Quick update: I wound up going to the doctor for various irritating symptoms and found out that I legitimately have a wheat allergy. So far it hasn't helped with the nagging guilt trips, but that's a subject for a different thing I'm planning on writing (and have been planning on writing since long before I was diagnosed with any allergies). I also almost passed out during a phlebotomy, which is directly related to my poor diet and weight problems. Will these factors be sufficient motivation to continue? I hope so, but I've had some damn good motivational triggers go sour before.
Anyway, enough of that, because I have something important to talk about that's relevant to trans men as well as anybody who injects testosterone: Please don't tell people it's safe to reuse your syringes and drawing needles.
I'm mentioning this because I'm reading a forum thread meant for trans men in which multiple people are talking about re-using syringes and drawing needles like it's no big thing. At least one has said that his doctor told him that reusing the drawing needle is OK "because that needle never goes into you."
First, let me mention that I understand sometimes people do these things out of necessity. Sometimes pharmacies are ridiculous and don't give you enough syringes, not everybody lives in a place where they can legally just buy extra syringes, not everybody even lives in a place where they can get testosterone legally. People make do with what they have. If the choice is really between re-using a drawing needle or syringe and not getting the medication you need, I'm not going to bother you for it. Harm reduction is important, even when it's not popular.
But I need you to stop acting like it's no big deal or carries no risk. Re-using products that are meant to be sterile always carries a risk. And the explanations people are giving are quite frankly horrifying and miss the entire point of sterile injection supplies to begin with.
When you have a needle, syringe, or set of both in the original package, that package is sterile. The testosterone itself is also sterile. That equipment has been kept out of the elements so that it can't be touched by any of the random crap floating around in our air supply.
Once you have opened a package, it's exposed to the air and can't really be considered sterile anymore. It needs to be used before the aforementioned random crap in the air supply attaches to it. From that point on, everything that needle touches also needs to be sterilized. That's why you take an alcohol prep pad to the top of the T bottle, and it's why you use the same on the injection site. Everything that needle touches that is not sterilized is a contaminant. If your needle taps into your desk before it goes into your T bottle or before it goes into you... that's a contaminated needle now, and ideally you will change it. If you take that contaminated needle and then punch it into your T bottle, that T is also contaminated. This is why needles and syringes are one-time-use. They even say this right on the package, so don't act like it's a huge surprise.
When it comes to users of illegal drugs especially, there are instructions available on how to clean them for reuse and sharing. This is a harm reduction technique. It's very risky, but it's better than not cleaning them for people who are going to reuse their needles and syringes no matter what you tell them. These techniques typically don't work for testosterone. Testosterone is usually carried in oil... sesame or cottonseed... and cleaning them is just not reliable.
To make matters worse, it's clear that a lot of trans men who reuse syringes and drawing needles are either just letting them sit in the air for a week or rinsing them with regular tap water. Leaving these supplies in a non-sterile environment compromises that sterility (otherwise there would be no need to sterile package them to begin with). Regular tap water isn't sterile, either.
I know some of you probably have heard people say--or are one of the people who continues to say--that you reuse syringes all the time and haven't gotten an infection. And you know, it's true that if you reuse a syringe it's not an automatic guarantee you're going to get an infection. This is a risk that grows over time as you continue to make these decisions. Several years of testosterone injections are bound to result in some mistakes made... accidentally dunking your needle in an artery, injecting air into yourself, having to stick yourself three times in a row because you screwed up the first two times. It happens... we just need to make sure it happens less by taking all possible precautions.
Finally, what can you do if you go through syringes too quickly or are broke? First, you can contact your doctor. Syringes are extremely inexpensive, and there's always a chance your doctor will just give you some spares if you're in a tight spot. If money isn't the issue but you just find yourself running out of supplies (maybe you drop them a lot or your dosing has been a bit weird), I recommend you order--if it's legal where you live--bulk needles and syringes so that you don't run out. There are also needle and syringe exchanges, some of which specifically cater to transgender participants. When I buy syringes and needles combined, they're usually about $25 for a hundred of them including shipping. If you have some trans friends you can even split that cost (on a related note, if I'm the trans friend, you can just ask me for some because I have dozens extra--again, mentioning for clarity that it's totally legal here to do that). There are also, of course, needle and syringe exchanges, some of which cater specifically to transgender people.
Again, I don't mean to write this to shame people who legitimately feel they have no option. The inability to get safe injecting supplies isn't necessarily a failure, it's a human rights and medical accessibility issue. Because it's an accessibility issue, it's important that we don't act like the need to reuse these things is normal and safe. It really isn't.
