This scoping review examines how telemedicine addresses healthcare needs in the LGBTQIA+ community, focusing on gender-affirming care, mental health, and testing for HIV and STIs.
A literature search of MEDLINE, Embase, Web of Science, and Scopus was conducted to identify studies published until March 2024 focusing on telemedicine services for LGBTQIA + individuals. Data extraction captured study characteristics, telemedicine applications, and patient and provider satisfaction, and was synthesized to map current knowledge and identify gaps. Thirty-eight studies, comprising observational studies and one randomized controlled trial, were included, encompassing 21,774 participants. Telemedicine facilitated access to gender-affirming care, reduced mental health disparities, and supported HIV and STI testing, with high satisfaction reported among patients and providers. It was particularly effective in reducing appointment no-show rates, enabling remote initiation of pre-exposure prophylaxis for HIV, and offering mental health support through virtual counseling. The studies also highlighted increased telemedicine adoption for follow-up visits and medication management. However, challenges like digital privacy concerns, technological accessibility, and cultural competence were identified. Telemedicine holds significant potential to improve healthcare access and outcomes for LGBTQIA + populations, particularly in rural and underserved areas. Future efforts should focus on enhancing provider training, ensuring digital equity, and developing culturally competent telehealth models to fully realize these benefits. The findings can inform the design of inclusive telemedicine policies and services tailored to the needs of LGBTQIA + individuals.
Introduction
The lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other sexual and gender minority (LGBTQIA+) community is characterized by a range of identities, with specific healthcare needs and challenges1. Within the LGBTQIA + community, each group faces unique challenges that require tailored healthcare approaches. For example, gay men have higher rates of human immunodeficiency virus (HIV) and sexually transmitted infections (STIs), requiring tailored prevention2. In 2020, CDC data showed that HIV diagnosis rates were highest among gay, bisexual, and other men who have sex with men (MSM)2. Thus, specialized services, like pre-exposure prophylaxis (PrEP) for HIV, are essential3. Lesbian women face unique health issues, such as reproductive and mental health disparities, but are often under-screened3. Bisexual individuals also face distinct stigmas and health risks, resulting in higher rates of mental health challenges and substance abuse4.Transgender and gender nonconforming individuals face significant barriers to care, including prejudice, a lack of skilled providers, and limited access to gender-affirming treatments5. Research indicates that over half of transgender individuals experience significant mental health challenges, with 51.4% of transgender women and 48.3% of transgender men reporting depressive symptoms and 40.4% of transgender women and 47.5% of transgender men experiencing anxiety5. Additionally, queer individuals may grapple with fluidity in their identities and related healthcare needs that are not always addressed in traditional healthcare settings6. Lack of provider education and cultural competence contributes to healthcare inequalities, worsening disparities and outcomes for LGBTQIA + subgroups7.
