Hamnvik Ole-Petter R, Agarwal Shailesh, AhnAllen Christopher G, Goldman Anna L, Reisner Sari L
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.
Transgend Health. 2022 Apr 11;7(2):113-116. doi: 10.1089/trgh.2020.0122. eCollection 2022 Apr.
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.
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。
