How to Inject Hormones

Here are two new pamphlets designed as guides to giving yourself intramuscular and subcutaneous hormone injections.

The link below is an external resource designed to help gender diverse individuals and their care providers with hormone injections.

Please note that the dorsogluteal site (ie: the buttocks) is no longer recommended for intermuscular (IM) injections because of the chance of the needle affecting the sciatic nerve. Instead, many people self-inject into subcutaneous (fat) tissue - it is easier, safer and equally effective. We encourage individuals to speak to their care provider about the injection routes and sites that are best suited for them. If you need help connecting with a knowledgeable care provider, please contact our Care Coordination team at  1-866-999-1514. 

Injection Supplies

Injection supplies can be accessed for free through many harm reduction sites across BC. To search for the nearest harm reduction site, go to and follow the instructions below:

  1. Search "drug use supplies" for sites that provide safer injection equipment near you.
  2. Then call in advance to ensure they have what is needed. Ask about the follow supplies according to the type of injection you do:

Intermuscular (IM) injections

  • Alcohol swabs
  • 18 gauge needles (to draw up the medication)
  • Syringe (ideally 1cc or 3cc)
  • 22 or 23 gauge needles (to inject), approximately 1 or 1.5 inches long
  • Sharps container
  • Little bandages (if needed)

Sub-cutaneous (Sub-Q) injections

  • Alcohol swabs
  • 18 gauge needles (to draw up the medication)
  • Syringe (ideally 1cc or 3cc)
  • 25, 26 or 27 gauge needles (to inject), approximately 0.5 or 5/8 inches long
  • Sharps container
  • Little bandages (if needed)

Navigating hormone shortages

Manufacturer supply shortages can sometimes result in difficulty obtaining your usual medications. This unfortunately seems to occur fairly often with injectable testosterone, and can lead to anxiety, frustration and inconvenience.

If you are concerned about a shortage and running low on your prescription, here are things you can try:

  • Check with your usual pharmacy to see if they have your prescription in stock or if they are able to locate it at another site.
  • Call different local pharmacies to ask about availability of your prescription. It may be especially helpful to try smaller pharmacies (as opposed to large chain pharmacies).

  • Consider a temporary switch to another form of your medication (if possible). If you are unable to find your usual medication, your pharmacist may be able to contact your prescriber to approve a temporary change
    • Note: Different types of injectable testosterone have different concentrations, so you will need to change the amount that you inject to get the same dose (testosterone enanthate is more concentrated than testosterone cypionate).
    • For example, if your usual medication is testosterone cypionate and your dose is 60 mg weekly, you would inject 0.6 ml of medication. If you switch to testosterone enanthate, you only need 0.3 ml to get the same dose.
    • Speak to your doctor, nurse practitioner or pharmacist if you are unsure how much to inject.

  • Contact your healthcare provider to discuss the situation. They may be able to prescribe a different form of your medication until your usual medication is available. If there is a shortage of both types of injectable testosterone you may need to use a gel or patch until your medication is available.
    • Note: Different medication forms may be more expensive than your usual medication. For example, topical forms of tesosterone are significantly more expensive than injectable testosterone. Your doctor or nurse practitioner can apply for Special Authority coverage for topical testosterone and state that injectable forms of testosterone are currently unavailable.
    • You must apply to Fair PharmaCare (if you have not already) in order to do this
    • Information on how to apply for Fair PharmaCare can be found here
  • If your provider is unsure about how to help or has questions about the process, they can call the RACE Line and speak to an expert in transgender health: 604-696-2131 or 1-877-696-2131

  • For a list of virtual peer supports and counseling resources, contact Trans Care BC's Care Coordination Team: or 1-866-999-1514

SOURCE: How to Inject Hormones ( )
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