How does gender/gender identity relate to HCV?

People Born Male and Living as Male

The main form of transmission for hepatitis C is IV drug use. Males are statistically more likely to begin to self-medicate and to use higher doses. This is impactful when considering IV drug use, where hepatitis C transmission often occurs. When a male begins to self-medicate, he may not have access to clean needles and this increases his likelihood of using a dirty needle and exposing himself to the hepatitis C virus. In addition, over time, as his body craves more and more of the drugs, he may be injecting herself more frequently than a female addict. This results in additional chances of exposure to hepatitis C. Plus, as males statistically increase their dose of IV drugs at a more rapid pace than females, men may be making riskier choices regarding needle use due to stronger drug cravings and more frequent need of injecting the drugs into his system.

People Born Female and Living as Female

Although both males and females are equally likely to become addicted to some drugs, females experience IV drug use differently than males. Females are less likely to self-inject and they typically use less of the drug at each injection. They are also typically addicted for shorter periods of time than males. The combination of these makes females less likely to become exposed to hepatitis C from the use of dirty needles. However, females are more likely than males to trade sex for drugs during periods of addiction. If a female becomes infected with another illness during these experiences (such as a sexually transmitted infection), her immune system can become compromised and thus she can become more susceptible to other illnesses. This can lead to an increased likelihood of becoming infected with hepatitis C if she is exposed to the virus.

People in Hormonal or Surgical Transition and Gender Non-Specific People

Although the main forms of transmission are primarily known for being related to IV drug use and being tattooed in an unlicensed facility, people who are utilizing needles for other procedures can be at increased risk of exposure to hepatitis C as well. If a person is receiving hormone therapy or surgery related to gender alignment through a legal and licensed medical facility within the United States, there is no need for concern. All medical facilities in America that accept forms of insurance and are open to the public follow the medical guidelines of cleanliness, which includes the use of clean needles that are used only once on one patient and then disposed of in marked receptacles.

Due to the expenses of hormonal interventions and surgical procedures, it is not uncommon for people with different gender-related needs to seek out less expensive options. Some people choose to seek out treatment through unlicensed medical practitioners or through obtaining supplies through the internet. Others choose to travel outside the United States for these procedures or to obtain supplies. When choosing to travel internationally, it is important to check that country’s laws and requirements regarding needles, blood, and exposure to viruses. In addition, make sure you speak the local language or have a medical translator present so you can ask any questions you may have about how the medical staff sterilizes their equipment and how they keep patients from being exposed to the illnesses of others during office visits and procedures.

While it is not recommended that people choose to obtain equipment or have medical procedures done outside the care of a licensed medical professional, some do make this choice. It is important to use only new, sterilized needles. In addition, some people choose to take a photograph of the labels and bottles of everything being used, as well as of the person or people administering the procedure. This can help medical professionals to best understand the situation if there is a medical complication requiring treatment.

While some are interested in specific hepatitis C statistics for the transgender and gender non-specific populations, these numbers are currently unknown. This is due to a combination of some forms lacking the option to identify as such within the testing or treatment centers and because some choose not to identify as such on paperwork that may be seen by their insurance companies. Although this means that it is currently unknown exactly how likely a person is to become exposed to hepatitis C during gender-related hormonal or surgical procedures, it is always recommended that a person take Universal Precautions during any and all treatment processes to keep the risk of exposure and infection as low as possible.^1-4