Making trans health care accessible through e-health

Access to health care by trans-informed professionals has a critical impact on trans people's health and quality of life. However, trans people often face barriers such as long routes to specialised gender clinics and a lack of qualified health professionals. Thus, e-health services could specifically help with barrier reduction. The aim of this symposium is to present innovative e-health approaches from different disciplines, and to shed light on their potentials when implemented in transgender health care.

The first project is located in Germany, where trans people – similar to other countries in Europe – are often dependent on a few specialised clinics in metropolitan areas, such as the Interdisciplinary Transgender Health Care Centre Hamburg. In early 2020, the e-health project i²TransHealth which is conducted by researchers from the Institute for Sex Research, went online testing its online interventions for effectiveness in a randomised controlled trial (RCT). Compared with a waiting group, participants in the intervention group receive 4 months of support from mental health professionals via video consultation, as well as crisis intervention from nearby GPs and psychiatrists if needed. Until the end of March 2021, 94 participants are enrolled in the study. We expect i²TransHealth to reduce symptom burden (BSI-18; primary outcome) and to improve both quality of life (WHOQOL-BREF) and treatment satisfaction (mod. ZUF-8) as secondary outcomes.

Italy was one of the first countries in Europe to be severely affected by the occurrence of the COVID-19 pandemic. Therefore, researchers at the University of Florence performed a study on a sample of 80 trans people attending the clinic for gender dysphoria, before and during the lockdown for the COVID-19 pandemic. Trans people were asked for consequences of the lockdown in terms of psychopathology, quality of life, and interference with other treatments, such as endocrine care. Data were compared with those obtained from a group of 85 controls.

Since March 2020 a surgical unit from Essen University Hospital set up the possibility of video consultation for both preoperative consultation and postoperative monitoring. The video consultation was frequently requested, especially by those who have to travel a long way. However, some clients preferred personal face-to-face contact because they feared privacy issues. In addition, to overcome the difficulties in training medical students, we initiated an e-learning seminar with clinical case presentations together with our partners from Hannover Medical School. The results and experiences with this interdisciplinary format will be reported.

It is not only the aftermath of the COVID-19 pandemic that has given digitalisation a boost, also in the field of transgender healthcare. E-health approaches seem valuable for improving transgender healthcare, but their specific benefits need to be robustly proven both empirically and clinically.