By: William Cuthbert (he/they)
Gender-affirming hormone therapy (GAHT, sometimes also called HRT or hormone replacement therapy) is essential for the well-being of many transgender men, transmasc people, nonbinary folks, and folks who identify as FTM or AFAB.
There are many ways for folks undergoing this type of gender transition to take testosterone safely and effectively. If you’re thinking about injecting your gender-affirming hormones, there are two routes open to you. This article will help you decide which is right for you.
How do I inject testosterone?
Subcutaneous and intramuscular (IM) injections can both be administered at home or with the help of a medical professional. You can read more about how to safely self-inject here.
Often, injections are taken on a weekly basis. Each shot type also holds the same basic ingredients: liquid testosterone (or T) hormones suspended in a thick, viscous carrier oil. The oil-based delivery means either injection method can take more effort than you’d expect to push the liquid through the needle. But despite the similarities between these two methods, they aren’t exactly the same. One may be more suitable for you than the other.
What’s the subcutaneous injection method for T?
A subcutaneous injection means you inject your medication into the soft tissue just underneath the skin, known as subcutaneous fat. During the injection, the short needle is inserted at a 45-degree angle. Some people feel this is more comfortable than IM injections because of the shorter needle.
Subcutaneous injections work anywhere you have fat on your body. (Always follow your Care Team’s guidance on where to inject your medication, especially if you’re new to this uptake method.)
You can choose which injection site you’d prefer, which can be anywhere with that fatty layer. Some people choose the thigh, as the outer or front thighs are often easy to reach and position yourself for. But other options include the belly or buttock, which you might prefer—just make sure you have a loved one to help you reach the area.
What’s the intramuscular injection method for T?
In comparison, intramuscular injections need a large area of muscle, a longer needle and a deeper insertion, as the hormones need to be sent directly into the muscle. While needles for subcutaneous injection are less than an inch in length, IM needles are between 1 and 1.5 inches long. These might feel more painful going in, as well as potentially causing some mild bleeding, bruising or soreness of the muscle. They can still be easy enough to self-inject, as the thigh and buttock are options here too.
It might feel strange putting a needle in your body at a 90-degree angle, but there’s no need to worry about safety with either injection method, so long as you inject carefully and properly dispose of needles in a sharps container.
Injection is a popular way of taking testosterone because of the ability to inject weekly, or even bi-weekly with IM injections, as muscle can hold a larger supply of hormones for longer. Anecdotally, some people feel that they look and feel more masc in a shorter time with injecting, but there is no evidence that this uptake method is different from taking your medication in a different way. All forms of T work equally well. The important thing is to pick the uptake method that works best for your body, abilities, and preferences.
Injecting isn’t right for everyone, and there are alternatives. Gender-affirming hormone therapy is available in patch, pill, cream and gel forms which—while needing daily upkeep—are usually pain-free and much less invasive. As always, choose your method of health care based on what feels right. You can adjust as needed at any point during your transition.
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.
