Patient Preferences for Receiving Gender-Affirming Hormone Therapy

Erin Inman; Daria Stelmak; Emily K Kobernik; Juan J Andino; Daphna Stroumsa; Molly B Moravek; John F Randolph Jr

doi:10.1089/trgh.2020.0125

Patient Preferences for Receiving Gender-Affirming Hormone Therapy

Transgend Health. 2022 Feb 14;7(1):85-91. doi: 10.1089/trgh.2020.0125. eCollection 2022 Feb.

Authors

Erin Inman¹, Daria Stelmak², Emily K Kobernik¹, Juan J Andino³, Daphna Stroumsa^{1

4}, Molly B Moravek¹, John F Randolph Jr¹

Affiliations

¹ Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA.
² University of Michigan Medical School, Ann Arbor, Michigan, USA.
³ Department of Urology and University of Michigan, Ann Arbor, Michigan, USA.
⁴ Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA.

Abstract

Purpose: To characterize patient preferences regarding gender-affirming hormone therapy (HT) providers and telemedicine use.

Methods: Between May and October 2019, a survey was administered to adult patients attending a tertiary medical center's HT clinic. The survey included questions on demographics, barriers to care, and preferences for HT follow-up care. Interest in telemedicine was measured using a Likert scale. Multivariable logistic regression was used to identify patient factors associated with interest in telemedicine.

Results: Among 111 patients, 63.1% (n=70) preferred an in-person visit with a specialist and 21.6% (n=24) preferred a video visit with their specialist. While only 15.3% (n=17) preferred follow-up with a primary care provider (PCP), 71.0% (n=80) felt comfortable transitioning future care to a PCP. Notably, 52.3% (n=58) of patients were interested in a telemedicine visit. Factors associated with interest in telemedicine included identifying as a transgender man (aOR 3.94, 95% CI [1.24-12.53], p=0.02), minority race/ethnicity (aOR 6.71, 95% CI [1.79-25.17], p=0.005), no need to travel (aOR 3.34, 95% CI [1.14-9.85], p=0.03), no concerns about video visits (aOR 14.66, 95% CI [4.34-49.56], p<0.0001), and concern about their PCP offering a broad range of gender services (aOR 8.63, 95% CI [2.41-29.67], p=0.0006).

Conclusions: Patients presenting for HT follow-up prefer continued care with a specialist. However, patients were willing to transition care to PCPs and were interested in telemedicine before the COVID-19 pandemic.

Keywords: access to care; hormone therapy; telemedicine; transgender care.