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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The biggest obstacle is a lack of open-mindedness and an unwillingness of people across the industry and across generations to work together. Photo via Getty Images

What’s the biggest obstacle between us and net-zero? Is it policy? Technology? Financing? All of these are important, yes, but none of them is what is really holding us back from our energy transition goals.

The biggest obstacle is a lack of open-mindedness and an unwillingness of people across the industry and across generations to work together.

In October of 2022, I was invited to speak at Energy Dialogues’s North American Gas Forum, a conference that brings together executives from across the energy industry. Over the two days of the conference, I was amazed by the forward-thinking conversations we were having on decarbonization, the future of clean energy, emissions reduction, and much more. I returned back to campus at Duke University, energized by these conversations and excited to share them. But rather than seeing the same sense of excitement, I was met with doubt, disbelief, even scorn.

There’s a fundamental distrust between generations in this industry, and it goes both ways. Experienced energy professionals often see the younger generation as irrational idealists who are too politicized to be pragmatic, while the younger generation often paints the older generation as uncaring climate denialists who want nothing to do with clean energy. Neither is true.

Over the past two years since founding Energy Terminal, I’ve met hundreds (maybe thousands) of people all across the energy industry, from CEOs of major energy companies to students just getting started on their career journey. Despite being so different on the surface, their goals are strikingly similar. Almost all can agree on three things: we want to reduce emissions, we want to expand energy access, and we want to do so while encouraging economic prosperity. The perceived barrier between generations in the energy industry is exponentially larger than the actual barrier.

For experienced professionals — take a chance to engage in conversations with young energy leaders. Understand their priorities, listen to their concerns, and find the middle ground. We are a generation passionate about impact and growth, and enabled with the right resources, we can do incredible things. The changing energy world presents unbelievable opportunities for both progress and profit, but without the next generation on board, it will never be sustainable.

For the young energy leaders of the future–listen to the experiences of the leaders that have come before us. Understand the balance between energy that is clean with energy that is secure, reliable, and affordable. We have brilliant ideas and an insatiable appetite for progress, but we won’t do it alone. Every person and every company has a valuable role to play in the energy transition, so consider how we can amplify our strengths rather than attack each other’s weaknesses.

If my co-founder, a climate activist from New York, and myself, the son of an oil and gas family from south Texas, can do it, so can you. This is a call to find the middle ground, to open up your mind to new possibilities, and to make real progress by working with each other rather than against each other.

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Michael Wood III is co-founder of Energy Terminal, a platform that aims to build the next generation of energy leaders and to bridge the gap between youth and the energy industry.

This article originally ran on EnergyCapital.

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