I grew up in Charleston, South Carolina. As a teenager, I experienced anxiety and depression and found myself seeking mental health counseling to get through it. My therapist was all I needed at that age–she gave me string cheese sticks and mini water bottles during our sessions, and we sifted through all my deepest fears and desires.

The next time I went to counseling, my intention wasn’t as much to resolve depression or anxiety as it was to learn how to navigate ethics with my growing awareness of racism, misogyny and the like. I had grown into my voice in my 20s, evolving to be more outspoken in instances of bigotry or exclusion. This challenged me to refine my sense of what was right and wrong. It was a pivotal personal journey, and so I resolved that it was important to find a counselor who could understand my social and political perspective. I tried working with counselors in Maine and New York, and although one of them was a member of the LGBTQ+ community, both avoided addressing issues I had raised that were related to my identity or orientation in the world. Neither seemed to understand what it meant to be a QTPOC (queer and trans person of color), particularly its dynamics and language. This meant I often walked out of sessions feeling emotionally unresolved and, for a while, I stopped trying to find a competent therapist. I decided speaking with my close friends and writing would be both cheaper and more effective.

For the past year, I’ve split my time between Cape Town and New York. Accessing healthcare while traveling internationally is tricky, so when I decided to give therapy another try, this added another layer of complication to finding a counselor who was competent in speaking with me about the nuances of my experience. Finally, after six months browsing local therapists on-and-off, I managed to find one solution that worked for me–Pride Counseling, a mobile app for queer-competent mental health counseling. Through the app, I was able to find a queer person of color to work with who had an embodied understanding of my experience, and could speak to me without major gaps in understanding. 

I used the Pride Counseling service for about three months. The app was more affordable than my previous traditional counseling sessions, offering services at a sliding scale with rates starting at $40 per week. The app allows clients to text, call or videochat their counselor, and I chose to call mine. 

My counselor with Pride Counseling had the language to offer me informed feedback and guidance on my mental health and everyday life. This was refreshing! It gave me confidence that a network of QTPOC-friendly therapists exist. However, I knew from experience that they were most accessible online rather than in-person.

If you face similar issues in accessing competent providers in your area, digital health apps might help bridge the gaps for you too. Six months after I ended counseling, I turned to Twitter to research others who had used the Pride app and found Mercy Escobar. Like me, Escobar grew up in the southern United States. She was homeschooled in a small Texas town of less than 25,000 people, which was socially isolating for her as a young queer person. She would hear members of her community describe queer people as “big city liberal,” which, in the post-Confederate south, is far from a compliment. I know this as a fellow southerner.

As she grew older, Escobar wanted mental healthcare, but she struggled to find competent LGBTQ+ counselors. For her, location was the biggest obstacle to this. In January, Escober signed up with Pride Counseling. She’s happy with digital counseling and expressed, “To me I’m not talking or typing to a computer. I’m talking to someone I feel connected to.”

Social media and online forums have also created opportunities for people across the world to connect, which has been especially helpful for members of marginalized groups to free themselves of feeling alone. Instagram is a platform that I have used to connect with people of similar identities to me, and where I have learned that I’m not as different as I sometimes feel. 

But physical healthcare centers, in particular, aren’t welcoming to everyone, nor do they always uphold inclusive ideals that you might be able to curate on social media. Providers are too often under-educated when it comes to treating queer and trans patients. 

According to a 2018 Human Rights Watch report, 29% of transgender respondents confirmed that a healthcare provider had refused to see them in the past year on the basis of their sexual orientation or gender identity. 8% of lesbian, gay and bisexual respondents reported this same treatment. LGBTQ+ respondents in this report not only experienced outright refusal but they also disclosed experiencing “harsh or abusive language” when seeking medical care. 

While some state and federal laws take aim at anti-trans discrimination in health care, that discrimination hasn’t stopped. And that means trans people who need care may postpone it in order to avoid dealing with providers’ and insurers’ transphobia. The findings from a 2018 survey reveal that 22% of transgender people and 8% of all LGBTQ+ respondents disclosed having avoided or foregone needed medical care as a result of prejudice experienced from healthcare staff. 

This year, the Trump administration announced its plan to rollback the Obama administration regulation (Section 1557 of the Affordable Care Act), which could lead to even more discrimination against trans people in the United States healthcare space in years to come. 

I reached out to Dr. Izzy Lowell, the founder of QueerMed, to find out more about digital services for hormone replacement therapy (HRT) and other healthcare services for trans and non-binary people of all ages. QueerMed is a medical practice located in Decatur, Georgia, but operating in the Southeastern United States. 

Lowell founded the practice when she realized that many of her patients either were located outside of the region with limited options for transportation or were commuting long distances to her office just outside of Atlanta. She consults nearly half of her patients via video conferencing, and holds pop-up clinics to meet new patients. 

Lowell explains that the hard part in widening access to care is not only that potential patients lack insurance, but that a huge number of their young LGBTQ+ patients have never interacted with the medical system before. “They think, great, I have insurance, so I’m going to go get this service, but it goes straight toward their deductible, which it turns out was $8,000.” 

The problem of accessibility goes even further for queer and trans youth. A lot of LGBTQ+ youth have strained relationships with their families and don’t have support in changing their appearance or undergoing transition-related care. This rejection is the most cited factor in driving LGBTQ+ youth to make up 40% of all homeless youth in the US. These homeless queer and trans youth often don’t have access to phones or computers let alone the finances to pay off their deductibles.

The LGBT Technology Partnership and Institute (LGBT Tech) was founded by Chris Wood. Wood was kicked out of his family home after coming out to his parents as gay, and because he had his cellphone, he could reach out to friends for a place to stay. His organization now distributes desktops, laptops and smartphones to homeless and at-risk LGBTQ+ youth. 

“When you don’t have access to technology, and so much is moving online, you’re automatically digitally disadvantaged in a really big way,” Wood explained. “It [becomes] a really vicious negative cycle which then makes technology almost like one of the four [requirements for] survival–you know, shelter, food, water…sometimes you can’t find shelter or food without having access to a piece of technology.”

Digital tools can dramatically improve access to quality mental healthcare and telehealth services as well as to life-sustaining professional and social networks. I have experienced their benefits firsthand, and have brought that knowledge to my current work with Mayo Clinic’s online patient platform, Mayo Connect, as a digital mentor and ally to vulnerable populations normally discriminated against in healthcare spaces.

If you think you can benefit from digital health tools, I encourage you to look into the following to decide whether they’re the right fit for you and your needs: 

Pride Counseling, which provides online counseling for the LGBTQ+ community.

QueerMed, a medical practice for trans patients of all ages, which offers telemedicine services.

Amaze, an online platform that provides medically accurate, affirming sex education for young people in 196 different countries.

Ample, a review app dedicated to helping plus-size, trans and disabled people, as well as people of color, in informing themselves about the accessibility and inclusivity of doctor’s offices, but also businesses and other establishments.

they2ze, an app dedicated to helping connect trans youth to inclusive health services and peer support, currently operating only in California. 

Care4Today, a health monitoring app to help patients manage medication administration and track other health and wellness goals. 

PrEPTECH, an online program aiming to increase pre-exposure prophylaxis (PrEP) uptake among young gay and bi cis men.

NEXT, a website dedicated to facilitating access to preventative services, specifically for sexual health and social services for youth exiting foster care and/or the juvenile justice system. 

SHOUT, a free and confidential 24/7 text service for anyone in crisis or in need of immediate help.  

To donate unused cell phones, laptops, tablets, hard drives, and other technological devices to LGBTQ+ individuals in need, visit https://www.poweronlgbt.org/donate-your-phone.