Gender Affirming Hormone Therapy (GAHT), is a treatment that provides transpeople with the gender affirming hormones they need. GAHT is lifesaving treatment all trans folks deserve, but don’t always have access to, for many reasons including medical gatekeeping and transphobia.

In general, there are two different types of hormones: bioidentical and synthetic. Bioidentical hormones are naturally produced by bodies and pose less risk than synthetic hormones.

GAHT Injection Tips

There are two different injection methods for GAHT, they are intramuscular (IM) and subcutaneous (sub-q) injections.

IM

• IM injection requires a needle that is 21-23 gauge and 1-1.5 inches in length.
• Injection should be done at a 90 degree angle.
• The best injection site for IM is in the top of the thigh.
• The inner buttock is no longer a recommended because of the risk of hitting the sciatic nerve.

Sub-Q

• Sub-q injection delivers hormones into the fat underneath the skin, which requires a needle that is 23-25 Gauge and ⅝ inches.
• Inject at a 45 degree angle.
• Before injecting you will need to draw up your hormones with an 18g needle.
• Common areas for sub-q injections are the side of thighs and abdomen.
• Avoid the belly button or bony areas.
• Pinch about 1 inch fold of skin to inject into.

Harm Reduction Tips for GAHT

• If you are unable to obtain a medical prescription, try to obtain hormones from someone who has a prescription to avoid counterfeit hormones.
• “Start low, go slow” is the rule of thumb. Starting on a lower dose, and staying consistent with it is the best way to minimize negative health risks. Increase your dose slowly over time.
• You will need blood testing every three months for the first year of GAHT and then every 6 months after. For people taking masculinizing hormones it is necessary to check hematocrit and lipid profiles. For those taking feminizing hormones prolactin and triglycerides should be monitored.