Long COVID in trans people

from LONG COVID ESSENTIALS
a resources series by The Sick Times x Long COVID Justice

Navigating across gender clinics and Long COVID care


Trans people are more likely to report having Long COVID than cis people are. According to one survey, over 27% of trans adults reported ever experiencing Long COVID as of September 2024, compared to 14% of cis men and 22% of cis women. More research is needed to understand this pattern, though some advocates suggest lower income and less access to healthcare among trans people could contribute.

Both trans people and people with Long COVID often experience discrimination in the healthcare system, which can make finding providers competent in both trans care and complex chronic illnesses very difficult. 

Being trans may affect your experience of Long COVID. Some areas for trans people to consider when navigating care include:

Intersecting risks

Trans people are at elevated risk for chronic conditions, and the experience of living with multiple interconnected illnesses or disabilities is not uncommon. Long COVID might worsen existing conditions, or trigger new ones. 

  • When seeking a new diagnosis for Long COVID, or conveying the severity of Long COVID symptoms, tell your provider how symptoms impact your daily life.
  • Keep a record of symptoms to track how your health baseline functioning has changed.

Additionally, hormone replacement therapy (HRT) and hormone blockers may interact with off-label medications or supplements for Long COVID.

Tips for taking multiple medications:

  • Ensure at least one provider overseeing your healthcare is actively monitoring interactions between all your medications/supplements.
  • If treatments affect hormone levels, even temporarily, you can request a dosage adjustment or more frequent monitoring.

Interacting with clinicians

Trans people are more likely to experience bias/discrimination from healthcare providers.

  • “Trans broken arm syndrome” is a form of discrimination in which providers see trans people’s symptoms through their gender identity, even for unrelated issues such as a broken arm. This may lead providers to blame symptoms on transgender identity or gender-affirming care.
  • If you recognize that clinical staff are discriminating against you, you can ask your primary care provider (PCP) for a second opinion or a referral to a different specialist.

Conversely, gender clinics may not be knowledgeable or respectful about Long COVID. For example, many clinics may not have mask requirements or filtered air, which can put patients at risk of COVID-19 or other infections.

Options for talking to providers:

  • Share Long COVID is a Trans Issue by Long COVID Justice as an informational resource with your provider, as well as important Long COVID reviews like this one in Nature.
  • Consider alternative ways of getting care, such as switching appointments to telehealth when possible or requesting a provider willing to wear a mask.
  • If you are experiencing post-exertional malaise (PEM), let your provider know. Share this letter from the Workwell Foundation about why exercise can be a harmful treatment.
  • You can also request a referral to a Long COVID clinic, or another specialist who understands and sees people with Long COVID and related diseases.
    • If possible, ask members in your community about recommendations for these providers.
    • Note that not all Long COVID clinics are familiar with treating trans people.

Look out for more research:

Some research suggests that sex hormones could influence the body’s immune response, which might affect the severity or symptoms of Long COVID.

  • For example, one preprint (not yet peer reviewed) found that people with lower levels of testosterone were more likely to have worse Long COVID symptoms.
  • This article includes more information about sex hormones and the immune system.

More research is needed to better understand why trans people may be more at risk for Long COVID and to develop treatments. 

Resources

Writer: Fayth Tan • Editor: Miles Griffis • Medical reviewer: Dr. Zil Goldstein

Printable version of this resource page

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Notes

  • This series was published in fall 2024; some information may be subject to change.
  • Although each topic has been reviewed by medical professionals, they are informational resources, not medical advice. Always talk to your medical providers before trying treatments or symptom management strategies. 
  • Each resource page offers brief information and is not comprehensive. We know there is much more information on each topic we cover, and that there are additional topics not yet addressed in this series.