii/S1055329009001071. 2. Cruz, Taylor M. “Assessing Access to Care for Transgender and Gender Nonconforming People: A Consideration of Diversity in Combating Discrimination.” Social Science & Medicine, vol. 110, June 2014, pp. 65–73., www.sciencedirect.com/science/article/abs/pii/S0277953614002111. 3. Deutsch, Madeline B. “Center of Excellence for Transgender Health.” Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender-Nonconforming People: Overview of Masculinizing Hormone Therapy, transhealth.ucsf.edu/trans?page=guidelines-masculinizing-therapy. 4. Jaffee, Kim D., et al. “Discrimination and Delayed Health Care Among Transgender Women and Men.” Medical Care, vol. 54, no. 11, Nov. 2016, pp. 1010–1016., www.ingentaconnect.com/content/wk/mcar/2016/00000054/00000011/art00009. 5. “Prescribing Information - PROPECIA (Finasteride) Tablets.” MERCK, Sept. 2013, www.merck.com/product/usa/pi_circulars/p/propecia/propecia_pi.pdf. 6. Roberts, Tiffany K., and Corinne R. Fantz. “Barriers to Quality Health Care for the Transgender Population.” Clinical Biochemistry, vol. 47, no. 10-11, July 2014, pp. 983–987., www.sciencedirect.com/science/article/pii/S0009912014000708. 7. Safer, Joshua D., et al. “Barriers to Health Care for Transgender Individuals.” Current Opinion in Endocrinology, Diabetes and Obesity, vol. 23, no. 2, 1 Apr. 2016, pp. 168–171., www.ncbi.nlm.nih.gov/pmc/articles/PMC4802845/. 8. Snelgrove, John W., et al. “‘Completely out-at-Sea’ with ‘Two-Gender Medicine’: A Qualitative Analysis of Physician-Side Barriers to Providing Healthcare for Transgender Patients.” BMC Health Services Research, vol. 12, no. 110, May 2012, bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-12-110.
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