Supporting Our Transgender Patients Through COVID-19 and Beyond

CINCINNATI — It’s hard to say, but 28-year-old University of Cincinnati graduate student Kaeden Kass guesses he contracted COVID-19 in the community, possibly at the grocery store.

It was March 2020, around the time that COVID-19 was declared a global pandemic.

“I was following all the guidelines that they said we should follow at the time,” Kaeden said. “I don’t know how I got it, but I just got sick one day.”

First, it was a sore throat along with fatigue. Then followed more typical symptoms: a bad cough, shortness of breath and a fever that lasted two weeks. He described the experience as scary, worse than any bout of the flu he previously had.

“I was so exhausted that I would get winded walking to the kitchen,” Kaeden said.

Like many transgender people, Kaeden has a chronic condition that may have placed him at a higher risk for COVID-19. The Cincinnati native has ankylosing spondylitis, an inflammatory arthritis that requires he take medication that makes him immunocompromised.

More than one in five transgender adults have at least one chronic illness like diabetes, arthritis or asthma, according to the National Center for Transgender Equality.

“I feel like every trans person I know has some kind of chronic condition,” Kaeden said.

The presence of chronic conditions is just one risk factor among the transgender population that makes their COVID-19 care unique. UC Health’s Transgender Medicine subspecialists are addressing how this new illness affects our community’s adult transgender population as part of their ongoing care.

Kaeden also discussed how many transgender people may also experience the fear of stigma and discrimination in the healthcare industry.

“When I’m seeing a provider, there are so many extra hoops that trans people have to jump through because you can’t walk into any doctor’s office and presume you’re going to be treated with respect and competency,” Kaeden said. “It’s the worst situation in the world to be going in to seek help from a medical professional and realize you have to educate them. It makes you feel like your provider isn’t really equipped to meet your needs or seeing you as a full person.”

That’s something Kaeden doesn’t have to worry about with his UC Health care team. He said he feels “understood” by his primary care provider, Sarah Pickle, MD, UC Health family medicine physician and associate professor of in the Department of Family & Community Medicine at the UC College of Medicine.

Throughout his illness, Kaeden regularly communicated with Dr. Pickle and other providers, receiving ongoing care through virtual visits. Every time he was prescribed a new medication, his providers would check in a few days later.

During the pandemic, UC Health has embraced telehealth to care for transgender patients.

“Through phone and video visits, we have been able to identify and treat patients with COVID-19 who are safe to stay at home and manage their care,” Dr. Pickle said. “We check in through the electronic patient portal at key points during their illness when we expect that things could start to look better or start to get worse, and we provide 24/7 wraparound coverage with a clinician on call if their conditions worsen.”

“This has allowed us to treat acute illnesses to avoid unnecessary Emergency Department (ED) visits, identify when the ED is truly the best location for care, maintain patients on their gender-affirming hormones and manage other chronic health conditions to try to keep patients their healthiest during the pandemic,” Dr. Pickle continued.

Many of our highest risk and most vulnerable UC Health Primary Care patients are enrolled in the Comprehensive Primary Care Initiative through the Centers for Medicare and Medicaid Services.

“During COVID-19, our care managers and social workers have maintained communication with vulnerable patients, helped identify resources to aid in crisis and have provided a continuity of care through a time that for many, is exceptionally isolating,” Dr. Pickle said.

After about a month, Kaeden’s condition improved. Today, he is doing well.

And while the world looks to recognize the LGBTQ+ communities in June during Pride Month, our team of providers at UC Health dedicated their careers to transgender medicine year-round, like for Kaeden, long after he recovered from COVID-19.

Our transgender subspecialists are experts in the specific needs of people whose gender does not align with their sex assigned at birth. These providers work in many different medical specialties, from gender-affirming primary care, to transgender voice therapy, surgery, endocrinology and hormone therapy.

Our experts are also safe and trusted professionals who our patients know will provide the respectful, gender-affirming care that they need.

“It’s so important for physicians to be competent in caring for trans people,” Kaeden said. “My trans-ness in some way or another touches every facet of my life. I feel like I couldn’t have gotten the competent care that I did for COVID-19 if my physician hadn’t also been trans-competent.”

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