Just A Heart Beat Away

I was reading the trans news this morning and there were a couple of articles about trans health that I thought was timely.

Why The Transgender Population May Be More Susceptable To COVID-19

WVXU

By Ann Thompson

July 13, 2020

The pandemic is exposing an increased socioeconomic vulnerability for lesbian, gay, bisexual, transgender and intersex (LGBTI) populations, according to a new survey. For transgender people, it may come down to a variety of factors, says an University of Cincinnati doctor.

Dr. Sarah Pickle can't track the entire Tri-State transgender community to see who is having COVID-19 symptoms and who is testing positive. But, she says, "Of the patients I have who  have called me with COVID symptoms - who've been confirmed COVID and by testing or assigned COVID, based on symptoms - most of them are my transgender folks."

[…]

In fact, one in five transgender adults have at least one chronic illness according to the National Center for Transgender Equality.

[…]

Because large percentages are not going to a physician, Dr. Pickle says underlying health factors may get missed and that is putting them at greater risk for the coronavirus. She also says they have less access to insurance, stable employment and housing, and those are all factors related to health.

Okay that might be the good doctor’s opinion but I have my theory…

I think that we’re more susceptible because we many trans people live at the poverty level, they share apartments, and they live in high population areas. And also the fact that many trans people cannot find doctors willing to treat us.

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Many think that telehealth is the answer, I think the jury is not back on the subject.

Telehealth offers transgender people a new way to receive hormone therapy, during the pandemic and beyond

North Carolina Health News

By Hannah Critchfield

July 8, 2020

Taylor made the video call from the car.

The vehicle was as familiar as an office by now – before the pandemic hit, it was where 27-year-old Taylor changed into dresses before going out with friends, and where they wiped the makeup off their face before returning home each night. It was still the only place Taylor was sure they wouldn’t be called by their birth name by one of the many family members they are now quarantined with.

It was a 30-minute conversation and medical consultation – the licensed physician, who themselves was transgender, asked Taylor a few questions, briefed them on the process, and sent a prescription to a nearby Walmart.

A growing number of transgender people in North Carolina and nationally are using telehealth to seek transition-related care, particularly for hormone replacement therapy (HRT), a treatment process in which a person takes hormones to change their physical characteristics to more closely align with their gender identity.

Telehealth use has spiked in general during the pandemic, as many in-person visits shifted to video consultations to prevent the spread of COVID-19, and both federal and state governments waived certain HIPAA and Medicaid requirements, as well as bumping up reimbursement to support the practice.

Many people love telehealth but I have some questions…

“There are a lot of people who are afraid to sit in a waiting room,” said J. Clapp, executive director of the LGBTQ Center of Durham. “It’s exceptionally uncomfortable for marginalized people, because you wonder whether or not the person sitting next to you is actually supportive of who you are. That’s the importance of telehealth.“

[…]

“Many people have reported having someone at the front desk use their deadname,” said Collie, referring to the act of calling a transgender person by the name they used prior to their transition. Many say it’s, a practice that can be both emotionally and physically harmful by exposing the person to the risk of discrimination.

[…]

“What many trans people are finding is that they have to spend the majority of the time educating their provider, as opposed to having that time for themselves to be able to ask the questions that they have,” they said. “And if they do get that chance, the providers might not even be able to answer it.”

These are genuine concerns, I hate waiting when I get lab work, I hate waiting in the dentist office, and I hate waiting when I am getting my car serviced.

We all hate waiting but for trans people it is even harder especially if you stick out as trans. When people see you as trans it becomes hard sitting there.

My concerns about telehealth is that a healthcare provider can tell a lot with you just sitting across the room from them. Second the healthcare provider takes your weight and blood pressure during the office visit. Third, there are some healthcare specialties that are not conducive to tele-med like a proctologist.

Lastly practical stuff, what about licensing? Are they licensed to practice medicine in the state that their patients are located? What about insurance? Are they out of network?