Pride month has come around again. Companies' logos are more colourful, and what were once protests for equal rights have become parades and celebrations in many parts of the world. Yet LGBTQIA+ communities still face discrimination within many facets of life; this is especially pronounced when accessing healthcare.

Fear of a possible hostile reception and sometimes a lack of knowledge among healthcare professionals about appropriate care for non-cisgender, non-heterosexual people are just some of the barriers that LGBTQIA+ communities face when seeking medical advice or treatment. 

In many countries, LGBTQIA+ healthcare is gated behind long waiting lists in public systems while private care demands a financial commitment beyond what many can afford. Recently, we’ve seen moves to reverse access to healthcare, with 19 US states now having laws restricting gender affirming care. 

Digital health companies can and are helping inclusivity and reducing health inequity here. Digital solutions are enabling virtual care, whether its remote mental health services, providing vital access to specialist care, or simply accessing treatment and medication. This week, we take a look at some of the ways digital health solutions are supporting LGBTQIA+ communities: 

Extending the reach of inclusive and LGBTQIA+ competent care

Many healthcare providers are not trained in the provision of LGBTQIA+ competent care. The lack of appropriate training coupled with a still widespread lack of awareness can foster prohibitive environments that delay disclosures and appropriate health seeking behaviours. For instance, research has found that participation in cervical screening programmes is low among women who have sex with women. This may be explained by inconsistencies in messaging around the importance of participation in such programmes for this particular population. 

Over the past few years, a number of LGBTQIA+ minded digital health companies have entered the market – these companies have evolved their product offerings to be more inclusive of LGBTQIA+ consumers and patients. Telehealth provider Babylon for instance offers its users consultations with LGBTQIA+ clinician allies, that is progressive providers who deliver care without judgement and can address healthcare needs holistically. Babylon also provides users with on-demand access to LGBTQIA+ doctors and therapists providing gender affirming care. 

NOCD, a virtual care platform for the treatment of obsessive compulsive disorder (OCD) has partnered with Violet to review and benchmark providers cultural competencies with a view to address skills gaps preventing the delivery of identity-centred care. 

Mental health is also a major concern within the LGBTQIA+ community. Companies such as Talkspace cater specifically to the LGBTQIA+ individuals and provide access to competent therapists experienced in working with this community. VODA, on the other hand, is a mental health wellness app designed to help users cope with the challenges of living in a heteronormative and cisnormative society. 

Digital health companies have the potential to extend the reach of LGBTQIA+ competent care. Not only can digital health services eliminate physical barriers to access, but LGBTQIA+ inclusive companies are poised to improve the patient-provider interaction in this population. This is especially important as individuals are coming out as LGBTQIA+ at an increasingly younger age. Ensuring that LGBTQIA+ youth have access to the right resources and guidance as early as possible is an important social nudge to instil confidence and trust in healthcare systems.

Inclusive care must coexist with and complement specialised care for LGBTQIA+ patients

The healthcare needs, social and mental health concerns of this population are at times extremely unique and warrant highly specialised support. As such, inclusive care will need to coexist with and complement specialised care for LGBTQIA+ patients. Examples of needs that warrant highly specialised support and competencies are gender affirming care and family planning and reproductive health to name but a few. The digital health market has begun catering to the LGBTQIA+ population in this regard, making it increasingly inclusive. 

An attempt at facilitating the integration of inclusive and specialised care is the acquisition of Included Health by Grand Rounds and Doctor on Demand. In 2021, the two signed a definitive agreement to acquire Included Health; a comprehensive platform for the LGBTQIA+ community.

Digitally enabled access to gender-affirming care

Transgender and non-binary communities have been under attack in recent years. But several services provide remote access to specialised care for these communities. 

Folx Health is a US-based company offering hormone treatments and primary health care appointments for LGBTQIA+ people securely and safely through their HIPAA compliant platform. They also support patients experiencing lifestyle issues and provide care for problems relating to a range of other medical issues and STI prevention and treatment. In 2022, Folx announced a new employer partnership with Chronosphere, in a move to make LGBTQIA+ healthcare more accessible. 

They are not alone in their offering, with companies like Plume providing similar services in the US and Gender GP supporting communities throughout Europe. The High Court in the United Kingdom recently ordered the General Medical Council (GMC) to close its case against GenderGP founder Dr. Helen Webberley. The case was initiated following complaints by a small number of NHS doctors who disagreed with Dr. Webberley’s approach to trans healthcare. An exhaustive examination by the UK Medical Practitioners Tribunal Service (MPTS) resulted in the tribunal deeming her model of care to be “at the vanguard of this evolving approach to transgender care” and “right and fit for purpose”. The decision brings an end to years of investigation and is a huge victory for the cause of gender affirming healthcare. It is a prime example of new and successful models of digital and virtual care emerging.

LGBTQIA+ Competencies beyond Pride Month

The marketplace for digitally enabled LGBTQIA+ services is growing and the vibrancy of the market is highlighted once a year during pride month. It is our hope that the market remains vibrant throughout the rest of the year also. Consistency is key! LGBTQIA+ specific clinical and cultural competencies must be taught to all physicians and must be practised in all healthcare environments. Such competencies must be further expanded to address intersecting identities (e.g. race) that oftentimes compound vulnerabilities and discrimination in healthcare. Identities are complex and multifaceted, as are individual healthcare needs. Digital health solutions have the potential to expand access to identity-competent and vital services for LGBTQIA+ individuals at a time where this community continues to experience barriers to proactive health seeking behaviours.