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远程医疗与医疗保健获取方面的不平等:以跨性别健康为例。

Telemedicine and Inequities in Health Care Access: The Example of Transgender Health.

作者信息

Hamnvik Ole-Petter R, Agarwal Shailesh, AhnAllen Christopher G, Goldman Anna L, Reisner Sari L

机构信息

Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.

Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.

出版信息

Transgend Health. 2022 Apr 11;7(2):113-116. doi: 10.1089/trgh.2020.0122. eCollection 2022 Apr.


DOI:10.1089/trgh.2020.0122
PMID:36644516
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9829126/
Abstract

Due to concerns about the risk of infectious exposures during the coronavirus disease 2019 (COVID-19) pandemic, the uptake of telemedicine has increased rapidly, aided by increased acceptance by clinicians and patients and a reduction in regulatory and reimbursement hurdles. The increased access to telemedicine may have benefits beyond the reduction in contagious risk, especially for vulnerable populations. By breaking down some of the common barriers to care for vulnerable populations, the broad implementation of telemedicine may help reduce some inequities in health care access, but telemedicine does raise other challenges that need to be considered and addressed. One vulnerable group that can benefit from telemedicine is transgender and gender nonbinary (TGNB) individuals, who have less access to both gender-affirming and general medical care due to the consequences of stigma, discrimination, and marginalization. Telemedicine allows TGNB individuals to access clinical expertise even if it is not available locally, and without the expense of travel and without the concern for exposure to discrimination and mistreatment. However, lack of access to or expertise in navigating the required technology, lack of a safe and confidential space to access care, and an unpredictable regulatory and reimbursement environment remain hurdles for harvesting the full benefits of telemedicine.

摘要

由于对2019冠状病毒病(COVID-19)大流行期间感染暴露风险的担忧,在临床医生和患者接受度提高以及监管和报销障碍减少的推动下,远程医疗的使用迅速增加。远程医疗使用的增加可能带来除降低传染风险之外的益处,特别是对弱势群体而言。通过打破一些影响弱势群体获得医疗服务的常见障碍,远程医疗的广泛实施可能有助于减少医疗服务获取方面的一些不公平现象,但远程医疗确实也带来了其他需要考虑和解决的挑战。一个能从远程医疗中受益的弱势群体是跨性别者和性别非二元认同者(TGNB),由于耻辱感、歧视和边缘化的影响,他们获得性别肯定医疗服务和普通医疗服务的机会较少。远程医疗使TGNB个体即使在当地无法获得相关服务的情况下,也能获得临床专业知识,而且无需承担旅行费用,也不用担心遭受歧视和虐待。然而,缺乏使用所需技术的途径或相关专业知识、缺乏获得医疗服务的安全保密空间,以及不可预测的监管和报销环境,仍然是充分利用远程医疗益处的障碍。

相似文献

[1]
Telemedicine and Inequities in Health Care Access: The Example of Transgender Health.

Transgend Health. 2022-4-11

[2]
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[3]
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[4]
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[5]
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[6]
Acceptance, Use, and Barriers of Telemedicine in Transgender Health Care in Times of SARS-CoV-2: Nationwide Cross-sectional Survey.

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[7]
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[8]
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[9]
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[10]
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引用本文的文献

[1]
Telemedicine in Obstetrics and Gynecology: A Scoping Review of Enhancing Access and Outcomes in Modern Healthcare.

Healthcare (Basel). 2025-8-18

[2]
Social vulnerability, lower broadband internet access, and rurality associated with lower telemedicine use in U.S. Counties.

JAMIA Open. 2025-7-26

[3]
Prevalence and Correlates of Clinically Elevated Depressive Symptoms in a Nationwide Sample of Transgender, Nonbinary, and Gender Diverse Young Adults in the United States: Cross-Sectional Survey Study.

Interact J Med Res. 2025-3-24

[4]
Determinants of Repeating an HIV Test Among Gay, Bisexual, and Other Men Who have Sex with Men, and Transgender People Who Use an Online-Requested Self-Sampling Program and Attending Community-Based Testing Venues in Spain (2018-2021).

AIDS Behav. 2024-9

[5]
Will the United States pass on telemedicine progress?

JAMIA Open. 2024-2-26

[6]
Narrative review of telemedicine applications in decentralized research.

J Clin Transl Sci. 2024-1-22

[7]
The effectiveness of telehealth interventions for people with multiple sclerosis: A systematic review and meta-analysis protocol.

Digit Health. 2023-11-27

[8]
A Decade of HIV Preexposure Prophylaxis (PrEP): Overcoming Access Barriers in the United States Through Expanded Delivery.

Public Health Rep. 2024

[9]
Adolescent Perspectives on the Use of Telemedicine for Confidential Health Care: An Exploratory Mixed-Methods Study.

J Adolesc Health. 2023-8

[10]
Information and communication technology-based health interventions for transgender people: A scoping review.

PLOS Glob Public Health. 2022-9-15

本文引用的文献

[1]
Assessing Telemedicine Unreadiness Among Older Adults in the United States During the COVID-19 Pandemic.

JAMA Intern Med. 2020-10-1

[2]
Barriers to Care Among Transgender and Gender Nonconforming Adults.

Milbank Q. 2017-12

[3]
Demographic Characteristics and Health Status of Transgender Adults in Select US Regions: Behavioral Risk Factor Surveillance System, 2014.

Am J Public Health. 2017-4

[4]
Virtual visits--confronting the challenges of telemedicine.

N Engl J Med. 2015-4-30

[5]
Is physical examination required before prescribing hormones to patients with gender dysphoria?

J Sex Med. 2008-1

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