Which transgender and gender diverse groups benefit most from E-health? Subgroup analyses of the randomized controlled trial i2TransHealth in Germany

27/03/2026

Int J Transgend Health. 2025 Feb 22;27(2):824-839. doi: 10.1080/15532739.2025.2465710. eCollection 2026.

ABSTRACT

BACKGROUND: Transgender and gender diverse (TGD) people, particularly those living in underserved remote areas, often face barriers to accessing primary and specialty healthcare services due to geographic isolation and the scarcity of trained professionals in these regions. While e-health interventions have gained prominence in TGD-informed healthcare, no research to date has examined their subgroup-specific effectiveness in addressing the challenges faced by TGD people.

AIM: This study aimed to investigate the responsiveness of various subgroups within the TGD population in Germany to the i²TransHealth e-health intervention, shedding light on its potential to mitigate disparities in healthcare access and outcomes through digital solutions such as video consultations and chat conversations.

METHODS: In this secondary analysis of a randomized controlled trial (RCT) conducted in Hamburg, Germany, involving 174 TGD study participants from four northern federal states of the country, we assessed the impact of the i²TransHealth e-health intervention on psychological distress.

RESULTS: Subgroup analyses revealed that i²TransHealth demonstrated effectiveness for TGD individuals overall, with higher age and education levels being associated with greater reductions in psychological distress. Clinically meaningful differences in treatment effectiveness were not observed in other subgroup variables, including residence size.

CONCLUSION: E-health interventions like i²TransHealth offer promise in addressing the specific challenges faced by TGD people, particularly those in underserved remote areas. To enhance inclusivity and equity, interventions should consider the diverse needs of this population, emphasizing the importance of tailored approaches that accommodate varying educational backgrounds and geographic contexts.The trial was pre-registered at Clinicaltrials.gov (NCT04290286).

PMID:41891088 | PMC:PMC13015102 | DOI:10.1080/15532739.2025.2465710

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