Transgender HRT Needles and Syringe Safety: How to Safely Dispose of Sharps
Since you’ve been supplied needles and syringes to self-inject hormone replacement therapy (HRT), do you know how to safely dispose of them?
Needles and syringes fall under the medical term “sharps” which describes anything that can cut or puncture skin. Sharps pose a risk of injury to anyone, even those who self-inject estrogen or testosterone gender affirming hormone therapy (GAHT), when not treated with proper care and attention.
This situation begs the questions: How can you store used sharps safely? How do you safely dispose of them? What precautions should you take to avoid injury and other risks? Read on for more information.
Why it’s important to dispose of needles safely
Safe disposal is a matter of both self and collective care. For yourself, it’s important to avoid poking, cutting, and overall puncturing skin from loose sharps. The only time when a needle should be exposed is the moment you’re injecting. During all other times, the needle should be covered with its cap, even when disposed of in a safe sharps container, which will be discussed later in this article.
If you or someone you know does happen to get injured, show up for yourself and/or the other person by providing basic first aid care. Wash punctured skin with running water, use soap, then dry and cover the area with an adhesive bandage. (Be sure to go easy on yourself emotionally, too, because even the author of this article has accidentally punctured themself!)
When it comes to your community, it’s important for everyone—including people who use drugs (PWUDs)—to have access to clean needles, syringes, and other medical supplies. Clean needle and syringe access reduces the risk of HIV transmissions. Without access to clean needles and other medical supplies, you can get HIV from injecting any substance, even injectable testosterone and estrogen hormones via needles and/or syringes. Additionally, you can also contract hepatitis C from previously used needles, according to the Harm Reduction Coalition.
Step one: Obtain a sharps container
Do not throw away sharps in the trash by themselves, especially without their caps on. It’s unsafe for yourself and those around you (including sanitation workers) and is illegal in most municipalities. Unsafe disposal of sharps also can hurt wild animals who go through trash—yes, even the adorable racoons.
All FOLX HRT members receive a sharps container with their injection kits. Those who don’t have a sharps container can purchase one from a pharmacy or another vendor, which can usually be purchased for under $5.
You can also repurpose a household hard plastic container, such as a laundry detergent bottle or bleach bottle, as an alternative sharps disposal container. Make sure any potential household sharps container has a thick barrier where sharps cannot poke through. A disposable plastic water bottle, for instance, is too flimsy and insufficient, so don’t use it!
If utilizing a sufficient and sturdy homemade container, be sure to label the container as “SHARPS” one or multiple times, making it very obvious that the container contains sharps. Other puncture resistant containers, such as tin, can be used if plastic isn’t available to you. Glass can be used in a dire situation, but it’s not preferred since it can shatter.
Only needles need to be disposed of safely in a sharps container. Ideally, you should remove the needle from the syringe and throw the syringe away in the regular trash. You’re welcome to also dispose of the syringes since both are considered medical waste, but be aware that your sharps container might fill up quickly this way. Before dropping needles into the container, ensure they have their cap covers on them. When placing the needles in the container, be sure the sharp tip is faced away from you and faced down in the container. Here are some additional pointers:
- Never place your hand into the container
- Avoid overflowing the container
- Dispose when the container is three-quarters full
- Store in a place away from children and pets
- Do not reuse the container
Step two: Find where to dispose your sharps container
There are different kinds of community centers that accept sharps containers. Be sure to consult your local municipality for their recommendations as well as the Food and Drug Administration (FDA).
Thanks to the HIV and harm reduction movements, many states have state-funded needle exchanges, also known as syringe exchange programs, which help reduce community transmission of HIV and other viruses by providing clean medical supplies for free. Overdose prevention sites, otherwise known as safe injection sites, also practice proper medical waste disposal and may be another community center you can lean on for support. Although these health centers were initially intended to serve people who use drugs, they are also open to the public to anyone injecting substances, legally prescribed or not. We recognize that drug use, including both recreational and problematic use, isn’t a stranger to our community and therefore encourage people who use drugs, FOLX members or not, to seek support at community harm reduction centers.
Needle exchanges often also provide sharps containers as well as clean needles and syringes for free. They may also provide harm reduction education, such as basic first aid and proper injection demonstrations. However, be aware that these spaces may not be LGBTQ+ competent or friendly, so be intentional about how or if you want to disclose why you inject at all. If this poses as a barrier for you, consider seeking out transgender-led organizations like the Trans Needle Exchange.
Other than needle exchanges, there are also other ways to safely dispose of sharps. Mail back programs are available, where you are able to send your full sharps containers back free of charge. Some companies who sell sharps containers also have a mail back & container programs.
Additionally, depending on your municipality, you may be able to schedule a residential waste pick-up service to safely dispose of your sharps. Check your local city or municipality’s health department for recommended guidance for your area.
If all else fails, you may be able to safely dispose of a sharps container in the garbage, although this isn’t recommended. Refer to your health department for guidance on proper disposal because some may outlaw garbage sharps disposal of any kind, even for covered sharps. Be sure to approach this correctly since unsafe disposal can cause injury to yourself and others.
If you’re not a FOLX member, your health care provider may also have their own recommendations compliant with local laws. In some areas, you’re permitted to throw a sharps container in the garbage. It’s recommended to duct tape the cap onto the bottle. Do not recycle a sharps container. Double check the bottle has “SHARPS” written over it to communicate to waste removal workers that the bottle includes sharps.
What to do when traveling with sharps
A commonly asked question among the FOLX community is, “can I travel with my needles and other injection supplies? The answer is yes, you’re legally allowed to travel (including fly on an airplane) with needles and syringes.
Per Transportation Security Administration (TSA) guidelines, unused syringes are permitted when accompanied with injectable medication in checked bags. Syringes must be accompanied by medication in their original packaging and prescription labels. Additionally, all syringes and prescribed medication must be declared to security officers at the checkpoint for inspection. TSA also recommends, but doesn't require, that your medications be labeled to facilitate the security process.
Keep in mind that you won’t be the only one traveling with syringes! Many others travel with non-GAHT injectable medications, such as diabetes medication, so having injection supplies doesn’t automatically out you as being on HRT.
Although unused syringes are permitted on carry-on luggage, be cautious of any potential anti-trans sentiment among TSA staff or agents. While many FOLX members have traveled with their hormones in their carry-on luggage without an issue, ultimately, “final decision rests with the TSA officer on whether an item is allowed through the checkpoint per TSA guidelines.” If you’re a FOLX member and do happen to experience any issues, please let us know and we can do our best to support you.
Traveling with your existing sharps container isn’t ideal, especially since you’re not allowed to travel with used syringes. This situation begs the question: what is an optimal travel sharps container? Although FOLX doesn’t provide travel sharps containers currently, they can be purchased through online retailers like Stealth Bros (who also sells stylish travel bags for all HRT supplies). Additionally, some airport bathrooms and other community spaces may have sharps containers you can dump used needles and syringes into.
Whether you’re on injectable estrogen or testosterone, we understand it can be overwhelming and nerve wracking to not just inject, but to also be responsible for handling sharps safely. Our team reassures you that you’ll get the hang of it and until then, we’re here for you every step of the way.
Are you ready to get started with FOLX? Go here to start the estrogen HRT process and go here to start the testosterone HRT processes. Existing FOLX members with questions about safe needle disposal and injections overall can message with their clinician. For non-members with remaining questions, reach out to us directly at firstname.lastname@example.org.