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SAFETY 101
- ALWAYS wash your hands!
- Needles are SINGLE USE only!
- The syringe and the needle should only touch once, when they are being connected
- Once uncapped, the needle should never touch anything besides the vial enterance
- After injecting, keep the needle cap on the surface as you slip the needle back into the cap, so that you do not have to hold the cap and risk poking yourself. Then snap the cap into place.
- Needles should be disposed of in a sharps container or a clear container made of thick plastic. LABEL YOUR CONTAINER.
INTRAMUSCULAR (IM)
- 22-25 guage needle
- 1-1.5 inches in length
- 90 degree angle to inject
- injection sites: 3 fingers below shoulder bone, outer side of your leg in the middle of your thigh, or buttocks
- PROS: quicker absorption, safer for higher doses
- CONS: can be more intimidating
SUBCUTANEOUS (SUB-Q)
- 25-27 gauge needle, ⅝ to ½ in
- injection sites: tummy (2in below belly button), top of thighs, back of your arm
- 45 to 90 degree angle to inject
- PROS: smaller needle size, can be less intimidating
- CONS: must be done weekly
STEP BY STEP GUIDE
- Wash hands. Collect supplies on a flat, clean surface: new needles & syringe, 2 alcohol wipes, sharps container, band-aid, HRT!
- Alternate injection site from last injection. Inspect the site for bruising or swelling. Clean area with alcohol wipe. Clean top of medication bottle with the second alcohol wipe.
- Attach the drawing needle to the syringe and remove cap, placing the cap on the surface. Flip the vial upside down and insert the needle, drawing up the medication to the dosage
- You can pull the syringe down to create an air pocket between the needle and the syringe, so no HRT is left in the drawing needle.
- Remove the needle from the vial and slip it back into the cap. Snap the cap into place and twist off the drawing needle. Replace with the injecting needle. Remove the cap and set it on the surface.
- Push the syringe up until a bead of HRT comes out of the needle. Flick the top of the syringe to get out any small bubbles.
- Inject the needle with your dominant hand at the angle needed for your injection type. If you can, inject it quickly and with force, it will hurt less! Push the plunger down completely to inject the full dose; testosterone is thicker so will require a harder push.
- Remove the needle quickly. Replace the cap on the needle.
- Use a band-aid and apply pressure if needed.
- Dispose of needles and syringe in sharps container.
SELF-CARE AND AFTERCARE
- BE KIND TO YOURSELF!!!!!!!!
- injections can be hard, and your capacity to safely self administer may change over time
- find space that feels safe and comfortable
- music and sensory (buzzing, heat or cold) can be used as a distraction – the smell of an alcohol wipe helps with pain!
- having a buddy can help, as well as a treat to look forward to!
RESOURCES
- Injection guide with images: https://fenwayhealth.org/wp-content/uploads/2025/06/Hormone-Injection-Guide-V2024-FINAL_WEB.pdf
- Tips to make injections easier/less painful: https://queerdoc.com/tips-for-less-painful-injections/