Transmasculine DIY HRT Guide

Last Updated September 2023

──────────────────────────

What is Testosterone?

Testosterone (T) is an anabolic steroid and sex hormone found in those assigned male at birth.

Since we were not assigned male at birth, we only produce a small amount in our bodies naturally, and produce estrogens instead.

What does it do?

Testosterone induces both androgenic and anabolic effects.

Androgenic effects are the masculinizing changes that come with taking testosterone, which includes clitoral enlargement (bottom growth), voice deepening, cessation of menstruation (stopping periods), increased definition of facial features and a more masculine fat distribution, facial and body hair growth, increased libido, acne, etc.

You can think of anabolic effects as changes to your body’s metabolism, protein building and how it uses energy. Anabolic effects include increased muscle mass and strength, increased bone density, increased appetite, etc.

The androgenic and anabolic effects of testosterone are about equal. You won’t necessarily have high levels of strength nor gain significant muscle mass, especially if you don’t exercise regularly. Your mileage may vary.

What kind of methods can I get T in?

There are multiple ways, each with their drawbacks, pros, and levels of ease in terms of obtaining them.

Injections

By far the most popular and well known method, injections are by far the easiest to come by if you choose to DIY.

There are certain esters testosterone is commonly compounded in. Testosterone is esterified in order to last longer in your body. Raw testosterone injected into your tissues will dissipate very quickly, which is why testosterone injections all come in ester form.

Testosterone propionate, cypionate and enanthate are the most commonly prescribed and used testosterone esters.

We will only focus on cypionate and enanthate due to their long half lives (amount of time it lasts in your body). Testosterone cypionate and testosterone enanthate both have very similar strength and half lives.

Cypionate’s half life is about 8 days when injected.
Enanthate’s half life is slightly shorter. Treat it similarly to cypionate. This means that for most people, it’s best to inject weekly for ideal hormone levels.

Gels

This is harder to find in concentrations required to suppress estrogen on the grey/black market. Also quite expensive if buying DIY. Usually not feasible for most who choose to DIY due to lack of sources and high cost. Fine for prescribed T. Currently only some UK sources offer gel, so DIY gel is not possible for most people.

These come in packets or in a pump.

Pellets

Not available from DIY sources (obviously), but are very effective if you can find a doctor that offers this form of testosterone.

These are experimental in terms of dosages compared to the other tried and true methods. You can get them surgically implanted if your insurance covers it (or you are very wealthy).

They let out a small dose of T each day and you don’t have to worry about missing a dose. They last about 3-6 months.

Sourcing/Dosing:

Ideally, you would be on T through legal means. However, you may not have the privilege, so this guide may be of use for you.

Regardless, if you are willing to attempt DIY, it is a preferable option to not being on T for many.

Prescribed T:

You have to be 18+ to access informed consent services.

Informed consent ensures you understand all the information about a medical treatment and accept the risks involved.
Informed consent in the context of trans HRT means that the the effects of T (including risks and side effects) are explained to you by a medical professional. You can then agree or refuse starting T.
Under an informed consent model, an adult is able to start T very quickly (within days or weeks of the first appointment) after they agree to receiving T treatment.

See this short document for a full list for all current informed consent resources in the USA and worldwide: Informed Consent and Telehealth.

To save on prescribed T in the USA, try goodrx.com for free coupons to use at participating pharmacies. There are no strings attached to this service! Cost Plus Drugs is also a good source for affordable medications delivered to you by mail if you have a doctor’s prescription.

Beyond this point, this guide will focus exclusively on how to safely dose, source, and administer DIY T.

DIY:

If you don’t want to be on waitlists, have to prove your transness while allowing your body to feminize, or are unable to get T legally, then you may have to order it online. You may need to learn how to buy Bitcoin. (If you are unable to, get a trusted friend to purchase the Bitcoin for you, or go to your local BTC ATM.) Some sites also offer payment in methods such as Zelle, Bank Transfer, Western Union and MoneyGram. (Keep in mind that these methods are often subject to minimum order requirements, unlike Bitcoin.)

If you choose to order testosterone without a prescription, it will be illegal in most countries (although the risk of a domestic order being seized, let alone any person in possession of anabolic steroids for personal use being prosecuted, is unheard of). Testosterone is legal to possess without a prescription in places like the UK and Canada (sale of testosterone without a proper license is illegal, however).

Accurate Dosing:

Here is a table of typical doses of testosterone used in transmasculine hormone therapy:

I usually recommend people start on 50mg/week. You can either choose to slowly ramp up your dosage, or you can start at a high dose. There is no evidence that either method is clearly better than the other. I would not recommend you go over 100mg/week unless you have obvious signs of insufficient T levels after a year on that dosage (still having menstrual cycles, or a blood test showing inadequate levels).

Vials of testosterone are usually compounded at either 200mg/mL, 250mg/mL or 300mg/mL. This means that for a 200mg/mL vial, every 1mL of liquid will contain 200mg of testosterone. A 10mL vial will then contain a total of 2000mg of testosterone.

We will unfortunately be doing some math here.
The formula to calculate how much liquid to inject is: (amount you want to inject) ÷ (concentration of the vial) = amount to inject per dose in mL

Dosing Examples:

  • If you wanted to inject 20mg and you have a 200mg/mL vial,
    20 ÷ 200 = 0.1
    0.1mL per injection
  • If you wanted to inject 50mg, and you have a 200mg/mL vial,
    50 ÷ 200 = 0.25
    0.25mL per injection
  • If you wanted to inject 100mg and you have a 200mg/mL vial,
    100 ÷ 200 = 0.5
    0.5mL per injection
  • If you wanted to inject 50mg and you have a 250mg/mL vial,
    50 ÷ 250 = 0.2
    0.2mL per injection
  • If you wanted to inject 50mg and you have a 300mg/mL vial,
    50 ÷ 300 ≈ 0.17
    0.17mL per injection

Not too complicated now, hopefully!

How to perform a T injection

Needles can be bought from any pharmacy over the counter in most countries without a prescription (you may have to ask the pharmacist directly). Most countries also have online sites that sell appropriate injection needles. Amazon is a popular source for those in America.
Link to our page for injection supplies: Injection Supplies

There are two methods for a T injection, subcutaneous/subq (injection into the layer of fat under the skin), and intramuscular/IM (injection deep into the muscle underneath the skin and fat). Both methods result in identical absorption rates and levels of the drug, whether you prefer subq or IM is mostly personal preference.

Because of the presence of benzyl benzoate in most steroid site sourced vials, some people find subcutaneous injections to cause some minor post-injection pain.

Appropriate gauges (needle thickness) for a subcutaneous injection are 25-30g, for intramuscular, 23-25g. Subq needles are thinner than IM needles, which some people find less intimidating.

Recommended needle lengths are as follows:

  • 1”-1 ½” (IM, 1 inch is better for thinner people and 1 ½” for thicker people)
  • ½”-⅝” (Subq, up to personal preference.)

There are many online videos and guides for how to administer an intramuscular or subcutaneous injection, here are a few decent ones:

Guide by Plume:

https://members.getplume.co/support/solutions/articles/72000544742-all-about-injections#Injection-video-tutorials

Extremely detailed video guides on both IM and subq injections, with the downside that they are split into multiple long videos. Slightly less professional but shorter guide videos are below:

Subcutaneous:

https://www.youtube.com/watch?v=APSPbpqefKw

Intramuscular:

https://www.youtube.com/watch?v=W5GAyZzDpNU

Be sure to dispose of your needle tips inside of a hard plastic container or a sharps bin to prevent injury.
Note that around 0.1mL of fluid will be lost with each injection due to needle dead space.

Blood testing:

$50-$150 per test, depending on source

Regular blood testing every ~3 months or so is useful, but not absolutely mandatory¹, especially if not particularly affordable or feasible. Here are some sources of private blood testing² if you cannot access blood testing through the medical system:

(USA): https://www.privatemdlabs.com/
(USA): https://labsmd.com/
(USA): https://www.walkinlab.com/
(UK, Ireland): https://www.medichecks.com/
(UK): https://www.medichecks.com/products/ultimate-performance-blood-test
(Canada): https://bloodtestscanada.com/
(Sweden): https://werlabs.se/
(NL): https://www.bloedwaardentest.nl/
(NZ): https://www.pathlab.co.nz/patient-requested/

International sources for blood testing are unfortunately rare. You can try to find local private blood testing services or ask a doctor if they can provide you with the appropriate blood lab requisition forms.
Unfortunately, depending on your circumstances, you may be unable to find a way to get blood tests.

Get your estradiol (E2) and total testosterone (T) tested every time. Get your blood taken as close as possible to your next scheduled injection/dose (Test your blood as far away as possible from a previous dose, right before your next scheduled dose. Preferably the day of your shot, or the day before).
Your blood levels of estradiol and testosterone when taken at this time are called ‘trough levels’, because they are the levels of E2 and T that are present in your body at the lowest point in your HRT dosing regimen.

What should my total testosterone (T) reading be?
The Endocrine Society’s 2017 clinical guidelines for transgender HRT recommend that trans men maintain “testosterone levels in the physiologic normal male range”, a range which is typically given as 300–1000 ng/dL. Slightly higher or lower testosterone levels above or below this range are not something to worry about unless your estradiol levels are also too high.

What should my estradiol (E2) reading be?
The typical range for adult males is 10 – 50 pg/ml although this varies due to age and individual factors. Try to aim within this range, although slightly higher levels are not something to worry about. Try to keep your estradiol under 70pg/mL
Occasional testing of Complete Blood Count (CBC), Liver Function Tests (LFT)/Liver enzymes, Clotting factors test, and Lipid profile test (cholesterol, triglycerides) can be useful to monitor certain health risks associated with testosterone therapy.

 

Risks/Side effects

Warning that taking testosterone will likely cause infertility, possibly irreversibly.

For a full list of potential increased risks of certain health issues associated with transmasculine HRT, you can refer to this resource.
Most of the serious side effects are extremely low in absolute risk.
Polycythemia (high concentration of red blood cells in the blood) is a unique risk for transmascs taking any testosterone therapy. CBC (complete blood count) tests to monitor your hematocrit (red blood cell count) are recommended.

What should my CBC look like?
Polycythemia is defined as serum hematocrit (Hct) or hemoglobin (HgB) exceeding normal ranges expected for age and sex, typically Hct > 49% in healthy adult males. So there is no need to worry if you have Hct levels lower than that.

Aromatization
In all people, a small portion of the testosterone in their bodies is converted into estradiol (estrogen) through a process called aromatization. However, in healthy cisgender males, the testosterone levels typically remain within a range that does not cause a significant increase in estradiol levels, thereby mitigating any unwanted feminizing effects.
As a transmasculine person, it’s important to not take too much testosterone (please stay within recommended dosage guidelines) to prevent estradiol levels from getting too high (which can cause unwanted feminizing effects).
As long as you take reasonable dosages of testosterone and do not go over the recommended dosages, you are unlikely to deal with excessive aromatization.

Hormone therapy in general is very safe and effective as long as you take reasonable doses.

Sources:

CAUTION: If there is not a source listed, please check https://www.eroids.com/reviews/ before buying.

US Sourcing:

RoidBazaar US

(Accepts Bitcoin, Zelle, Bank Transfer, Western Union, Money Gram)

ALL Testosterone Enanthate –
https://us.roidbazaar.me/testosterone-enanthate/

ALL Testosterone Cypionate –
https://us.roidbazaar.me/testosterone-cypionate/

Canadian Sourcing:

Alpha North Labs

(Accepts Bitcoin, Takes Interac E-Transfer!)

Testosterone Enanthate –
https://alphanorthlabs.com/product/testosterone-enanthate/

Testosterone Cypionate –
https://alphanorthlabs.com/product/testosterone-cypionate/

UK Sourcing:

RoidBazaar UK

(Accepts Bitcoin, Zelle, Bank Transfer, Western Union, Money Gram)

Testosterone Enanthate –
https://roidbazaar.me/satan-pharma/testosterone-enanthate/

Testosterone Cypionate –
https://roidbazaar.me/satan-pharma/testosterone-cypionate/

https://roidbazaar.me/hemi/test-c/

https://roidbazaar.me/intex-pharma/tc-200/

Steroids UK

(Accepts credit/debit card)

Testosterone Enanthate –
http://anabolic-steroids.shop/injectable-steroids/enanthat-250

Testosterone Cypionate –
http://anabolic-steroids.shop/cypionat_250

Testosterone Gels –
http://anabolic-steroids.shop/gel

EU sourcing:

RoidBazaar EU

(Accepts Bitcoin, Zelle, Bank Transfer, Western Union, Money Gram)

Testosterone Enanthate –
https://eu.roidbazaar.me/human-labs/testo-e/

https://eu.roidbazaar.me/europe-domestic/testosterone-enanthate-250-1297/

Testosterone Cypionate –
https://eu.roidbazaar.me/human-labs/testo-c/

https://eu.roidbazaar.me/europe-domestic/testosterone-cypionate-250-1296/

Australia Sourcing:

Austarlabs

(Accepts Bitcoin only)

Testosterone Enanthate –
https://austarlabs.com/product/testosterone-enanthate-250mg-ml/

International Sourcing:

Almost all steroid sites will ship internationally, but there will always be an increased risk to ordering internationally for seizure of packages versus ordering domestically. Unfortunately, many countries lack international sources. Order at your own risk.

RoidBazaar Int

Has a good reputation in the roid community for successful international shipments. (Accepts Bitcoin, Zelle, Bank Transfer, Western Union, Money Gram)

Testosterone Enanthate –

https://roidbazaar.me/SCIROXX-Pharma/testodex-enanthate-250/

https://roidbazaar.me/7Lab/testolab-e-250/

Testosterone Cypionate –

https://roidbazaar.me/SCIROXX-Pharma/testodex-cypionate-250/

https://roidbazaar.me/7Lab/testolab-c-250/

Frequently Asked Questions:

Traveling with testosterone.

It is NOT recommended to travel with DIY-sourced testosterone, as airport security may check through all luggage. If your T vial shows up on a scanner, you may be charged with possession of a controlled substance.

The absolute risk isn’t very high, but it’s best to try and stay on the safe side.

If you MUST travel with DIY-sourced T, get a large clear Ziploc bag, have your T clearly labeled as testosterone, and throw in some aspirin and allergy meds inside with the T. Most likely airport security will not hound you for a prescription.

If you are arrested, do not say anything to the police (but don’t make things up and lie to them) and contact a lawyer as soon as an opportunity is provided to you.

Obviously, it is fine to travel with legitimately obtained, prescribed T. Just make sure you have the prescription with you.

Testosterone dosing after a hysterectomy.

Testosterone dosages do not usually need to be adjusted after a hysterectomy.

────────────────────────────────────────────────