I have to admit, mine may have health complications later in life because I accidently stepped on it >_<. What happened was as I was cleaning my tank, I took out my decor and put the on the floor so I could better vaccum the tank and apparently, my Raphael somehow hitched a ride on the wood. I walked out of the room and came back and felt a slight crunch under my feet along with a grunt. My soul left my body when I realized that I had stepped on my favorite fish (Thank God that I was barefoot and I had felt him before I completely crushed him). He bled a lot and not knowing what to do, I first put him in a bowl to get him back in water and let the blood get into that water, and then I put him back into the tank.
To this day, he is eating and swimming well and he has thrived in my tank. Another reason I love Raphs is that they are literal tanks. It has survived all of my stupid mistakes and being crushed partially alive. I also had a Green Phantom Pleco for many months (it was best friends with the Raph, they used to hide/sit together) that unfortunately passed away because of one of my stupid mistakes, but it survived through many of them.
Also regarding gender differences between Raphs, I don't believe there is an easy visual way to tell if they are male or female. One source I read said that males are slightly darker and a yellowish tan between the dark stripes while the female was lighter and has almost white between the stripes. But I don't know if that is true or not.