Introducing Gender-Affirming Care to Primary Care Settings, Telehealth Services

December 19, 2022 - Although primary care clinics offer numerous beneficial healthcare services to patients, they often fall short of delivering effective gender-affirming care (GAC), which requires empathy, trust, and understanding. Due to this gap in care, a high rate of suicide, substance use disorders, HIV infections, and other health inequities heavily impact the health of the transgender community, who have been known to face harassment and discrimination when seeking care.

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In this episode of Healthcare Strategies, Kate Steinle, nurse practitioner, Chief Clinical Officer at FOLX Health, and former Planned Parenthood employee, discusses ways of breaking down these barriers to care and expanding access to this historically underserved community.

“It is well known now the health disparities this entire community faces. This community has always weathered attacks against its visibility,” echoed Steinle, but “more and more people are identifying as gender variant or gender nonconforming.”

According to a 2022 UCLA report, the number of teenagers and young adults in the United States who identify as transgender has doubled in the past five years — estimating that there are 1.6 million transgender individuals 13 or older in the US alone.

“And that younger generation, as they continue to grow, they’ll need more healthcare,” added Steinle. “To allow access across the entire country and minimize barriers, not every healthcare provider needs to be a specialist to provide gender-affirming hormones.”

Steinle explains that the best way for the healthcare system to adapt to this growing need in care is to integrate GAC into primary care settings and telehealth services.

“People who are in rural areas and don't have parents who can drive them three hours or don't feel supportive or safe going three hours away to a city to access a gender-affirming hormone provider can do that through telehealth,” Steinle explained. “People accessing care through telehealth is allowing them to do this on their own time.”

While expanding access seems simple, most providers have not yet received the proper education or training to give appropriate GAC. However, Steinle notes that medical and nursing schools are moving in the right direction by starting to incorporate GAC into their curriculum.

Additionally, healthcare professionals who want to learn more about GAC can benefit from interdisciplinary professional and educational organizations such as the World Professional Association for Transgender Health (WPATH), US Professional Association for Transgender Health (US PATH), and the National LGBTQIA+ Health Education Center, a Fenway Institute program.

“In general, this is not rocket science-type medical care. It's pretty simple in terms of how to prescribe and change doses and review labs,” Steinle added. “You need to be a kind and open person who listens to their patients and takes some of the education into your own hands.”