telehealth

Nonprofit pivots to telemedical treatments and therapies amid pandemic

Planned Parenthood has made several of its services — including gender-affirming hormone therapy — available virtually. Getty Images

Naomi West has been homebound since COVID-19 became a threat in February. Sitting in front of her computer screen, much of her time is spent pursuing her graduate degree in physics from Rice University and teaching courses through Zoom. Most of her virtual meetings are the same except for one recurring appointment. Every 90 days, West logs on her computer to sit with a Planned Parenthood Gulf Coast (PPGC) nurse practitioner and check-in on her gender-affirming hormone therapy.

West, a Houston trans woman, made her first appointment to receive hormone therapy in October, prior to the pandemic. As she embarked on her transition, she saw an immediate change within herself.

"There was absolutely no going back...it was a night and day difference within 24 hours," she explains.

West has been receiving treatment for ten months at Planned Parenthood. After being hospitalized for depression and drowning in hundred-hour work weeks, West was feeling hopeless. Inspired by her best friend's journey with hormone therapy at Planned Parenthood, West felt motivated to change her life.

"The difference [trans care] makes is immeasurable to say the least," she says, "I couldn't imagine having it any other way. I couldn't imagine being without it."

Trans care is offered at two Houston-area Planned Parenthood locations—Prevention Park and Northville. Since the coronavirus, Planned Parenthood's services have gone virtual, allowing Texans outside of Houston to experience the service.

"COVID-19 has really changed the way we approach patient care," says Dr. Bhavik Kumar, medical director of Primary and Trans Care at PPGC.

The centers first rolled out virtual appointments on April 1, allowing them to safely serve 5,539 patients in four months.

"We've moved a lot of our care towards telehealth, which has allowed people to access care in a way that is safer for them and also protects our frontline workers," explains Dr. Kumar.

The healthcare provider has six centers in the Houston area, as well as two in Louisiana, that are providing virtual appointments with experts as well as access to curbside birth control. Trans care first became available at Planned Parenthood in 2019, and includes gender-affirming hormone therapy for patients over 18.

"We went into providing trans care knowing that a lot of folks have bad experiences accessing healthcare and perhaps bad experiences with providers," says Dr. Kumar. "There's a lot of fear and anxiety in accessing care for trans communities, whether it's being misgendered, having their dead name used, or having a number of different things that can lead to traumatic experiences," he explains.

To a transgender person, access to health isn't just a hot button political issue but a lifeline. Like West, many transgender Americans struggle with depression and feelings of hopelessness.

In a 2019 survey from The Trevor Project, 29 percent of trans and non-binary youth reported that they'd attempted suicide while 54 percent considered it. The striking statistics are a glimpse into the struggles trans and nonbinary people face daily as they experience discrimination, violence, and cohersion due to their gender identity.

West, like many in the trans community, shared the same fears prior to her first appointment.

"I've always come down with what I say is white coat syndrome, but within 10 minutes I realized it was all completely unfounded," she explains.

PPGC follows an informed consent treatment model, meaning patients are not required to receive an approval letter from a therapist to begin treatment. After speaking with a patient to explain the risks and benefits of hormone therapy, patients can make the decision to move forward.

"It was just a conversation," explained West, "I felt no judgement. It was just support for my decision to begin hormone therapy and suggestions for how to go about it, when to go about it—they were nothing if not accommodating.

Telehealth lends itself as a suitable substitution for in person care, according to West. Many of the appointments are spent discussing her psychological state and feelings regarding the treatment, and she goes for a blood test every 90 days. West, who has been very careful to prevent exposure to COVID-19, has felt at ease meeting virtually with her nurse practitioner.

Thanks to the ability telehealth has to connect us with people regardless of distance, transgender Texans have access to care at any distance. One of the core benefits of trans telehealth is that "folks who are further away from our health centers, perhaps in rural communities, don't have to make the several hour drive to the health center and then back," says Dr. Kumar.

The convenience has allowed PPGC to accommodate 240 gender-affirming hormone therapy appointments and serve 176 transgender patients.

More than cut travel time, the emergence of telemedicine also welcomes comfort. "They get to be in the safety and the comfort of their home or wherever they do feel safe," explains Dr. Kumar, "They can have other folks around them if they want, whether it's family or friends."

"We are constantly analyzing the way we provide care, but even more so in a different way during the pandemic," shares Dr. Kumar. Telehealth services include birth control consultation, emergency contraception, long-acting birth control implant consultations, PrEP follow-ups, primary care, STI treatment, and other healful visits to address problems like pelvic pain or bleeding.

Of the many services that are now remote, Depo birth control shots and oral contraceptives, are available curbside.

"Patients don't have to get out of the car; they don't have to worry about touching the door handle or anything else they have anxiety around," explains Dr. Kumar, "They're able to access the care they need without having to deal with potential exposure."

Will telehealth at PPGC become a permanent staple? Only time will tell, but Dr. Kumar has found that patients have found the service to be helpful during the COVID-19 pandemic.

"We always strive to provide as many options for our patients so that they can get the healthcare that's best for them," shares Dr. Kumar.

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Building Houston

 
 

Business and government leaders in the Houston area hope the region can become a hub for CCS activity. Photo via Getty Images

Three big businesses — Air Liquide, BASF, and Shell — have added their firepower to the effort to promote large-scale carbon capture and storage for the Houston area’s industrial ecosystem.

These companies join 11 others that in 2021 threw their support behind the initiative. Participants are evaluating how to use safe carbon capture and storage (CCS) technology at Houston-area facilities that provide energy, power generation, and advanced manufacturing for plastics, motor fuels, and packaging.

Other companies backing the CCS project are Calpine, Chevron, Dow, ExxonMobil, INEOS, Linde, LyondellBasell, Marathon Petroleum, NRG Energy, Phillips 66, and Valero.

Business and government leaders in the Houston area hope the region can become a hub for CCS activity.

“Large-scale carbon capture and storage in the Houston region will be a cornerstone for the world’s energy transition, and these companies’ efforts are crucial toward advancing CCS development to achieve broad scale commercial impact,” Charles McConnell, director of University of Houston’s Center for Carbon Management in Energy, says in a news release.

McConnell and others say CCS could help Houston and the rest of the U.S. net-zero goals while generating new jobs and protecting current jobs.

CCS involves capturing carbon dioxide from industrial activities that would otherwise be released into the atmosphere and then injecting it into deep underground geologic formations for secure and permanent storage. Carbon dioxide from industrial users in the Houston area could be stored in nearby onshore and offshore storage sites.

An analysis of U.S Department of Energy estimates shows the storage capacity along the Gulf Coast is large enough to store about 500 billion metric tons of carbon dioxide, which is equivalent to more than 130 years’ worth of industrial and power generation emissions in the United States, based on 2018 data.

“Carbon capture and storage is not a single technology, but rather a series of technologies and scientific breakthroughs that work in concert to achieve a profound outcome, one that will play a significant role in the future of energy and our planet,” says Gretchen Watkins, U.S. president of Shell. “In that spirit, it’s fitting this consortium combines CCS blueprints and ambitions to crystalize Houston’s reputation as the energy capital of the world while contributing to local and U.S. plans to help achieve net-zero emissions.”

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