A question arose considering the difficulty in some African countries to access gender-affirming treatment, whether a South African health professional can provide treatment to a patient in another country, via online consultation.

The challenges with this possibility are:

• To provide treatment to a patient who resides in a different country, a health professional would be required to be registered with the appropriate regulatory body in that country and to abide by that country’s rules and regulations.
• Prescriptions written in South Africa may not be valid in another country.
• Should the patient need emergency assistance or reacts badly to medication prescribed, it would be very difficult to manage this patient remotely.
• Should the patient complain or institute legal action, it would be in their country of residence where legislation will be different from South Africa.
• Medicolegal support would be difficult to obtain, as malpractice insurance is usually only for practice in the country where the health professional is registered.

We propose that a patient who resides in another country, finds a local health professional willing to assist them. A South African health professional can then support and advise the local health professional to provide care, while the medicolegal responsibility remains with the local health professional.