a collection of informative excerpts from conversations with people more knowledgeable than me
note this is skewed towards England, especially the Londonwards side
i also recommend the DIY HRT directory and especially A PRACTICAL GUIDE TO FEMINIZING HRT
before having a blood test, ensure you are hydrated (otherwise your blood will be viscous and they will need to poke many holes in you instead of few)
they list liver function tests as a separate service but i'm pretty sure they perform them by default on your first visitation; generally you can just explain whatever your reasoning is to the volunteer taking the test and they will add your desired metric to the order form
for both, book in advance via email
both offer quite similar ranges of services (they also will administer injections if you have proof that they're from prescriptions, and provide screenings/vaccines for STIs)
transferring records between services operating in different counties is difficult and annoying and unreliable
cliniQ is willing to provide a recommendation that one's GP offer a 'bridge prescription' but they require an in-person appointment with a doctor to do this; note that unlike blood tests (which they offer to walk-ins), their doctors are in short supply, and you must book such appointments about 3 months in advance
if you do get a prescription, it is a good idea to get a HRT prepayment certificate; they cost £19.80 rather than the £9.90 per prescription item, so will save you money if you collect your prescription > twice yearly
(written for me by my friend sophie, more-indented annotations by me)
Supplies needed:
Before first ever injection, feel free to practice by injecting water into an orange
Before injection:
Injection:
After injection:
Do alternate injection sides (like switch between left and right)
once you have said equipment, the expendible parts are either replaceable over-the-counter (ie. IPA wipes) or via Boots's harm reduction needle replacement programme (bring your sharps bin ask at the till)
transharmreduction.org's page gives lists for further needle exchanges in Scotland/Ireland
from cursory internet searches, one finds what seems to be a pretty decisive consensus in favour of using separate needles
however, a brief summary of my discussion with an acquaintance more well-versed is
note that THNX is willing to provide both
anecdote from friend who is quite experienced
post injection pain depends, a small amount of pain is normal and is mostly down to luck. sometimes people have irritation in the injection site that lasts a few days. it's normally not all too serious. larger injections can cause more irritation, as can larger needles size (larger sizes are smaller gauges, so 27G is bigger than 29G). irritation can generally be reduced by doing IM instead of SubQ (and for context, I get pain/irritation when I SubQ instead of IM, but your mileage may vary), in which case the vastus lateralis site on the thigh is best for that.
anecdotally from me, the first injection i had (administered by someone else) was of 10mg in 0.25ml, and the second (by me, with some hesitancy) was of about 5mg in 0.125ml; the second caused a small raised lump to develop lasting for 5 days while the first did not, so it is somewhat down to the technique
drone i know that in attempting to do IM injections amateurly into the leg, one will often miss and dispense the oil into the surrounding fat which is not something to be concerned about
so do the vials which one gets from pharmacies that say "for intramuscular use only" on them only say that to minimise liability because their manufacturers are run by lawyers who don't understand the interoperability/negligibleness of the risk or is there a genuine reason?
MitziIn the case of estrogen, basically. It's only approved for IM use, and running a trial to prove subq is fine to the FDA (given all the formulations are American) is a pointless waste of money to the manufacturer.
Some meds do actually need to be administered exclusively subq/IM/wherever. Administering the TB vaccine intramuscularly will land you in hospital for example. Depot antipsychotics come to mind as IM-only medication. But none of that's usually relevant to trans people (beyond depot testosterone formulations that can't be subqed because they're 4 ml)
| diagram intended for use by medical professionals (includes the back, which is not feasible for self-administration) | diagram from FOLX health's guide, which emphasises staying away from the naval (very important; there are a lot of nerves there) |
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(the FOLX health guide's IM diagram is the same but without the abdomen)
Mitzi Dorsogluteal IM is high risk because on a long enough time frame doing ~weekly shots, you'll probably statistically eventually hit the sciatic nerve, which is the nerve that can be actually-dangerous to hit. IM needles don't go in the butt, or at least not for hormones
Mitzi But the gist is as long as you're somewhere that vaguely resembles the abdomen or the thighs you're honestly fine for subq
i am currently taking 5mg estradiol enanthate (EEn) per week; second-hand anecdotally, i've seen reports from those on estradiol valerate injections on weekly schedules (imposed by their endocrinologists) that they experience mood swings towards the end of the week, so i recommend an ester with a half-life at least as long as EEn (and also Not getting into such a situation of biddenness to one's endo)
however, generally good advice is to start with 4mg estradiol enanthate weekly, and test at one to three months; see also pghrt.diy § 3 TYPES AND DOSAGES which is much more thorough and good than this guide
following my first injection on 2025-10-28
i was under the impression this would make injections into subcutaneous fat harder, but that was not the case at all! initially, my injector was going to try using my leg fat (through the fabric of my leggings), but ultimately chose my abdomen; abdominal fat is always feasible!
in fact, i had a blood test earlier the same day, of five stabbings, compared to each of which it was quite painless!