Blog 9/30/22

Mpox (MPX):  Answers to Common Questions from the Transgender, Non-Binary, and Gender Expansive Community 

By Rhea Debussy, Ph.D. (She/Her) 

In my role as Director of External Affairs at Equitas Health, a lot of transgender, non-binary, and gender expansive folks have been asking me about mpox (MPX). Many of my colleagues here and at other community organizations have noticed the same thing.

To help answer these common questions, I sat down with Teagan Vaughn, PharmD, RPh, AAHIVP (She/Her). Teagan is the Director of Gender Affirming Care and a clinical pharmacist at Equitas Health.

Rhea Debussy, Ph.D. (RD): There’s been lots of misinformation about how MPX is transmitted. Can you tell us the most common ways that MPX is spread? 

Teagan Vaughn, PharmD, RPh, AAHIVP (TV):  MPX spreads through close contact with people who have a MPX infection. Direct skin-to-skin contact with a rash, scabs, or body fluids from a person with MPX has the highest rate of spreading MPX. Touching objects, fabrics, or surfaces that have been used by someone with MPX can spread MPX too, but this isn’t as risky as direct skin-to-skin contact. MPX can also spread through coughs and sneezes during prolonged face-to-face contact.

MPX can spread from the time symptoms start until the MPX rash fully heals. 

RD: Just so we are clear, MPX is not a sexually transmitted infection (STI). So, why has so much of the messaging about MPX risk centered on sex? 

TV: U.S. health officials tied this MPX crisis to sex at the beginning of the outbreak. They did this to focus risk reduction efforts and a low vaccine supply where there were the most cases at that time. Unfortunately, this definitely led to misinformation, stereotyping, and stigma. 

But, you’re right, and MPX is not a STI. People get it when there is skin-to-skin contact, and that’s not just from sex. 

RD: Why is learning more about MPX risk important? 

TV: MPX can spread through something as simple as a handshake. It is important that people – even people who don’t have sex – know that sex is only one way that MPX spreads. Many people protect themselves against STIs with safer sex practices or medications like PrEP to help prevent HIV transmission. With MPX, a condom won’t protect you if rashes or scabs are on the arms, face, or legs. 

RD: Many people in the transgender, non-binary, and gender expansive community are wondering how concerned they should be about mpox. Is this community at risk? 

TV: Everyone is at risk. MPX does not pick and choose. Frequent skin-to-skin contact with someone who may have MPX is the largest risk. MPX doesn’t care about your race, gender identity, sexual orientation, or socio-economic status. The best way to stop the spread of MPX is for everyone to have good information about how it spreads and what it looks like when it does.  

RD: Thank you so much for that important information. To help folks know more about identifying MPX, what are the common symptoms? 

TV: A rash forms in nearly all cases. Most people also experience fever, feel tired, or have chills. About half of people with MPX may have headaches, swollen lymph nodes, muscle aches, or itching.  

RD: If someone is experiencing these symptoms, what should they do?  

TV: If they have a medical provider, they should reach out to them for evaluation and MPX testing. They should also avoid skin-to-skin contact with others. If they don’t have a medical provider, they should contact their local health department or Equitas Health for additional resources. 

RD: Where can folks get tested for MPX? 

TV: If you’re reading this, information is just a few clicks away at mpx.equitashealth.com. You can get a MPX test at our medical centers and additional resources with a simple phone call.  

RD: That’s definitely a good resource for folks. Vaccination is another important tool for preventing MPX. Can transgender, non-binary, and gender expansive folks currently get the vaccine?  

TV: Yes, Columbus Public Health (CPH) recently announced updated eligibility for the MPX vaccine. Any adult 1) who is an Ohio resident and 2) who identities as transgender, non-binary, or gender expansive can get the vaccine in Columbus. 

If folks can’t come to Columbus, they can get the MPX vaccine in their home county. But they have to meet their county’s eligibility. That information is included with MPX vaccine clinic announcements at mpx.equitashealth.com. 

And finally, folks outside of Columbus can get the MPX vaccine, if they have a high risk of exposure to MPX. In Ohio, the Ohio Department of Health (ODH) follows the CDC’s guidelines on who should get the vaccine. Currently, ODH recommends the vaccine for: 

• People who have had close contact with someone who has MPX  
• People who know that one of their sex partners in the past 2 weeks has MPX  
• People who had more than one sex partner in the past 2 weeks in an area with MPX cases  
• People whose jobs may expose them to MPX   

RD: That’s great to know that any transgender, non-binary, and gender expansive person can get the MPX vaccine at CPH or Equitas Health locations across Columbus! So, how well does the MPX vaccine work?  

TV: The vaccine for MPX – called JYNNEOS – is very effective! JYNNEOS has been around in different forms for a long time. It has a good history of preventing MPX with mild side effects overall.  

RD: I’ve also been asked lots of questions about intradermal versus subcutaneous vaccines for MPX. What’s the difference? Which one does Equitas Health use? 

TV: For intradermal MPX vaccines, you get your shot in your forearm between the top layers of the skin. For subcutaneous MPX vaccines, you get your shot in the fatty part of your upper arm.  

Intradermal shots use a smaller amount of vaccine. This means that as many as five times more people will be able to get the vaccine. To help make sure more people can be vaccinated, Equitas Health is giving intradermal MPX vaccines.  

RD: Is the lower dose just as good at preventing MPX? 

TV: Yes, intradermal and subcutaneous vaccines give you a similar level of protection against MPX. If someone has a history of keloid scarring, a subcutaneous vaccine is the better choice. 

RD: Is there anything else that you’d like to share?  

TV: Like the COVID-19 vaccine, people have doubts about getting the MPX vaccine. Some of this comes from misinformation about MPX overall. It also reflects the relationship some of the most at-risk communities have with healthcare. Why would people trust a system that may have ignored or harmed them? With MPX, Equitas Health has another chance to help repair community relationships, so more people feel safe getting the care they need.  

RD: Thank you for all of this information. I’m sure it will help many transgender, non-binary, and gender expansive folks in our community. I so appreciate you and your expertise, Teagan! 

TV: Thank you for elevating this important topic, Rhea! 

Still have questions? Visit mpx.equitashealth.com.