Trans Guy Tips #3; Testosterone HRT, How to Inject, & Its Effects On Body & Mind, Pt. 1
Note: I will likely add more sections to this at a later time, as I learn more about taking testosterone and its effects. Be sure to check back!
1. First, and this can change depending on your body type and what your own endocrinologist recommends for you,
but personally for me and for a lot of transgender men, Testosterone Cypionate, usually 200mg each dose, is the best choice, and so is taking the injection form, doing that intramuscularly, and taking them bi-weekly, meaning every other week on the exact amount of time from the time you took your last dose.
My endocrinologist explained to me that this is due to if you overload your body with testosterone constantly, or if you overdose it in an attempt to get more effects, you will instead have the opposite effect where you will instead gain estrogen, and more of it, because testosterone converts to estrogen when there's an excess of it and the body senses it as something wrong!!
So please please never take more than you are supposed to take, prescribed officially by your doctor.
They usually recommend bi-weekly for most if choosing injections, because it makes it so the testosterone spreads evenly throughout your system the entire time, and just has a very even perfect use that makes the effect stronger and it makes your body get used to it quicker, which speeds up the effects significantly, and tends to be the healthiest option.
2. Also in terms of safety, never ever get testosterone from a non-official source like the black market, online, or from a friend. You cannot trust this, as it has not been evaluated medically whatsoever.
Also, most importantly, you don't have a medical professional there to see if your hormones and all your health is correct and good to start or continue, or what dose to take, or which kind works best for your body, as well as not having any checkups, which is also vital when you take a new hormone in your body to make sure everything is balancing right!!!
So it is very dangerous, you could accidentally overdose, or your body could malfunction somehow, or you could just be injecting yourself with stuff that doesn't work ever!!
There are many things that could go wrong, so PLEASE never ever EVER do this.
Get a trans-familiar endocrinologist.
3. Now mind you, there are other options for taking T if you just cannot handle injections whatsoever.
Option one are tablets called subdermal capsules that they implant under your skin, usually under your arm or shoulder skin as it seems to spread the best that way. They will slowly leak testosterone until they replenish themselves and you have to get them replaced.
Some people praise these as they are pretty even in effects, and they make it so you have a steady supply pretty well, and also you don't have to think about it very often as the tablets last quite a while.
The downside is, that despite its evenness quality, it doesn't actually have very strong effects.
It will still give you effects for sure, but it will take a lot longer, possibly multiple years, to see the full effects of it.
There are also things known as topical testosterone, where you can put a gel or cream on yourself and it will dose you with the amount it has in it.
This is the least invasive option, however it's one with a very small amount of testosterone, so it will take some of the longest to feel, or see, effects.
Also, I have heard from some people that if you are having someone else put the gel on you, if they accidentally get it on their skin, it will literally dose them with testosterone, which is not okay if you have someone who is not trans and does not want it doing it.
So if you choose this route, please do it yourself so you're not dosing any more on to other people, and instead just on to yourself.
It also doesn't waste the dose on others that way, and you get the full effects instead.
There is also things known as oral testosterone, taken through pill form. But I have heard some bad things about these, and I have heard recommendations not to use them due to there being a lot of downsides, as it doesn't absorb into your body nearly as well as any of the other options, even the slower ones.
But really what matters is what you need, and what your body needs, so even though injections provide the most amount and the most even supply when you use them, especially bi-weekly as well, it might be different for you as every single trans guy/transmasculine person is different, physically & mentally!
And some things work better for others, so consult with your doctor, and let them know the effects and the timing you want, and they will suggest options for you if you are not able to choose yourself without assistance due to lack of knowledge etc.
I would however recommend deeply researching every section of testosterone as I did, before going to an endocrinologist, so you are very prepared and know which kind you want already which will make the appointment take less time as well.
Also you never want to rely on the information of just one person, so always research.
Don't just trust my guide immediately or anyone's guide if it's just one you read, instead do your own research on many sites & forums, and find what works for you, as I can only say what works/worked for me.
4. And when it actually comes to the fun part, the injections,
I will give you a step-by-step guide on mostly how to have someone else inject you, but you can also take my advice for injecting yourself, however I have no advice for specifics of that, such as ways to calm yourself down from queasiness when doing it yourself, since I have never injected myself due to me honestly being just a little squeamish about doing it myself.
But I've always had my mother do it, and I have watched occasionally to see how best to do it, and have experienced it quite a few times now, so I know which way is the least painful as well.
If I were ever forced to do it myself, that way I would be able to because I know how to beforehand.
Now what you do is when you pick up your prescription of Testosterone, this is assuming if you take it bi-weekly and an injection form, you get two 1 ml bottles (A month's supply) and you have to unfortunately ask for & buy the syringe that comes preloaded with the needles.
Also make sure never to ask for just a needle, cuz they will literally give you just a needle, and no syringe.
It's happened to me before, LOL.
They usually have the syringes & needles in stock almost always, but there are a few occasions where they didn't have the needles.
But it is honestly annoying having to pay for something extra when the testosterone itself doesn't cost anything, yet the injection needles you need to use it do??? Lmao.
However it's not that annoying, because they're actually relatively cheap!
Here in Nevada, with no discounts used, they usually only cost you about like $3 usually, $4 at most, so it's pretty price effective.
5. I strongly recommend this, it was my mom's edition to this by the way, she strongly recommends as well,
that you should wait at least a month before taking your first dose of T.
Even when you just received it!
The reason for this is because sometimes they will be out of testosterone or out of needles, or you won't be able to afford it for whatever reason, you never know and it's so much better to have at least 1 if not 2 backup doses and syringes + needles on hand so you never have to worry about that.
I was impatient and injected the day I got it, and so though I haven't run into a problem yet, it is stressful knowing that if a mistake happens with the injection and the fluid leaks out too much, or something happens, whatever it is, that I won't have a backup dose.
So, I would highly recommend waiting a month or even two before injecting, so you have two doses and you pick it up way before you run out every time.
That's way more efficient.
6. Now although this comes from the point of view of someone who hasn't injected themselves, and only has been injected, I pretty much know how it works so I could if I had to, I would just be squeamish.
And for a lot of people they feel the same, so it's easier to get a family member or a close friend to do it for you, as long as they're always around when you need to take your dose.
Personally I have my mom do it because she's talented at injections due to having reptiles that needed some done the same way.
So, basically, you take everything out of its containers, and make sure not to touch the needle itself ever.
Once everything's out of its containers, then make sure to test if the needle is totally closed onto the syringe.
If it is, it's good to go.
Checking the tightness of the needle is very important because if you don't, you can end up having the needle pop off inside you, and release none of the testosterone actually inside of you, wasting a dose completely & it just hurts like a SOB.
Now, take the cap off the needle.
I would recommend always sanitizing the needle, the syringe, and also having a little gauze pad or paper towel piece, all soaked with rubbing alcohol to sterilize the area you will be injecting, so there is no risk of infection at all.
Although not extremely important, I'd recommend you'd also want to bring a tiny Band-Aid.
It will be a very very tiny wound, more like a dot, but it actually bleeds quite a bit after, due to it going deep in, so it's helpful to put a Band-Aid on just for the first hour or so, then take it off and let it breathe, and it heals super quick. It'll be gone before, or by the next day, usually.
Please remember not to touch the needle ever as it'd ruin its sterilization. They're usually sterilized, but it might be a good idea to sterilize them again just in case, to basically make sure there is no risk of infection whatsoever.
Also this is just a common sense cleanliness rule,
but I still want to state it to make sure people know;
Always throw away every single needle and syringe you use, as soon as you are done using it.
Do not keep it or EVER re-inject with the same needle.
And also be sure to throw away any testosterone you have left that is excess from your dose.
You do not need that, as it goes bad and won't work after being exposed to air, so it's impossible to save and use later, unfortunately.
Now, you will be injecting intramuscularly in the leg, either leg will do, hell you can switch them up each time if you'd like. It doesn't matter much.
This means you will be injecting on the area of your thigh that is a little high up, and towards the top, but a little to the outer side.
This means the testosterone is injected straight between the muscles, and goes to the bloodstream quickly also, when you inject.
Now you want to remove the lid from the Testosterone Cypionate bottle, and shake It up very very good, so that there are no bubbles, no particles visible in the Testosterone, and no oil separation either.
If it looks completely clear, or is a slight yellowish colour but mixed together well, then you're good to go.
The possible slight yellowish color comes from the cottonseed oil that they use to store the testosterone correctly in.
It makes it to where you have to use a little bit of a bigger needle to inject yourself with, but it's actually a very very small needle and it's not painful very much at all.
A lot of myths I read about testosterone before I received it said the needles were huge and scary and painful, but the truth is they're not at all, even to me who's slightly scared of needles and has low ability to tolerate pain.
Literally, popping a zit hurts worse than the injections.
The pain is something like a very tiny ant bite, or a slight pinch on your skin, it doesn't really hurt very much at all.
In fact, whenever I take mine, even the very first time I did, I didn't even make a sound! And it's over very quickly, as well.
I would recommend for the easiest time however, for a little higher price, getting a 21 gauge syringe needle, and also an 18 gauge syringe needle for each dose you take.
The 21 gauge is larger for drawing up the testosterone from the vial easier than the 18 gauge would.
Then you remove that 21g needle from that syringe, and instead put on the 18 gauge for the actual injecting.
If you want a cheaper price tag, and/or you're just lazy like me, you can get away with using just an 18 gauge needled syringe, however it makes it much significantly harder to draw up out of the vial.
It is still quite possible, but is for sure challenging, mistakes can occur so be very careful if you choose this route.
Now when you're trying to draw up the Testosterone Cypionate out of the bottle, you want to hold it upside down, or downward at an angle kind of diagonal, and you want to make sure the needle is visibly in the liquid.
Then, you draw back slowly, but try and fill it as much as you can. You can always dispose of extra that you don't need.
If using only the 18 gauge like said earlier, which is what I personally do, it is very hard to draw up out of the bottle, so be very careful, and try to figure out the trick to it, is all I can say.
Everyone has a different trick for it.
Don't use all the testosterone in the bottle however for your actual being-injected-dose.
You need to usually use only 75 mL of the 1 ml bottle each dose.
Also before you ever inject, but after you fill the syringe, make sure to aspirate the needle, which means to act like you're injecting it, in the air pointing up, needle upwards, and you very slowly push down, which expels a little bit of the testosterone, but you also expel any air particles or bubbles that are trapped inside.
This is why you want to put a little more in the syringe than you actually will inject, because when you aspirate the needle some will leak out and make it the perfect amount to inject, rather than losing it an amount of it that you need.
If there is even a single bubble inside the syringe, that can cause a heart attack, and many other deadly problems!!!
So do not ever inject, if there is a bubble in your syringe.
If there is, best case scenario is you try to aspirate it heavily, even if you need to then refill it somewhat afterwards, the most important part is making sure no air bubbles are in it.
If there is no way to get the bubble out, you'd need to buy a new syringe, as it most likely has a deformation of some kind.
But that's the worst case scenario, and personally I haven't experienced that yet.
That, however, is why it is so important to aspirate, to make sure there's no air left in the syringe before you inject.
Now you want to make sure to get exactly .75 ml, that you put it up to the line right before 1 ml and that's about the amount you need.
And remember; never take more than prescribed, it will have the opposite affects you want.
Now that you know all the details, here is how to perform injecting the actual testosterone.
You take the needle to the sterilized area of thigh that you cleaned with the rubbing alcohol.
And you can either use a kind of sideways diagonal position to go in, or you can use straight on.
I find straight on makes it much less painful for me, so I usually go with that, but either way works, and whatever is most comfortable for you is what you should use.
Now you just go in kind of slowly, and try not to move the needle around too much, just push slowly all the way in 'till the needle is completely in the leg.
Then dispense slowly the testosterone to the intramuscular area, and once all the testosterone is out of the syringe and inside your bloodstream, pull it out very slowly, all the while holding the skin around it firmly, so that it doesn't hurt as much pulling it out. If you pull it out fast it fuckin' hurts.
You can also sterilize the area of injection again, if you want, but it's not really necessary.
Then, you just put that Band-Aid previously mentioned on, for like an hour, and you're good!
7. Now for the effects of testosterone, though I don't have a perfect timeline. But around one DAY in, I noticed for some reason my clitoral growth where your clitoris pretty much changes into a tiny penis except the urethra doesn't move unfortunately without surgery.
It can grow one to two inches at max, although I have not experienced that much yet.
However for some reason I had definitely experienced minor clitoral growth pretty much as soon as I took my first shot of testosterone, which is incredibly rare, as it's supposed to happen six months to a year in and be one of the later effects!! But for some reason, it was the first effect I got, so that really goes to show that everyone is built quite different, so some things in this guide might not be totally accurate for everyone.
1 week in, I started experiencing a very hoarse voice, not a sore throat or anything, but just where your voice sounds like you're sick or you're losing your voice, for some reason.
This is the first step in your voice changing to a deeper baritone.
It's usually not painful whatsoever, but I have heard from some people that it can irritate their throat occasionally due to the foreign feeling of it, this stage doesn't last very long though.
Then, about 1 month in, I started noticing extensive hair growth. Also I seem to have got way darker hair than any of my family members ever had, and way more hair than they ever had, so you can't totally rely on the predictions of what your family looks like to see how you're going to change.
You kind of have to be ready for anything to happen, but usually the hair growth and the masculinity of your family will almost always pass on to you when you transition physically.
This can even include male pattern baldness eventually.
Sometimes it happens to trans men immediately after taking it, other times it will take years and other times it will be when they're elderly like cis men have.
Personally, I have not seen any male pattern baldness yet, however my front l of my hair slightly receded back and in the shape of male members of my dad's side of my family, but nothing like a total receding hairline.
It still looks like a full head of hair!
Usually you can tell what type of hair you get by looking at your family members closely.
If your family includes a lot of thick hairy people naturally, then you are going to usually get very large amounts of hair.
If you have a family with barely any hair, or very light coloured hair, you'll usually get a small amount of hair or a large amount of hair but with light colour. Personally, I got real lucky so it's clear that there are exceptions, but that's usually how it goes is that you can look to your family members as to how you're going to look and sound like.
About 3 months in, my voice started really deepening and I mean really deep. But the funny thing about it is that sometimes it will switch from being really low and masculine and amazing, to being kind of regular like before, to a little low but not super low, and even to what I call the "permanent helium" which makes you literally sound like you inhaled helium but it's literally just your vocal cords cracking that bad from growing to a male length.
Sometimes it will crack in a way where you can't stop talking in that high pitch, and it's really awkward, but it is also really funny if you learn to laugh at yourself, and always remind yourself that this is the process of gaining a deeper voice.
I have heard that vocal training to make your voice deeper also helps exponentially for more effects if you want a super deep voice.
About 4 to 5 months in, which is where I'm currently at, I've experienced way more hair growth!
Even more so than the start of it.
My head hair seems to be thicker and healthier for some reason, I'm not sure why because I have never heard of that affecting your head hair, its texture, or its thickness like that?
But it seems to have happened, so I guess it's possible?
I'm gaining a moustache and a few beard hairs, but mainly my moustache is super dark and already very visible.
Also due to my moustache and my deep voice alone, now I can already pass pretty much 100% of the time if maybe 99%, and I'm a very naturally baby-faced person too, so that's impressive!
My voice is mainly settled into a pretty deep baritone.
It still has a little bit of a high pitch sometimes, but barely.
I can tell there's a little more progress needed, but not much.
I don't do the helium thing as much as I used to, but it does still occasionally occur as lengthening your vocal cords, which is what occurs when you take testosterone, can be a lengthy and frustrating process at times.
I have also specifically seen lots of body hair at this time, way more than the sparse amount at first, including even a happy trail and a little bit of chest hair although it's not noticeable yet unless you squint, but it still has way more than I used to!
Also my hair on my arms, and especially on my legs, is thick, dark and everywhere.
I've also noticed my fat is starting tk begin redistributing a little bit.
It's not totally doing it yet, but it's getting close, as my thighs, hips, and behind area lost a bunch of weight, while my stomach gained a little bit of weight and so did my arms.
I also gained a fair bit of muscle as not only can I see it when I flex, but also I can lift things a little easier than I used to, and muscle seems to develop easier for me, even when I work out barely.
I've never been a very physical person, so it's still hard, but it's way easier now that I take testosterone.
Those are all the effects I have to record right now, as I'm only 4-5 months in, but I will update this with new parts as I experience more and more.
Also, please take all effects and timelines with a grain of salt, because everybody works differently.
Also I specifically was mentioning Testosterone Cypionate, bi-weekly injection form, so if you take testosterone in a different way, some of this might be different, irrelevant or even completely useless to you, but I am only able to provide information on these forms as they're the only form I've taken of it myself.
Now, to quickly dispel a few stupid myths that circulate around taking testosterone, to ease your worries.
Myth #1. "Testosterone makes you aggressive, violent, and a bad person!"
The truth is that testosterone does not change who you are, whatsoever.
It can however change certain little preferences like for example what flavor food you like will sometimes change, but usually not all foods, just a couple, or sometimes even just one.
It can change little tiny details, like maybe your favorite colour may change, and it definitely does have its emotional effects for sure, but it does not make anyone aggressive or violent automatically.
Testosterone is not an angry hormone, and estrogen is not a peaceful hormone, despite what most people stereotype them as being, so just blanketing everyone under the term of "aggressive" because they have testosterone in them is straight-up incorrect at best, and also sexist at worst.
Estrogen is not better than testosterone. Testosterone is not better than estrogen. It just matters what you want in your body.
What it may actually do is sometimes, people will experience a wide variety of emotions, including extreme euphoria and confidence (that's the effect I seem to have had, thankfully!)
Other people however will get very emotional and sad and will cry over things easier, and no, that's not an estrogen trait, testosterone can do that too.
And sometimes, on a rare occasion, people can get more irritable or cranky. But they're never violent.
They just get a little grumpier than usual.
However, all these emotional effects eventually do phase out and stabilize, and you'll be back to all your regular moods.
You never truly change who you are as an individual, and your beliefs and morals will stay the same.
It's not like you will completely change into a different person, you will never have to fear that, nor should any of your family and friends.
Myth #2. "Testosterone is steroids, right? So doesn't that mean that you're stronger than everyone else?"
This is a ridiculous notion, and I'm not even sure how it got spread im the first place, but I've heard it firsthand, and it's really as stupid as it sounds.
Testosterone is not steroids, they may have some similar properties due to chemical makeup, but they are not in any way steroids.
Steroids are an addictive & potentially harmful drug. Testosterone is a naturally occuring hormone that we all have some of.
For instance, testosterone also does not make you any more muscular just automatically.
It can make you a little more muscled subtly due to the muscle structure changing to that of a cis man's, but it can't straight up make you jacked, that's just not possible.
Also it does not make you any stronger than anyone else.
It might make you a little stronger than a cis female, but you are not stronger than a cis man, in fact you're weaker, due to starting out assigned female at birth.
I'm not sure why people assume that if you take testosterone, that means you're strong??
Because you're taking testosterone because you don't have any so clearly you don't have very much.
I'm not totally sure where this silly notion got spread, possibly as a way to make trans people feel guilty for taking T, by making them think it's a drug, and it's just not when you look at the facts.
It's good to dissuade folks who think this way, from this notion, as it can also make us look like drug addicts or on steroid pills, which both are just completely false.
Testosterone is not even addictive.
It's a natural hormone inside your body.
Myth #3. "Testosterone will give you all forms of cancer, and strokes and heart attacks, almost certainly!"
I'm not sure where or how this got spread either, it is true that it is possible, they said, in a scientific study, that they can't confirm completely that it could theoretically make your chances of stroke and heart attack a little higher due to your system basically changing to that of a cis man's, and going through a cis man's puberty.
But honestly, you have less risk of strokes and heart attacks than even cis men do, and you don't have a prostate which is a common location for men to get cancer, so you actually have an advantage over most!
It's very rare that you would ever come into contact with one of these things happening, pretty much as rare if a little less as it would be if you didn't take T at all.
There is also no evidence whatsoever that testosterone causes cancer, of any kind, let alone all of them.
A lot of people have tried to spread this rumour, to stop people from getting HRT treatment, which is really cruel and fucked up, and a lot of parents will use the "cancer" excuse as a way to not give their child HRT.
The truth is that it does not cause cancer, and that is a complete myth.
There's actually some evidence that being on T might improve your chances of fighting cancer, and having a stronger immune system for it as well.
Myth #4. This kind of goes along with the other one, but some people believe that "If you take testosterone, you could be shortening your lifespan by many years!!"
This is complete speculation, nothing has been confirmed.
It's possible, perhaps, that it could shorten your lifespan by a couple years, but not many.
You still would have an advantage over cis men again.
But it's never been truly proved that your lifespan gets shorter from T, so there is no reason to fear less of your life occuring just because you're trying to make yourself happier.
All right, I think that's all the rumours I can set straight, and all the info & advice about injections and medicine and general information about testosterone that I can give you at the moment.
I will update this post later, so please check back again in maybe a few month's time from now, as then I will have more effects to discuss.
But if I want to leave you with anything to think about,
remember that testosterone is a completely safe and natural chemical hormone that produces itself in your body already.
You just don't have enough of it to look the masculine way you want to.
It is not dangerous, it won't hurt you and if you really want it, go after it!!
But I would also very much advise you to be sure you want to go ahead with it, and that you are okay with all effects happening.
Because if you aren't, if you are even the least bit hesitant, not only will the doctor not allow you to proceed because you are not mentally fit to yet,
but also if you did end up taking testosterone then you could end up getting effects that you don't want, and having them be permanent, and causing you dysphoria for the rest of your life.
So please, make sure to know yourself well, and know your wants and needs clearly.
I also highly recommend having a psychiatrist or a mental health therapist for quite a while before going into testosterone therapy.
Not only does it make you more qualified to acquire testosterone because it shows you actually thought it through, but also it is exceedingly helpful for the mental and physical changes you will be proceeding with over these next years.
The last thing I want to say, my closing note, is congratulations on your testosterone, if you received it!
And I hope my guide helped in any way, and apologies if it ended up really long this time, there's a lot of things you need to know about T.
Thank you for reading, and I hope this humble trans guy's journal entries help you at all.
- Atom T. L. Yorke
