Updated information:
- 10 Ways to Make Intramuscular Testosterone Injections Less Painful
- Common T Injection Site No Longer Recommended
Last Friday, I finally got to do my first testosterone self-injection. Most guys I know are taught from day 1 to do their own shots, but my doctors were surprised by this and so I’ve been going into their office every two weeks for my shot since my first one in April.
Two appointments ago my doctor gave me Part 1 in Self-Injection Technique: Drawing Up. He was a little rushed so he gave me my shot and said we’d do Part 2: Injection at my next appointment. And so for shot #12 last Friday, I did the whole enchilada myself:
Drawing Up
- Lay out supplies: 3 ml syringe, needles, vial of T, alcohol swaps
- Clean the rubber stopper of T vial with alcohol
- Attach 18 gauge needle to syringe
- Draw plunger back to 1ml (cc) mark (syringe now contains 1ml of air)
- Pierce the center of the stopper of the vial with the needle of the syringe
- Turn the vial upside down and inject the 1 ml of air from the syringe into the vial
- Keeping the tip of the needle in the oil, withdraw fluid from vial into the syringe
- Remove and discard 18 gauge needle
Injecting
- Attach 22 gauge needle
- Cleanse the injection site (thigh muscle) using an alcohol prep-pad
- Insert the needle into the injection site
- Aspirate slightly by attempting to withdraw the plunger of the syringe. If no blood is seen, proceed. If blood is seen, a second site must be used—withdraw!
- Depress the plunger slowly to administer the injection
- Withdraw the needle and apply pressure to the injection site
- Properly dispose of the syringe and needle assembly
It was easy, and the actual moment of injection is fast and doesn’t hurt at all.
We considered the bubble or air-lock method of injecting but it seems unnecessarily complex.
Something else I might try is a smaller gauge needle for injecting, perhaps a 25 or 27. The thing with testosterone is that it’s suspended in oil and very thick so it can take a while to inject with a smaller gauge needle. However I was reading on some body building forums that some guys draw up, then leave the syringe sitting on a heating pad for 20 minutes or so, then inject with a small gauge needle. This sounds like something I might eventually try out of interest, particularly when I go up to a higher maintenance dose.
Speaking of higher doses, I’ve now completed the six shots of 100 mg and will be going up to 150 mg for my 13th shot on September 19. I will be going into the doctor’s office for that shot but doing it myself, then will be doing all my shots at home after that.
Also, I may try the Z-track method next time since I had a small bubble of T seep out of the injection site after withdrawing the needle. With Z-track injection you displace the skin and subcutaneous tissue 1–1.5 inches laterally prior to injection and release immediately after the injection, sealing the medication within the muscle and allowing no exit path back into the subcutaneous tissue and skin.
Gender Outlaw 
Thanks for taking the trouble to document your transition. I am following your journey with interest – as well as your book reviews. Half way thru Kate B’s Gender Outlaw (which is great).
All the best
Mimi
Thank you very much for your comment and interest, Mimi! Yeah, Kate rocks, I was totally inspired after reading that book, hence the name of this blog. I have a few more book reviews up my sleeve…
I just wanted to make a couple of suggestions. If your getting thigh pain make sure that your leg is totally relaxed. Also be sure you don’t move it during the injection! Use a 25 Gauge needle to inject. You don’t need to use heating pads or anything it just take a little while to do the injections. 22 gauge is still pretty large and thats probably the source of your pain.
Thighs do make a good injection site.
Here is a link to my favorite cheat sheet. Even after you’ve done injections for years its good to have a check list and this is mine.
http://www.forge-forward.org/handouts/injection.pdf
Well i just have a question. Im an 18yo female and want to be a male. ive felt this way for the longest time but never knew where to start or what to do. I want to get my breasts removed at least first before i go through with the FTM full operation. But my question what do i say to my doctor? how do i get the testosterone? or do i go to an endo?
Thanks for posting your question. The process you are considering sounds very familiar: I too wanted chest surgery above all else when I started on this path.
If you’ll be paying out of pocket for top surgery, then you do not need a referral from your family doctor. You will only need to choose a surgeon (not necessarily an easy choice) then satisfy their requirements for support letters. My surgeon required one letter from a psychologist or psychiatrist with gender issue experience.
For testosterone, the process can vary, but typically you would get a referral from your family doctor to an endocrinologist. (I have heard of some family doctors with FTM experience who will prescribe T without the endo involved, but that wasn’t my experience.)
As for what to say to your family doctor, I would go into the appointment with as much information as you can. You want to let them know that you have thought about this with a sound mind, and that you have done your research. My doctors didn’t have any FTM experience, so I brought them handouts and a copy of Nick Gorton’s guidebook. You can find a link to this, as well as other information that may be helpful to you, on my FAQ page, under “I want to transition. Where do I start?”.
Hope that helps, good luck!
Due to limited funds and my insurance not covering my trasition my Endo did my first injection and then scheduled me for injection training for my second. My wife does them for me and on my 3rd injection she did great!
It took a little poking to get my doctor to teach me, but I couldn’t imagine having to go every two weeks for a shot. It’s nice to be freed up and just do it myself.
I’m on Androderm (patch) right now. It’s awesome. No ups or downs. However, I do tend to run out of places to stick the damn patched to. But I have discovered that medical tape (the white kind they stick the cotton ball down with after a blood test) will hold that thing in place all day and night.
I’ve also tried Andriol (pill). Not bad..but super low doses..may be worth taking at the end of an injection cycle (days 10-13).
I just got a prescription for Delatestryl..waiting for my fist app’t for injection. I gotta say I’m worried about the highs and lows. Any suggestions?
Not medical tape, noooo! Just kidding, but I have had enough medical tape and hair rippage this past year to last a lifetime. As I was being discharged after my hysterectomy, the nurse ripped the tape off my inner thigh that had held the catheter in place. That is the most pain I can recall ever experiencing.
Anyway al, personally, I don’t experience highs and lows at all with my injection cycle, though I know it’s common. Weekly injection helps fight it (I inject biweekly.) Perhaps you’ll want to try this.
Thank you for the informative post . . .
I’ve been receiving testosterone injections for several years in conjunction with circulation issues with my legs (testosterone increases red blood cell formation) . . . last Friday, the medical technician gave me the injection in the thigh, instructing me how to do-it-myself . . . the muscle started feeling sore on Saturday . . . I stopped limping in pain on Wednesday.
I’m gonna return the testosterone and the syringes to my doctor’s office, pull down my pants, and take my shots in the butt like a man, LOL!! (I’m too big a baby to take ’em in the thigh again)
I know how you feel! I’ve jabbed myself badly before and limped around for a few days too! It doesn’t always happen. I guess it comes down to technique, but I haven’t figured out what I’m doing differently when I wind up with post-injection muscle pain. Thankfully, it’s not too often. I have some bike accident related issues that cause me spasms if I try and twist to shoot my rump, so thigh it is. Perhaps one day I’ll try the sub-cutaneous pellets… ps. I enjoyed looking at your website! Really beautiful, stunning work!!
Thank you for the compliment . . .
I meant no disrespect when I mentioned taking my shots in the butt like a man (I made the comment before it dawned on me what “FTM” stood for) . . . DUH!!
yeah they want me to do it myself from the get-go, not even trained using the real stuff yet. I don’t like needles at all… still scream whenever one is inserted into any part of my body for any reason. I tried but i ended up not sleeping due to the pain that lingered (still there a bit) and it was a 9 on a scale of 1-10 in my thigh. i don’t know if i wnat it in the butt because my pcp is is going to have a female do it (and i’m more comfortable with men) so i guess i’ll just hike up my shorts for her. thing is i DON’T want to self inject! i WANT the doctor to do it. is it that the thigh really does hurt that much? i admit that i’m a complete baby and have an extremely low pain tolerance so i’m trying to find out if it’s just me or not.
Some training is important to get a good injection technique. It’s natural to not like needles, but it’s something worth working to overcome since many of us can expect to have injections the rest of our lives.
It doesn’t sound like you got a good injection last time around—that’s more pain than should be endured.
Check out this article, especially the 10 tips to reduce post-injection pain.
Also this one: Common T Injection Site No Longer Recommended
I hope this helps!
No worries, didn’t take it that way at all! Thx! 😉
Hi, my girlfriend is planning on going through the ftm transition and just wants to know how much it was for you to get testosterone? Were not sure where to look it up.
Thank you.
Charli, I think you’ll find the Transition Expenses page helpful. Keep in mind, I’m in Canada. I think T is slightly more expensive in the US.
okay thank you :]
Hi my name is Teagon, uhmm i really enjoyed your website it has some really useful information.. I’m a 15 year old transgenderd youth who lives in sudbury ontario… I’ve always known I was transgenderd.
My mother and i are going threw what testosterone actually does to your body… is there anything fatal? what should i be worried about? just anything in general… like embarrising but would i still get my period or do i have to wait awhile to get a hystorectami. what types of side effects did you go threw? What is the best age to actually go threw with prosedures and what not?
Hey Teagon, thanks for your comment! I think I can point you in the right direction… These are the best resources I’ve come across for questions like yours:
1. Medical Therapy & Health Maintenance for Transgender Men by Dr. Nick Gorton et al. This is an excellent medical manual that covers all the medical aspects of testosterone, and also includes surgery information.
2. The VCH TransHealth Library has several high quality PDFs under “Consumer Information” that cover hormones, surgery, youth, health and more.
3. Hudson’s FTM Guide is perhaps the best trans male reference site out there. It’s very comprehensive.
4. Lastly, your folks would appreciate this book: The Transgender Child.
Hope this helps! Let me know!
Great post! I’m about to inject myself for the first time, next week – with the help of a nurse friend. But your post really helped answer some questions. Will have to watch the videos before next week!
Glad you found this helpful, Jordan! Neat timing… I revisited self-injection techniques a month ago after badly hitting a nerve in my thigh, which caused my leg and knee to swell up painfully for several days. The key was simply injection location, and I guess I’d strayed a bit from the “sweet spot” over the years. On my next shot, I was nervous, my hand shook a lot, and it took me four jabs to get the sucker in. I’ve never been nervous like that with my injections, but I got “back on the horse” and it was OK. I did another shot this morning without any fanfare. Good!
Regarding this post, I still do my injections the same way, and I’m still injecting in my thighs. (Side note: Butt shots have fallen out of favor in Canada due to potential for nerve damage; ventrogluteal is now considered “best of breed” injection site for IM.) I tried the Z-track method and didn’t think it was worth the extra fumbling. Also, I notice that I made a point of mentioning to do the injection slowly. My doctor tried to get me to go faster, but going slowly is actually pretty important: when you inject, you create a bubble of T in your muscle. Do it too quickly, and that bubble has a much greater chance of bumping into a nerve, which will cause some lingering pain.
Other things I do that I don’t mention in this post: I gently warm my T on an electric heater to bring it closer to body temp; I only inject after a hot bath or shower so my muscle is warm; I take Arnica Montana right before I inject, and I use an Arnica cream on the injection site afterwards.
It’s very cool that you have a friend to help out initially. Good luck!!
Great post! I’ve been battling testicular cancer for 3 years now and have just starting self-administering my hormone treatments… in my thigh vs. the ol’ ass. HOLY SMOKES! I thought I did something due the crazy muscular pain in my thigh and shooting down my leg. But I realize this pain is normal. Thanks for the grounding! I see this post is a few years old. Hope your transition was a healthy one (minus the thigh pain)