Hormones are to be injected only into the thigh or buttock muscle. When injecting, be careful of nerves, veins, and bones. The buttock is the most common place people inject. You can switch buttock cheeks to avoid bruises and sores. After you inject into these muscles, you might be sore for a day or two.

Do not inject more than the prescribed amount: it will not speed up your treatment process. You can cause serious liver damage and increase the risk of blood clots. Blood clots can appear in the veins of the legs and can travel to the lungs. This is called pulmonary embolism, which can be fatal. People who smoke cigarettes and inject hormones are more likely to develop pulmonary embolism.

Most doctors recommend 1cc to be injected once a month and in some selected cases, twice a month. This will depend on the type of hormones and concentration. If you do not have a doctor, see one before your start hormone therapy treatments. Referrals can be made to doctors who specialize in providing health care to the transgender community.

Needles and syringes are to be used one time only. NEVER share your needles with anyone. If a new sterile syringe is not available the next time you inject, always clean it first. To clean your syringe, do the following: Rinse the syringe with water 3 times, bleach 3 times (keep bleach in syringe for at least 30 seconds and shake each time), and then rinse with water 3 times.

When injecting hormones follow these helpful steps to avoid HIV and other serious infections:

  1. Clean the top of the bottle with an alcohol prep pad.
  2. Fill the syringe with the amount of air equal to the amount of hormones you will be injecting. If you inject 1cc of hormones put in 1cc of air. This makes it easier to get hormones out of the bottle.
  3. Insert needle into the bottle, turn the bottle upside down, and push air into the bottle. To fill the syringe with hormones, pull the plunger down so the top of the plunger lines up with the 1cc mark on the side of the syringe.
  4. Pull needle out of bottle, tap syringe with your finger to make any air bubbles in the syringe rise to the top. Push out all the excess air with a little dribble of hormones to make sure there is not air in the needle.

Now your syringe is filled with hormones. Put the cap back on the needle while you choose and prepare the injection site.

If you inject into your thigh, do it in the front area, between your hip and the knee.

If you inject into the butt, divide your butt into four sections. Across the center of your butt side to side, and up and down each cheek. Inject into the top right or left outer portion section of your butt.

After your pick an injection site, clean the area with an alcohol prep pad. Put the needle straight in, not at an angle or sideways The needle should always be held straight at a 90 degree angle.

Once the needle is inside you, draw back a little bit to make sure no blood enters the syringe. If there is no blood, inject hormones. If you see blood, it means you hit a blood vessel. You can pull the needle out slightly and test again. If no blood returns, inject or choose another site and start again.

Bring back all used syringes to Positive Health Project [or your local health facility] to exchange for new ones.


The information in this article has been written in collaboration by Positive Health Project and Edward S. Cheslow MD, and reprinted by permission of a representative of Positive Health Project. Positive Health Project does not encourage the use of prescription medications without a prescription. Hormones are prescribed and are intended to be used as a treatment therapy supervised by a doctor. Consult a doctor before taking any medications.

Positive Health Project is located at 301 West 37th St., 2nd Floor, New York, NY 10018, or can be reached by phone at (212) 465-8304 or by fax at (212) 465-8306.