Wednesday, May 09, 2018

Telemedicine brings transgender care to rural areas

Much has been made about the value of telemedicine in rural areas, but there's another, not often discussed, benefit to it: its ability to help transgender people access discreet, experienced medical care. Ten percent of transgender people said they'd faced discrimination while seeking care, and 22 percent said they've avoided seeking care because they worried about discrimination, a 2017 poll found. "Many fear discrimination will increase with strengthened protections for doctors and nurses refusing to provide certain care on religious grounds," Keren Landman reports for NPR. "The more care refusals transgender people experience, the less care they seek, and the higher their rates of preventable and treatable conditions, including cancers, mental health problems, and substance-use disorders."

Beyond the fear of discrimination, it's hard for transgender people to find medical care in rural areas because there are far fewer doctors and nurses competent in transgender care. And that's on top of the challenges cisgender people face in finding rural medical care: long drives and long waits to receive care.

That's why Izzy Lowell, an Atlanta family practitioner who specializes in transgender care, created QMed in 2017. Transgender or gender non-conforming patients in the Southeast  can set up telemedicine appointments with Lowell in which she addresses sensitive topics like body changes or sexual function. To ensure privacy, Lowell uses headphones during webcam visits and uses white noise machines in her waiting room for in-person visits.

As with other telemedicine services, lack of reliable, affordable broadband may be a barrier for potential patients. And though 32 states have laws mandating that private insurance companies compensate doctors as much for telemedicine appointments as they do for in-person appointments, telemedicine providers in other states may struggle to get reimbursed and turn a profit, Landman reports.

Lowell reports that, less than a year after starting QMed, she's almost covered her startup costs and will soon turn a profit. But she says the administrative headaches are worth it. "The current system is not at all fair to transgender people," she told Landman. "And I don't like unfairness."

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