Strike a pose, and…virtual visit? Examining virtual vs. in-person consultations for gender affirmation surgery

The adoption of telehealth has surged in recent years, particularly following the COVID-19 pandemic, due to its ability to increase access, reduce logistical burdens, and improve convenience for patients and providers alike. In the context of gender-affirming surgery (GAS), where barriers such as stigma, geographic distance, and cost persist, telehealth offers a promising alternative to traditional in-person care. Telehealth in the gender affirmation surgery setting, virtual vs. in-person initial consultations in a surgical setting, and surgical conversion rates by initial consultation venue, are under-examined. This study aims to examine differences in patient "conversion rates" (completion of surgery) based on modality of initial consultation: phone call, video, or in-person.

All patients at a single gender affirmation surgery practice from practice inception to March 2023 were reviewed for initial consultation appointment modality, patient demographics, payor mix, type of surgery, and conversion to surgery. Data were compared via Chi-square independence analysis.

Of the 3581 patients who had initial consultations, 1728 (48.3%) pursued surgery. Of the 3402 initial consultations, 1898 (55.8%) selected video visits, while 1061 (31.2%) chose phone visits and only 443 (13%) chose in-person visits. No significant differences in surgical conversion rates between groups (46.1-47.9%, p=0.81) were seen. Subgroup analysis by type of surgery showed no significant differences in conversion rates versus consultation modality.

Most patients at our practice have initial consultations virtually. Virtual consultations for gender affirmation surgery do not demonstrate significantly different surgical uptake rates compared to in-person visits.