Caregiver Perspectives on Receiving Gender-Affirming Care with Their Transgender and Gender Diverse Adolescents via Telemedicine

Abstract

Telemedicine may help improve access to gender-affirming care for transgender and gender diverse (TGD) adolescents. Parents or guardians (i.e., caregivers) of TGD adolescents play a critical role in supporting TGD adolescents in accessing this care. The purpose of this study was to explore caregivers’ perspectives regarding their adolescent receiving pediatric gender-affirming care via telemedicine to help providers and health systems optimize this modality for future care delivery. Caregivers (n = 18) of TGD adolescents ages 14–17 participated in semi-structured, individual interviews that were transcribed and analyzed qualitatively. Caregivers cited participating in visits from their home environment, decreased anxiety, COVID safety, ability to have more family members attend, no transportation demands, and effective delivery of care as advantages of telemedicine. Disadvantages included dysphoria or discomfort with self-image, impersonal provider-patient interactions, video teleconferencing fatigue, difficulty with portal navigation, connectivity issues, and lack of privacy. Caregivers largely deferred to their child’s preference regarding the choice of visit modality, but many reported a preference for the first to be conducted in-person, and follow-up and less complex visits via telemedicine. Health systems should consider these perspectives as they adapt telemedicine infrastructure to better meet the needs of patients and their families.

Keywords:

• Transgender and gender diverse adolescents
• parents
• caregivers
• gender-affirming care
• telemedicine

Acknowledgments

This project was supported by the Seattle Children’s Research Institute and AHRQ (K12HS026393-03; PI: Sequeira) and Pivotal Ventures. The authors wish to thank the Gender Research Stakeholder program, a group of gender diverse adolescents and adults as well as parents and caregivers of gender diverse youth, for their guidance and feedback throughout the development, conduct, and interpretation of this study.

Disclosure statement

Dr. Sequeira is a consultant for Pivotal Ventures and the Fenway Institute. The authors have no other interests to disclose.

Additional information

Funding

Agency for Healthcare Research and Quality.