COVID-19 (Coronavirus): What Trans People Need to Know

Adapted with permission from transequality.org/covid19 and by Cianán Russell, Senior Policy Officer at ILGA-Europe. Huge thanks to community members Jack Metcalfe and Amelia Arnold for developing the wonderful ‘Navigating COVID-19 and Chest Binding’ resource. The following information is current as of 18 March 2020.

COVID-19 is a respiratory illness caused by a new strain of Coronavirus (SARS-CoV-2). It has been classified a pandemic by the World Health Organization. As this pandemic evolves, and information emerges, ACON will continue to monitor the situation to ensure our communities are aware and can take action to stay safe.

We know that trans and gender diverse people, and our allies, may have questions about how we can properly face this public health threat. We want all trans people to stay safe, both from COVID-19 and from some of the unique issues we may face as a result of it. 

We urge all trans people and allies to put together a plan of action that not only considers basic health needs, but also your specific needs as a trans person. It is important that trans people are prepared if an outbreak occurs in your communities. 

Symptoms include fever, coughing, sore throat and shortness of breath. COVID-19 is transmitted by inhaling contaminated droplets spread by open coughing, or by contact with contaminated hands, surfaces or objects. 

The best way to prevent the spread of COVID-19 is through social distancing and good hygiene, such as:

Practice Good Hygiene Habits (from Australian Dept of Health)

• Cover your coughs and sneezes with your elbow or a tissue
• Dispose of tissues properly
• Wash your hands often with soap and water, including before and after eating and after going to the toilet
• Use alcohol-based hand sanitisers
• Clean and disinfect surfaces
• If you are sick, avoid contact with others and stay more than 1.5 metres away from people. 

Here are some suggestions for songs to sing while you wash your hands – or use your fave song to create your own hand washing poster.

Trans people and our allies need to be aware of COVID-19 

• Trans people report high levels of discrimination and stigma in healthcare settings. We are regularly misgendered at hospital, particularly those of us who live visibly trans and those whose name and gender are not reflected accurately with Medicare.
   
• Bathrooms (where we should all be thoroughly washing our hands) are highly policed spaces for trans people, and even going to wash our hands leaves us at risk of harassment and violence.
  
  
• Isolation and quarantine in wards or hospitals is complicated by transphobia from staff and other patients. 
  
  
• It's important to understand the elevated risk for trans people and to help us stay uninfected so that we can avoid closed settings.
  
  
• LGBTQ people, including trans and gender diverse people, have higher rates of HIV and cancer, and may have a compromised immune system.
  
  
• LGBTQ people, including trans and gender diverse people, also use tobacco at substantially higher rates than the general population. COVID-19 is a respiratory illness that could be especially harmful to smokers.

Gender Affirmation Needs

We don’t currently know how COVID-19 will affect our healthcare system. It's ok to ensure you have a 14-day supply of daily items, please do not hoard. 

Looking after our health is essential and there may be things you will need specifically if you or a loved one is trans:

• Enough supply of gender affirming hormones, syringes, alcohol swabs and sharps containers.
• Up-to-date prescriptions for 1-3 months of hormones/anti-androgens and other medications (this does not mean a 1-3 month stockpile of meds).
• Vaginal dilators or other medical items.
• Find your Medicare and Healthcare cards, and any important medical letters.
• Gather identification that shows your chosen name and/or gender, including birth certificate, change of name certificate, passport etc If you don’t have identification matching your gender, a letter from your doctor if you have one.
• Specific grooming or beauty items: razors, make-up, wigs, binders, packers and other prosthetics, etc. 
• Consider printing a statement such as the following, if you need to go to hospital or see a doctor you do not know:
  

• Gender affirming medical and surgical procedures may be put on indefinite hold. This can seriously impact the health and wellbeing of trans people.  Consider asking your counsellor if they can do appointments over Skype, or use a phone or web-chat based counselling service such as QLife.
• Take care of yourself – sleep, connecting online with others, talking about your feelings, offering help to others, eating regularly, staying hydrated etc. Good general health is as important as any affirming care.

Binding and COVID-19

Binding when you’re ill can cause complications, but due to the nature of COVID-19 affecting the lungs, there are some specific complications that may occur.

Community members Jack Metcalfe and Amelia Arnold put together the above resource, which provides a lot of helpful information about chest binding and COVID-19. You can find the original post of this resource by clicking on the image below or here.

Looking after myself and others

The time between when a person is exposed to the virus and when symptoms first appear is typically 5 to 6 days, although this may range from 2 to 14 days. For this reason, people who have been in contact with a confirmed case should self-isolate for 14 days.

Currently, the risk of exposure to COVID-19 is believed to be highest for those people who have travelled overseas and there are an increasing number of countries with a high number of cases. 

Australia has implemented a policy of universal self-isolation for people who have returned to Australia from anywhere overseas for 14 days.

In addition to self-isolation for travellers, social distancing measures are recommended. NSW Health indicates that this means “separating yourself from other people as much as possible when you’re in public places, and avoiding crowded places. Practically, you should:

• attempt to keep a distance of 1.5 metres between yourself and others 
• avoid crowds and mass gatherings where it is difficult to keep the appropriate distance away from others
• avoid small gatherings in enclosed spaces, for example family celebrations
• avoid shaking hands, hugging, or kissing other people
• avoid visiting vulnerable people, such as those in aged care facilities or hospitals, infants, or people with compromised immune systems due to illness or medical treatment.”  

Those most at risk of COVID-19 include people who have travelled overseas in the past 14 days. People who have underlying illnesses and a vulnerability to respiratory illness, older people, and people with suppressed immune systems are also at higher risk. It is important to note that the great majority of people living with HIV who have an undetectable viral load and who have a CD4 count of 350+ are not considered to have a compromised immune system.

Each of us need to consider our own personal circumstances, social and other contact with people, and assess our risk. ACON’s advice for our communities is that each of us look at the best medical advice, and apply it to our own lives and circumstances.

Creating a Plan of Action

Talk to your COVID-Network - family members, housemates and close friends, or the people you interact with daily. Decide your course of action in case of an outbreak in your community.

• Identify who are the most vulnerable people: older people (ages 60+), people with disabilities, smokers, and those with a compromised immune system are the most prone to the virus and need the most support.
• Identify specific rooms in case you or your loved ones need to self-quarantine in an isolated setting.
• Get to know the people in your community (while practicing social distancing). Find out about their plans of action.
• Create an emergency contact list and share this with your support system and stay in touch frequently. Make sure to include your doctor and emergency numbers (outside of the COVID-Network). Google Sheets can be a good tool for this. 
• Create an online group chat with your COVID-Network. In the group description or notes area, list the most vulnerable and why.  
• If you are employed: find out your employer’s plan of action.
• If you have children: find out your child’s school/child care’s plan of action.
• Review the NSW Ministry of Health endorsed Emergency Pantry List 
• Staying Trans and Strong is available here
• Mental health in an emergency info is here
  

What to do if you think you are sick or meet someone who has it

• Please do:
  • Stay home except to get medical care
  • Separate yourself from people in your home
  • Wear a face mask when around other people
  • Call ahead before visiting your GP
• Please do not:
  • Walk into a GP or community health service (please call ahead instead).
  • Stay in public spaces or use public transportation
  • Share personal household items 

Important Resources

• health.nsw.gov.au
• Coronavirus Health Information Line: 1800 020 080. Call this 24/7 line if you are seeking information about COVID-19
• Health Direct: 1800 022 222