{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:44:35Z","timestamp":1777877075412,"version":"3.51.4"},"reference-count":12,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T00:00:00Z","timestamp":1648771200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Transgender Health"],"published-print":{"date-parts":[[2022,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To describe the development of the United States Air Force's (USAF) telehealth program from fall 2017 through fall of 2020 in response to the unique challenges associated with providing care for a global transgender military population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Telehealth visit completion rates were monitored at time of encounters and through electronic health record reports. Patient satisfaction data were obtained by immediate postvisit survey, across provider care received, logistics of setting up the appointment, and quality of the virtual health system connection. Patient cases highlighting opportunities for transgender telehealth were summarized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Between September 9, 2019 and October 28, 2020, 99 telehealth encounters with video-to-video connection occurred. Twenty-three of the encounters were for gender-affirming hormone therapy, 17 for mental health visits, and 59 for speech therapy. Thirty-five surveys were collected from 20 patients. Overall patients were \u201csatisfied\u201d or \u201cvery satisfied\u201d with providers' ability to manage their chief complaint through this modality (average 4.9 out of 5 on 1 to 5 scale with 1 being \u201cvery dissatisfied\u201d and 5 being \u201cvery satisfied\u201d) and \u201cstrongly agree\u201d that telehealth is an effective means to accomplish care (average score 4.8 on 1 to 5 scale with 1 being \u201cstrongly disagree\u201d and 5 \u201cstrongly agree\u201d). Services provided spanned 11 USAF bases worldwide.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Telehealth is successful in ensuring ongoing transgender health care services for a global military population. The success of this program may have implications for future military and civilian endeavors to bridge care gaps for transgender patients in resource-poor or distant-site locations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/trgh.2020.0167","type":"journal-article","created":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T16:54:20Z","timestamp":1618851260000},"page":"150-158","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["Improving Global Access to Transgender Health Care: Outcomes of a Telehealth Quality Improvement Study for the Air Force Transgender Program"],"prefix":"10.1177","volume":"7","author":[{"given":"Joshua M.","family":"Smalley","sequence":"first","affiliation":[{"name":"San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas, USA."},{"name":"59th Medical Wing, Wilford Hall Ambulatory Surgical Center, Lackland AFB, Texas, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janelle M.","family":"Lozano","sequence":"additional","affiliation":[{"name":"59th Medical Wing, Wilford Hall Ambulatory Surgical Center, Lackland AFB, Texas, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chari\u2019 J.","family":"McMahon","sequence":"additional","affiliation":[{"name":"59th Medical Wing, Wilford Hall Ambulatory Surgical Center, Lackland AFB, Texas, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey A.","family":"Colburn","sequence":"additional","affiliation":[{"name":"San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas, USA."},{"name":"59th Medical Wing, Wilford Hall Ambulatory Surgical Center, Lackland AFB, Texas, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,4,11]]},"reference":[{"key":"e_1_3_5_2_2","volume-title":"Military Service by Transgender Persons and Persons with Gender Dysphoria","author":"Department of Defense Instruction (DoDI)","year":"2020","unstructured":"Department of Defense Instruction (DoDI) 1300.28, Military Service by Transgender Persons and Persons with Gender Dysphoria. Washington, DC: US Department of Defense; 2020."},{"key":"e_1_3_5_3_2","volume-title":"Military Service by Transgender Persons and Person's with Gender Dysphoria","author":"Air Force Policy Memorandum (AFPM)","year":"2020","unstructured":"Air Force Policy Memorandum (AFPM) 2019-36-02, Military Service by Transgender Persons and Person's with Gender Dysphoria. Washington, DC: US Department of the Air Force; 2020."},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1255"},{"key":"e_1_3_5_5_2","first-page":"167","article-title":"Barriers to healthcare for transgender individuals","volume":"23","author":"Safter JD","year":"2016","unstructured":"Safter JD, , Coleman E, , Feldman J, et al. Barriers to healthcare for transgender individuals. Curr Opin Endocrinol Diabetes Obes. 2016; 23:167\u2013171.","journal-title":"Curr Opin Endocrinol Diabetes Obes"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2017.0136"},{"key":"e_1_3_5_7_2","first-page":"xxi","article-title":"Telemental health for our soldiers: a brief review and a new pilot program","volume":"174","author":"Nieves J","year":"2009","unstructured":"Nieves J. Telemental health for our soldiers: a brief review and a new pilot program. Mil Med. 2009; 174:xxi\u2013xxii.","journal-title":"Mil Med"},{"key":"e_1_3_5_8_2","volume-title":"Memorandum. Subject: Use of Virtual Visits for Telehealth in the AFMS","author":"Hogg DA","year":"2020","unstructured":"Hogg DA. Memorandum. Subject: Use of Virtual Visits for Telehealth in the AFMS. Washington, DC: US Department of the Air Force Surgeon General; 2020."},{"key":"e_1_3_5_9_2","volume-title":"Memorandum. Subject: Waiver of Restrictive Licensure and Privileging Procedures to Facilitate the Expansion of Telemedicine Services in the Military Health System","author":"Woodson J","year":"2012","unstructured":"Woodson J. Memorandum. Subject: Waiver of Restrictive Licensure and Privileging Procedures to Facilitate the Expansion of Telemedicine Services in the Military Health System. Washington, DC: US Department of Defense; 2012."},{"key":"e_1_3_5_10_2","volume-title":"6025.13, Procedures Manual","author":"Defense Health Agency","year":"2019","unstructured":"Defense Health Agency. 6025.13, Procedures Manual. 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