For many, consulting with a physician via screen feels like a convenient, hassle-free alternative to a traditional clinic visit—much like remote work. However, when it comes to services related to Sexual and Reproductive Health and Rights (SRHR), the transition to telemedicine is not without its challenges.
Concerns over the accuracy of remote consultations and the security of sensitive patient data cast a shadow over what could otherwise be a promising solution, offering an alternative to long waits and often inaccessible appointments with SRHR clinicians.
Would you trust the diagnosis of your OBGYN if given through video call? Would you feel safe talking to a sexologist about your performance problems online?
In Lebanon, where reproductive health can still be taboo, many might hesitate or find these virtual consultations less reassuring than their regular in-person checkup.
In recent years, several telemedicine platforms have emerged in Lebanon, such as DRAPP, WhatsDoc, and NAWAT. DRAPP, WhatsDoc, and NAWAT offer a range of health services, including sexual and reproductive healthcare. However, NAWAT is specifically focused on SRHR services.
Founded in 2021, DRAPP allows online consultations between patients and doctors based in Lebanon and Egypt.
The platform has gained significant popularity among both patients and physicians, attracting approximately 25.9k followers on Instagram and garnering support from numerous healthcare professionals. One such advocate is Dr. Gael Abou Ghannam, a Lebanese OBGYN and content creator who hosts a podcast and passionately champions women’s Sexual and Reproductive Health and Rights.
“I think telemedicine platforms are practical. I use them regularly, I’d say for about ten patients per month,” Dr. Abou Ghannam told SMEX.
She explained that while these platforms are practical, not everything can be done online. According to Dr. Abou Ghannam, teleconsultations are rather informational or educational, as she may sometimes need to conduct tests on her patients.
In her experience, teleconsultations effectively address fertility concerns, answer questions, and provide information. She can also order tests, issue prescriptions, and schedule follow-up appointments.
Access to SRHR Care
Dr. Abou Ghannam explained that there remains a significant taboo surrounding sexual and reproductive health. Both in the clinic and online, patients often struggle to discuss their concerns about sexuality openly.
“Patients avoid bringing up their sexual struggles until the last minute of the consultation,” added the physician.
She explained that one advantage of telehealth is that patients are not required to turn on their cameras. They can communicate using voice messages or the chat option, which some patients find more comfortable when discussing sexual or reproductive health.
Other physicians on the platform also claim to provide sexual medicine services, among which are dermatologists, urologists, and OBGYNs, many of whom offer Cognitive Behavior Therapy (CBT) services as well.
This blurring of specialties can confuse patients seeking specialized SRHR care and potentially undermine the services’ credibility. Are these professionals adequately trained in the specific nuances of sexual medicine? Or is this simply an attempt to broaden their service offerings without the necessary expertise?
“Sexual medicine is in demand nowadays,” said Dr. Abou Ghannam. She added that the medical syndicate does not overlook sexual medicine; to practice it, one simply needs to obtain a certification.
According to the physician, more non-governmental initiatives exist today to facilitate access to SRHR, though not specifically through telehealth. These NGOs often provide free testing for sexually transmitted diseases (STDs) and facilitate access to doctors, among other services.
However, Dr. Abou Ghannam affirmed that there is some skepticism surrounding these initiatives. She explained that while their work is commendable, they fall short in providing follow-up care for patients after initiating access.
“One patient underwent free testing, and it turned out she had all these STDs. Then what? They never followed up with her,” she exclaimed.
The physician also said that an ongoing project for telemedicine reserved for SRHR care in the SWANA region was initiated by Noor Jaber, a public health expert and the founder of NAWAT Health.
NAWAT provides a comprehensive range of services, including expert advice, engaging courses, and knowledge sharing on topics such as contraception, gender-based violence, reproductive health, and sexual medicine. The platform also emphasizes its commitment to ensuring privacy and confidentiality, according to its website.
“Today, and especially with the younger generation, everyone is resorting to the digital space for support and information. Many of it is certified or incorrect or invalid,” Jaber told SMEX on why she founded the platform.
What about the cost?
The cost of consultations with SRHR physicians varies among different physicians. For example, Dr. Sandrine Atallah, a renowned sexologist, charges $120 per consultation on DRAPP. Her fee is considered high-end, especially since she is one of the few specialists offering sexual medicine services in Lebanon.
Fees vary from one physician to another, ranging from as low as $20 for some physicians in Egypt to as high as $120.
“I do charge a lower fee for teleconsultations compared to in-clinic visits because, in the clinic, I am also physically examining my patients,” explained Dr. Abou Ghannam. On DRAPP, she charges $60 and may charge $40 for shorter consultations.
She added that while this is her approach, some physicians take the opposite stance, considering that teleconsultations offer unlimited time and should, therefore, be charged at a higher rate than in-clinic visits.
Telemedicine applications and platforms typically deduct a percentage from physicians’ consultation fees. Dr. Abou Ghannam confirmed that DRAPP takes 20% of the total consultation fee.
Other telemedicine platforms try to impose a minimum fee on physicians. She claimed that one platform even reached out to her and requested that she raise her consultation fees.
Patient Data & Privacy Policy
Health data is among the most sensitive. It contains personal and intimate details about an individual’s physical and mental well-being, and it carries significant risks if mishandled, which can be disastrous.
Any online platform handling health data, like a telemedicine platform, is expected to treat patients’ and doctors’ data with the utmost security and confidentiality.
An analysis by SMEX’s policy team of DRAPP’s privacy policy revealed multiple shortcomings in terms of data privacy. For example, the policy does not mention any third parties with whom DRAPP shares data.
“Without this information, users cannot fully understand or control how their data is being used and shared, which can lead to mistrust and potential misuse of data,” said Metehan Durmaz, a policy analyst at SMEX.
DRAPP’s privacy policy states that it has access to the users’ private information, which may be analyzed to enhance services. Patients usually expect that their medical information is guarded by doctor-patient confidentiality.
The app also does not mention how long the data is kept for, nor the legal basis for data transfer.
“I was shocked to hear that the platform can have access to my chats with the physician,” said Frida Baaklini, a patient who sought a telemedicine service for a pregnancy-related issue.
Baaklini explained that she trusted her usual doctors to provide her with a diagnosis while she was living abroad.
She noted that if she had known that her conversations could be accessed, she “wouldn’t have opted for a teleconsultation for an intimate issue that isn’t urgent.”
Information about patient health, particularly regarding sexual and reproductive health, should remain private in countries where such topics are still considered taboo.
“People in our region aren’t informed enough about data protection and the importance of privacy online,” said Dr. Abou Ghannam.
As for NAWAT, its privacy policy is still in development, explained Jaber. She also said that the privacy policy will be based on the “UAE’s stringent privacy policy laws,” since the platform is based in Abu Dhabi.
Jaber told SMEX that the app, which will be launched soon, will include measures to safeguard patients’ privacy, such as not asking for identifiable data, including names or gender.
According to Jaber, Nawat is currently offering free, 30-minute consultations with SRHR experts through google meet. Users seeking SRHR care approach Nawat through Instagram or WhatsApp, where they are redirected to a calendly link to book the session, said Jaber.
Jaber also told SMEX that once users are directed to the calendly link, they can access all relevant information, which includes a privacy policy.
“Data about sexuality, sexual health or sexual orientation is a category of ‘special data’ under data protection laws that demands high privacy standards and a clear privacy policy upfront,” explained Durmaz.
Despite the good intent behind the initiative, remaining within legal bounds for personal data protection is essential, given that Nawat is a private initiative, added Durmaz.
“The right approach to protect user data, especially when those services are provided for good intentions, should be guided by three core principles: transparency, informed consent, and data minimization, given the sensitivity of the data involved,” he added.
A fundamental requirement for any app collecting health and sexuality-related data, is to provide a comprehensive privacy policy publicly on their website and app, explained Durmaz, not only upon request. Transparency is particularly critical in sensitive areas like sexuality, as it allows users to make informed decisions.
“We launched this service for pilot-testing. On the App, once out, all this will move to an in-app experience with different software, privacy policy, and T&C integrated into the actual inApp-user experience,” Jaber told SMEX.
Another Lebanon-based platform that provides telehealth services is WhatsDoc. Neither NAWAT nor WhatsDoc currently has a privacy policy available on their websites.
Upon being contacted by SMEX, WhatsDoc’s founder sent their privacy policy that he stated is sent to the patients before signing up for the app.
SMEX’s policy team found that WhatsDoc does not comply with international standards for app privacy.
“The app lacks a privacy policy, a critical requirement for informing users how their data is collected, used, and protected—especially for sensitive health information. This violates international standards,” said Durmaz.
The terms and conditions are combined with the patient consent form, which may confuse users; ideally, these documents should be accessible separately.
Since these telemedicine apps can be accessed from European Union (EU) countries, they must comply with the Union’s General Data Protection Regulation (GDPR). This includes data protection, transparency, and proper consent. The text does not explicitly mention GDPR compliance or how personal data is handled in line with these standards.
According to the policy analyst: “The app is not liable since it is only an intermediary between the user and the doctor, but doctors are definitely liable. The app is responsible for verifying the doctor’s capabilities.
The form states that “de-identified data,” or data stripped of personal identifiers, may be used for research, but it does not explain how this data is de-identified or how user consent is obtained.
Users should be given clear options to opt in or out of having their data used for research.
“The language of the form is marred with legal jargon and may be hard for users to understand. Consent forms should be written in clear, simple language to ensure that users fully understand what they agree to,” explains Durmaz.
Lastly, the terms do not specify which jurisdiction governs disputes or legal issues, which is essential for an international app.
To address these issues, the app should create a separate privacy policy, clarify the consent process, and ensure it meets legal requirements specific to the jurisdictions it operates in, according to Durmaz.
Some of Dr. Abou Ghannam’s patients send her images of their vulvas, breasts, or other sensitive body parts on telemedicine applications without understanding the repercussions of sharing these images.
The physician also added that patients from the United Arab Emirates (UAE) come to Lebanon to access STD testing and consultations, in fear that the government may learn something about it, although it is a wide misconception, she explains.
Data Privacy Law
Lebanon has few explicit laws protecting personal data; however, privacy is governed by other provisions, and patient data privacy is safeguarded by Article 7 of the Code of Medical Ethics.
Lebanon’s Electronic Transactions and Personal Data Law, which regulates personal data, is vague and has many shortcomings. It does not specify in which cases personal data processing is allowed, whether the state can transfer data to foreign countries, and no independent oversight body exists to monitor its compliance.
Since telehealth applications fall under Lebanese law, personal data is subject to these laws. Since patient data has no specific protections, it is up to the platforms to take the initiative to safeguard it.
The law also does not define any time frame for data retention, so telemedicine platforms may keep them indefinitely, exposing sensitive data to misuse and breaches the longer it is kept.
In Egypt, regulations are more stringent, and a data protection law regulates personal data collected online. For cross-border transfers, the company transferring data outside of Egypt must obtain a license from the Regulator. It can only transfer data to a country with the same level of personal data protection as Egypt.
In countries and regions with more stringent data protection laws, the privacy policy of an app that collects sensitive information, such as health data, must have a very clear and complete privacy policy. DRAPP is open to use in various countries and regions, such as Egypt, Turkey, and the European Union, according to Durmaz.
Interestingly, DRAPP mentions in its privacy policy that data is stored in Lebanon, although it does not specify any contract or decision that legitimizes the transfer from a country like Egypt to Lebanon.
While telehealth holds great promise for bridging gaps in healthcare access—especially for sensitive areas like sexual and reproductive health (SRHR) in regions where these topics are often stigmatized—its implementation demands careful oversight to ensure that sensitive information, such as health data, is managed ethically and safeguarded against any kind of misuse.
Without stringent personal data privacy laws in the South West Asia and North Africa region, where surveillance is rampant, patients might be exposed to data breaches, potentially deterring them from seeking vital sexual and reproductive care.
Before signing up for any app, users should demand clear, accessible information about how their data will be used, stored, and protected. This will ensure that telehealth can truly fulfill its promise without compromising trust or security.
