By: William Cuthbert (he/they)
Your first day on T will likely be exhilarating, joyous and nerve-wracking all at once. But no matter the emotions you’re bringing to your physical transition—which may be overwhelming at first —know that you’ve already made decisions to take pride in. You’ve chosen a medical transition that’s right for you, arriving at this first time giving your body the right hormones for your identity. You’ll be excited for your body to reflect your gender, but try to be patient and kind to yourself while the changes you’re waiting for happen in their own sweet time.
Before this moment, you’ll have learned about testosterone and the ways your medication can be taken, with the guidance of your medical provider. You may be excited to go for a testosterone shot or injection. Or you may be dreading your first shot, and mostly excited about being seen as more masculine and treated by society as a man. (Some people say injections cause physical shifts in the body fastest, but scientific research shows that this isn’t true. All forms of T, including gels, patches, and injections, create the same changes over the same timeline.)
Emotionally preparing for your first T injection
When you’re ready for your first shot, you’ll either be self-administering or getting injected by someone you know and trust. Some folks see a medical professional for their first injection or even their first few injections. Before you receive your prescription for T from Plume, your Care Team will walk you through the process. You can also review some helpful tips here.
Your first day on T can all bring its own set of anxieties and worries. It’s so normal to feel nervous of needles, share your joyful jitters with a loved one, or make yourself vulnerable in a doctor’s office. Either way, you can rest assured that you’re beginning gender-affirming hormones as a gesture of compassion towards yourself. Sooner or later, injecting will begin to feel like part of your normal routine.
Before you do your first shot, make sure you read this
If you’re injecting at home, before you get carried away, make sure you’ve considered all safety precautions including the correct procedure and sharps disposal. Even if you or your medical provider has been trained to inject, it’s always best to go over the instructions.
Here are some suggestions that might make everyone involved more comfortable before you take on the real thing. Even if there are still nerves, this way there’ll be a smaller chance of potentially painful or dangerous slip-ups.
- Do a test run where you find an ideal spot in your home to inject
- Practice withdrawing the medication from the vial into the syringe
- Figure out whether you’ll lie down, sit, or stand while you take your medication
- Make sure you have all of the supplies you need
When self-injecting T, make sure you read your prescription’s correct use and safety information before you have your first dose. It can be useful to have this information close to hand early on, to refresh yourself or in case you forget the details or order of any steps. Even when you feel comfortable using your prescription without guidance, keep any leaflets with the box for your prescription in a safe place, as reference to your dosage for medical reviews and blood tests, or in case of adverse side-effects.
The injection method won’t be right for everyone. Some people have a fear of needles and need a different uptake method. Even if you feel jittery about your first day on T, you should have enough information and support to feel confident by the time of your first dose.
What if I want to microdose T?
If you identify as genderfluid or nonbinary, or don’t want to look too “masc”, your Care Team will make sure your dosage fits your needs. Though it’s possible to take a lower dose or even microdose with injections, you may find that one of the alternatives is more convenient. T can be taken in gel, cream, patch and pill form. Each of these can also be used for smaller doses, to give you a gentler rate and lower threshold of physical change.
As well as being a widely advised place to start with hormones (in fact, even folks who want to take the full dose of T will begin with a “starter dose”), lower dosing methods are sometimes helpful for transmasculine folks when our knowledge of our identities is still quite new to us, or if we feel that there might still be shifts or discoveries in our gender expression.
Gender-affirming hormone therapy can be a form of self-care
Your first day on T is a huge personal milestone. Remember to respect yourself and your reasons for transition from this first day onwards. Because we live in a culture that expects us to conform to a gender binary, we can feel pressured to transition in a way that makes us fit the “male” checkbox that’s presented to us exhaustingly often in daily life. But not all of us identify as FTM, transmasculine, or as trans men. Your T dosage should reflect your transition goals. At Plume, we understand that your medical transition should be as long, gentle or fluid a process as you need it to be to feel your best. After all, people are always changing and learning more about ourselves as humans.
If at any point after this first day you feel you need your medication to change with you—even if that means pausing or stepping away from testosterone—you can always contact your Plume Care Team for help with how to do this safely. You can increase up to a higher dose to affirm your blossoming masculinity. You can also step down, change uptake methods, or try microdosing if you want to take things slower.
It’s your transition, and these options are always open to you. Even after you’ve started T, it’s fine to still have questions. Don’t hesitate to ask about anything that worries or excites you about this process. If you want to share your feelings in a safe and supportive space, reach out to your Care Team or join a Plume Support Group. Your journey is so special—it’s just as unique as you are! Your first day on T can feel like stepping into the unknown, but remember that courage and self-discovery often walk hand in hand. Embrace the journey and trust yourself. You are brave, you are valid, and you are exactly who you were meant to be.
As the largest provider of gender-affirming care for the trans and nonbinary community, Plume is committed to providing information about many types of information, including questions about hormones like estrogen and testosterone, gender transitioning tips and experiences, and guidance on social transition and self care.
While we strive to include a diverse range of voices and expertise, not everything will be for every person. Each individual’s experience is unique, and the information Plume provides is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
Always first seek the advice of your primary and/or specialist physician, the Plume Care Team, or other qualified health provider with any questions you may have regarding a medical condition, your mental health and emotional needs, or your health care needs regarding gender-affirming hormone therapy. If you are experiencing an emergency, including a mental health crisis, call 911 or reach out to Trans LifeLine.
