Characteristics of transgender health-related provider-to-provider consultations in Brazil's public primary health care system: A cross-sectional study from a Southern Brazilian telehealth service.

OBJECTIVE

Transgender individuals often face structural barriers and adverse health outcomes. Provider-to-provider (P2P) consultations may improve the quality of care for this population. This study describes the characteristics, clinical questions, and care provided to transgender population in the Brazilian public primary health care (PHC) system, using data from a P2P telephone consultation service based in Rio Grande do Sul State.

SUBJECTS AND

METHODS

This cross-sectional study included all consultations classified as related to transgender health care conducted between TelessaúdeRS consultants and PHC professionals from 2015 to 2023. We extracted patient characteristics and clinical questions from each consultation. Continuous data are reported as means ± standard deviations or medians (interquartile ranges), and categorical data as absolute and relative frequencies.

RESULTS

Between 2015 and 2023, 752 of the 422,972 total consultations were classified as related to transgender health care. Regarding sex assigned at birth, 47.3% of patients were male, 43.4% were female, and 9.3% were unreported. The mean patient age was 24.5 years (±9.1). The most frequent consultation topics were laboratory monitoring (64.9%), hormone therapy (49.7%), and mental health (28.9%). Nonprescription hormone use was reported by 41.0% of patients. Referrals to specialized care were recommended in 68.4% of cases, and clinical guidance was provided in 71.4%.

CONCLUSION

The growing number of P2P consultations reflects an increasing demand for support regarding transgender care within PHC. Frequently asked questions reveal knowledge gaps among PHC providers, and the high rate of unsupervised hormone use suggests persistent barriers to appropriate care. P2P consultations can support PHC professionals in providing safer, more timely transgender health care.