Presently, telehealth cannot replace key aspects of in-person (particularly pre-surgical) consultation ( 3), which most TGE youth prefer for GAHT initiation ( 4). These changes vastly expanded access to telemedicine, permitting TGE young people to access primary care, counseling, and GAHT initiation virtually, or via hybrid models of care, typically extensions of established providers ( 3, 4). Federal regulations that had restricted reimbursement for telehealth services and barred cross-state practice were relaxed ( 3, 4). In the U.S., the Centers for Disease Control and Prevention recommended the suspension of in-person appointments. surveyed transgender and nonbinary respondents across 76 countries from April–August 2020, 55% of whom reported diminished access to gender-affirming care due to the pandemic 38% were less able or unable to live in accord with their genders at all ( 2). Most can be traced to the COVID pandemic, which disproportionately burdened marginalized subpopulations. Since the initial, July 2020, publication of that scoping review ( 1), upheavals have occurred within TGE mHealth, with implications for mHealth self-sustainability, broadly. ( 1), these interventions can be classified along distinct lineages: (I) academic medicine, often via NIH-funded clinical trials (II) human-computer interaction, user experience (UX) design, and adjacent subfields and (III) TGE-led community technologies, often developed via hackathons and crowdfunding. A diverse, innovative range of ICT interventions serves the gender-affirmation needs of TGE users. This is particularly true of TGE youth, who may lack autonomy or in-person support ( 1). ICTs permit socially isolated users to transcend the limitations of their physical environments, in which TGE social bonds, gender-affirming hormone therapy (GAHT) providers, or physical safety, may be lacking. mHealth interventions intended for TGE users are situated within-and, increasingly, informed by-this rich online milieu.

Interactive communications technologies (ICTs) are key sites of self-discovery, community formation, health education, and creative expression among the 0.7–3.2% of young people who identify as transgender and gender-expansive (TGE).

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