291 - Understanding Gender Diverse Youth’s Experiences Receiving Gender Affirming Care via Telemedicine

Poster Number: 291
Publication Number: 291.346

Yomna Anan, Seattle Children's, Seattle, WA, United States; Nicole F. Kahn, Seattle Children's Research Institute, Seattle, WA, United States; Gina Sequeira, Seattle Children's, Seattle, WA, United States; Laura Richardson, University of Washington School of Medicine, Seattle, WA, United States; Kevin Bocek, Seattle Children's Hospital, Seattle, WA, United States; Dimitri Christakis, U of WA, Seattle, WA, United States

Background: Gender diverse youth (GDY) experience significant barriers to accessing gender-affirming care. Although access to virtual care has increased during the COVID-19 pandemic, little is known about GDY’s perspectives on receiving gender-affirming care via telemedicine.

Objective: The purpose of this study was to explore GDY’s experiences receiving gender-affirming care via telemedicine, with goals of understanding 1) ways to make telemedicine more responsive to GDY’s needs and 2) whether telemedicine may be a viable way to overcome existing access barriers.

Design/Methods: Youth aged 14-17 who completed a telemedicine visit in the Seattle Children’s Gender Clinic (SCGC) were invited to participate in a 45-minute, semi-structured, one-on-one Zoom interview. The interview guide was developed in partnership with a group of GDY stakeholders and included open-ended questions exploring patients’ thoughts and experiences about using telemedicine, as well as their preferred visit modality (in-person or telemedicine). Interviews were transcribed and analyzed using an inductive thematic analysis framework in Dedoose analysis software. A waiver of parental consent was obtained and all youth provided verbal assent to participate.

Results: A total of 15 GDY participated in an interview. The most commonly cited advantages of telemedicine were 1) convenience (n=13) of the visit, and 2) comfort (n=9) with participating in visits in their home environments. Reported disadvantages of telemedicine included 1) technical issues (n=9) with internet connectivity and using unfamiliar video platforms, 2) discomfort (n=8) with how impersonal and unfamiliar virtual care was, and 3) privacy concerns (n=7; Table 1). Overall, slightly more youth indicated a preference for in-person visits (n=7) over telemedicine (n=5), with the remaining indicating it depended on the situation. GDY referenced both specific characteristics of their clinical visit (i.e., initial vs. return, complexity), and proximity to the clinic as reasons for these preferences (Table 2).Conclusion(s): This study provides new insights from GDY about their experiences receiving gender-affirming care via telemedicine. These perspectives can help providers and health systems improve care delivery and make decisions regarding telemedicine’s continued availability following the COVID-19 pandemic. Overall, results indicate that it is a valuable mode of care delivery for GDY; however, to accommodate the needs of all patients, gender-affirming care should continue to be provided both in-person and via telemedicine.

Table 1: Gender diverse youth's perceptions of the advantages and disadvantages of using telemedicine for gender-affirming care