Injecting hormones

Needle phobia

It is not uncommon for children and adults to have a fear of needles, which can be difficult for children and youth who are prescribed puberty blockers A group of medications for youth that temporarily suppress or inhibit puberty by suppressing the production of sex hormones and preventing development of secondary sex characteristics. or injectable hormones. BC Children’s Hospital has created a resource for children and youth with needle phobia. There is also a needle phobia program at BC Children’s Hospital through Psychology services.

Hormone injection

There are a number of resources available, including:

• Intramuscular injections pamphlet — A guide to giving yourself intramuscular hormone injections prepared by Trans Care BC and BC Centre for Disease Control (BCCDC) Harm Reduction Services.
• Subcutaneous injections pamphlet — A guide to giving yourself subcutaneous hormone injections prepared by Trans Care BC and BCCDC Harm Reduction Services.
• Transgender Health: Injection Guide by Fenway Health: A step-by-step guide for intramuscular (IM) and subcutaneous (SubQ) injections.

Safety tip

It’s no longer recommended to do intramuscular (IM) injections in the buttocks because of the increased risk of negatively affecting the sciatic nerve. Instead, many people self-inject into subcutaneous (fat) tissue on their legs and abdomen because it’s easier, safer and equally effective. Speak to your care provider about how to choose and safely landmark the injection sites that are best suited for you.

Accessing safe injection supplies for free

Hormone injection supplies can be accessed for free through many harm reduction sites across B.C. To locate the nearest harm reduction site:

1. Use your browser to go to: https://towardtheheart.com/site-finder 
2. In the “What supplies are you looking for?” field, choose “Hormone Injection Supplies” to find safer injection equipment near you.
3. Call the site you choose in advance to ensure they have what you need. Ask about the following supplies based on the type of injection you do.

Intramuscular (IM) injections

• Alcohol swabs
• 18 gauge needles (to draw up the medication)
• Syringe (ideally 1cc* or 3cc)
• 22 or 23* gauge needles (to inject), approximately 1 or 1.5 inches long
• Sharps container
• Little bandages* (if needed)

Subcutaneous (Sub-Q) injections

• Alcohol swabs
• 18 gauge needles (to draw up the medication)
• Syringe (ideally 1cc* or 3cc)
• 25, 26 or 27 gauge needles (to inject), approximately 0.5 or 5/8 inches long
• Sharps container
• Little bandages* (if needed)

* Indicates supplies that are not funded and would need to be purchased out-of-pocket

Hormone Injection Supplies Toolkit

If you use a harm reduction site that does not carry the supplies you need, you can let them know that Trans Care BC offers a Hormone Injection Supplies Toolkit—a handout that outlines recommendations and strategies for providing services for trans, Two-Spirit A term used within some Indigenous communities to reflect complex Indigenous understandings of gender and sexuality and the long history of sexual and gender diversity in Indigenous cultures. Two-Spirit encompasses sexual, gender, cultural and spiritual identity. It may refer to cross-gender, multi-gender or non-binary gender roles, non-heterosexual identities, and a range of cultural identities, roles and practices embodied by Two-Spirit peoples. Some people also use "2-Spirit" or "2S." (Source: Battered Women’s Support Services) and non-binary Umbrella term referring to people whose gender does not fall within the binary gender system of woman/girl or man/boy. Some individuals identify as non-binary while others may use terms such as gender non-conforming, genderqueer, or agender. Non-binary people may or may not conform to societal expectations for their gender expression and gender role, and they may or may not seek gender-affirming medical or surgical care. people. This handout was developed by Trans Care BC in collaboration with the BC Centre for Disease Control. 

Download the Hormone Injection Supplies Toolkit — Intended for harm reduction sites and any organization or program interested in offering hormone injection supplies and inclusive harm reduction services.