So where does the needle go?

[Toddin3D]

My mom and I got into another argument again. I think she's starting to be a little more condescending with her attitude about me being transgender. But regardless, we were talking about hormones and she was trying to convincing me to get top surgery only because she thinks she knows about HRT thanks to watching television.

She mentioned that she saw a transgender person injecting hormones through their leg (she didn't even know if they were a transman or transwoman, or what the hormones were so I have no idea if this applies to me).

So, that got me thinking: Where does the needle go when you're on T?

I'm curious because needles are always painful for me no matter how small they are, and yet Androgel is so expensive according to my mother (she works in Kaiser's pharmacy and said that it was in the hundreds without insurance coverage - and our insurance doesn't cover it...yay). So I'm trying my best to weigh my options here while also trying to figure out which available jobs in my area has transgender healthcare coverage.

[CursedFireDean]

Your mom is right about androgel. For the average dose it's roughly $450-500 per month without insurance.
As for the needles, if you inject intramuscularly then the big muscle in the thigh or the butt are the two most common locations so your mom is partially correct. Injecting subcutaneously (into fat), the locations I know of are the belly, the inner thigh, and the side of the butt on the fatty part. There's really lots of places that people can inject their hormones. Testosterone is, according to the manufacturers, an IM only injection, however plenty of people inject subq with no issue and the manufacturers haven't changed that notice on the side of the box. Since your mom works in a pharmacy she may push for intramuscular because of this- I've had several pharmacists try to give me bigger needles than I was prescribed.

I personally also have an issue with needles so I inject subcutaneously to minimize pain and reduce the risk of me fainting. The needle size affects that and subcutaneous allows you to use much shorter needles.

[FTMax]

Your mom is right about the expense of gels/creams. They are exceedingly expensive unless you have insurance coverage. And personal opinion, having been on both gel and injections, the only convenience to gel is not having to stick a needle in yourself. Daily application is nice for getting into a routine, but quickly gets to be a hassle.

As far as where the needle goes, it depends what kind of injections you're doing and what your doctor tells you to do. For subcutaneous injections, it's going to a layer of fat. I've heard of people doing this into the stomach and butt. Dean also listed the inner thigh.

I do intramuscular (IM) injections. You can do these into the outer thigh or butt. My doctor doesn't like people injecting in the butt, apparently there's a nerve that is prone to getting hit.

I had a fear of needles prior to starting. It definitely felt like it hurt a lot more because I was tense about it. Now that I've been doing it once a week for the better part of a year, I have no pain whatsoever. There's a slight little pinch where it initially breaks the skin, but it's not painful.

[Tossu-sama]

My doctor doesn't like people injecting in the butt, apparently there's a nerve that is prone to getting hit.

AFAIK it's the sciatic nerve that runs there, unfortunately close to the injection site. I get my shots done to my butt by my fiancée and last time she hit a nerve while injecting. Although I think it wasn't the sciatic nerve since it wasn't THAT bad, just a really sharp pain that lasted for a short while. I've had my sciatic nerve jammed due to work before so I'd expect it to hurt much more if it was hit with a needle.

I started T with gel and while it was nice at first to apply it daily it became a hassle like ftmax said, and an inconvience considering it should be applied around the same time everyday. Try to do that with a messed up sleeping schedule...

While I'm not fond of needles I prefer having my T as shots especially now that I gotta get my shot done every 12 weeks.

[Toddin3D]

I had an IM before in the upper arm. I wouldn't call it so much of a fear, but I definitely don't want to experience that level of pain again. I always have people use small needles too but they always bug me even when I relax.

How often do you get an IM for testosterone?  Once in 3 months or does it depend on the person?

[veniamviam]

How often do you get an IM for testosterone?  Once in 3 months or does it depend on the person?

AFAIK, it's kinda rare to get it every three months. I think that's for guys who are on Nebido, which isn't available in the US. Here, most people are either every other week or every week.

My shots are always in the thigh. My doc doesn't like doing shots in the glutes, 'cause of the bacteria that lives around there apparently (I think that's bollocks, since you clean the injection site first anyway, but whatever. I prefer the thigh anyway). IMs can go in any large muscle group--if you self-inject, thighs are the easiest. So long as I'm using a different needle to inject with than I am to draw with, there's no pain or next-to-no pain. You get used to it. As for price, she's right. Gel is considerably more expensive. One vial of T for me is ~60$ and will last me a few months, whereas the same price in gel might last a few days, maybe a week.

Really, what it boils down to, is what's being on T worth to you? Get on injections sooner and do a shot, or wait potentially indefinitely until you have trans-inclusive health care and can get on gel. It's kind of a rough choice, unfortunately, but you have to do what's right for you. Hope things work out!

[FTMax]

I had an IM before in the upper arm. I wouldn't call it so much of a fear, but I definitely don't want to experience that level of pain again. I always have people use small needles too but they always bug me even when I relax.

How often do you get an IM for testosterone?  Once in 3 months or does it depend on the person?

It depends on the kind of testosterone used. In Europe (possibly Australia as well, I'm not sure), there are types of T that are essentially prolonged release and are good for 3 months. Nebido is one, I believe Sustanon is the other. They are not available in the United States AFAIK.

From what I have seen, generally it is a weekly or biweekly injection. I do mine weekly. Some people's doctors put them on a shorter or longer cycle (# of days between shots) depending on what effects the T is having. It comes down to your chemistry and what your doctor thinks is best given the effects (or lack of effects) that you're seeing on T.

You can also look into having the doctor do your shot for you. I know a guy who goes in biweekly and has a nurse do his shot. I'm all about convenience, so I'd rather do it myself. But if you think that would be an issue for you, it's something else to consider.

[FTMax]

Also wanted to add: these are great questions for a pharmacist in your area. Prices are going to vary by type, brand, and where you're located. They'd be able to tell you what options are actually available and give you a rough idea as to the cost. It does fluctuate a bit. I pay around $70 every three months for my T and syringes. What I get ends up lasting closer to 5 months.

[Tossu-sama]

European (Finland) chiming in: we have Nebido and Sustanon as injectable T (Testogel and Tostran as gel) and I've been on both. Sustanon was every 17-21 days and Nebido is every 10-12 weeks (some might need even shorter interval, some are fine with longer than 12 weeks).

I actually had Sustanon injected to my shoulder couple times and it was horrible. My arm was basically useless for two or three days afterwards. Thigh was almost as bad. Then I had to switch nurses and the new one told he would never give an IM injection to shoulder and he preferred not to do it in the thigh muscle either.