COVID Vaccines Need an Advocate for Trans Healthcare

210504_Micha Dugan
Micha Dugan shares his journey to vaccination and the important factors to keep in mind.
jahleel shaheed

At first, I wasn’t sure about getting vaccinated.

As someone who was able to work remotely for the last year, I’ve had the privilege of watching the pandemic from afar. It was important to me that folks living “on the front line” — colleagues, friends, family, my partner, and other loved ones — would have access first. Although I am at high risk as an immunocompromised person, I worried that my appointment would be at the expense of someone who is forced to continue to go out in the world and work. Hearing stories about the extremely privileged using their wealth and whiteness to “steal” shots, up to and including faking their eligibility, scared me further away from scheduling an appointment. Would I look back on this choice as an equitable and kind one?

The choice was initially made for me: I was not eligible at first. This gave me time to research the vaccine and its side effects, as well as the moral and just arguments for taking, or not taking, the vaccine. Along with my own personal research, The Jewish Board, the New York City-based health and human services nonprofit where I work, provided educational materials and held informative talks with leading epidemiologists. Ultimately, it is a very personal choice, but so is actively choosing to live equitably in a way that is mindful of my own privileges.

I signed up for an appointment after my father, a late-stage cancer patient, received his shot. We are both disabled and immunocompromised. Strangely, what helped me make the choice was not the massive amounts of educational materials and informative talks shared by my workplace or my own personal research. It was a text from my father asking me when I was going to be vaccinated, because he wanted to go to a baseball game before he started an experimental trial this summer.

After a few weeks on a waiting list, a neighbor sent me a link from the nonprofit where she worked. I was scheduled in minutes, around the corner from my house. This is when my second wave of research began. I’m a transgender person who has been on testosterone for Hormone Replacement Therapy, or HRT, administering my own intramuscular shots every other week for approximately six months.

As someone who is both disabled and transgender, I have often had to be my own health advocate; in this instance, it turned out to be important to my vaccination journey. I had read a study that said some doctors have noticed that women and other people Assigned Female at Birth had more severe side effects. Being a scholar of my own body, I wondered if it was due to a hormonal variation and sent a quick message a medical professional who specializes in hormones and knew about my disability. He was happy to answer my question: we’re not sure, but let’s play it safe.

I’m grateful to know a provider who was thoughtful about all aspects of myself: my chronic pain and disability, my weakened immune system, my transition plan, and my need for a vaccine. Without his sensitivity, my reaction to the vaccine could have been much worse. I waited two days after getting vaccinated to take my testosterone shot. Although between the side effects and missing my shot I was very disoriented and in pain, I’m grateful that I was cautious. My partner, who is on estrogen, also had her hormones on a separate day than her vaccine. So far, neither of us have noticed any significant side effects other than those normally associated with the COVID vaccine and messing with our hormone schedule.

I’d encourage providers to check in with trans clients who are on hormones when promoting the vaccine, along with any other populations whose medical concerns are often minimized or who may be at a greater risk. Ask them if they’ve had the chat with a physician, and if they feel they have all the knowledge necessary to make a decision. Due to the lack of literature on trans health in general, neither myself or the doctor I spoke to are completely sure our caution was important. Lack of meaningful research is a perpetual risk of being marginalized: many medical studies aren’t made with everybody in mind. However, I think providers and advocates have the power to support others by asking, being cautious, and responding to concerns in a meaningful way. Without the advice I received, I may have gone into this with more anxiety than necessary, or worse — not gone at all.

Micha Dugan (he/they/we) is the Digital Content Associate at The Jewish Board, member of the National Child Traumatic Stress Network’s SOGIE group, former web designer for Arcanum Magazine, and LGBTQ+ teacher/advocate of 10 years. He also enjoys deconstructing racist systems and trying to recreate their obaachan’s cooking