How to Inject: IM & Subcutaneous (subq) Step-by-Step

This is a practical, harm-reduction guide to self-injecting hormones either intramuscularly (IM) — deep into a muscle — or subcutaneously (subq) — into the layer of fat under the skin. For most hormones the two routes give identical absorption; which you choose is mostly personal preference and comfort.

Medical disclaimer

This page is for educational and harm-reduction purposes only and is not medical advice. Injection carries real risks (infection, tissue damage, injecting into a blood vessel). If you can, have a nurse or provider show you in person the first time. If you feel faint, have severe pain, spreading redness/heat, or trouble breathing, seek medical help.

Watch first

Seeing it done makes everything below clearer. These are trans-focused self-injection tutorials:

• Intramuscular (IM): Hormone Self-Injection — IM technique
• Subcutaneous (subq): Hormone Self-Injection — Subq technique

Equipment you need

Never reuse needles or syringes, and use a new, sterile needle every time.

Item	Intramuscular (IM)	Subcutaneous (subq)
Syringe	1 mL Luer-lock (2–3 mL for testosterone undecanoate)	1 mL Luer-lock, or U-100 insulin syringe
Drawing needle (to draw from the vial — not for injecting)	1.5 inch, 22–23 g	1.5 inch, 22–23 g
Injecting needle	1 inch, 25 g	0.5 inch, 27 g
Alcohol prep pads	✓ (for vial + skin)	✓ (for vial + skin)
Sterile gauze / cotton	✓	✓
Sharps container (or sturdy sealable plastic)	✓	✓
Bandage / plaster (optional)	✓	✓

Notes

• Use a thicker 22–23 g drawing needle rather than an 18 g — it reduces "coring" (shaving bits of the rubber vial stopper). Draw with it, then swap to the thin injecting needle.
• U-100 insulin syringes read in units: 10 units = 0.1 mL, 50 units = 0.5 mL. Do NOT use U-40 insulin syringes (sold for veterinary use) — they are hard to measure.
• Oil-based hormones are thick; drawing is easier if the vial is at room temperature.

Supply specifications from the DIY HRT Directory — Injection Supplies.

Choosing a site

Rotate sites each injection so tissue can heal.

Subcutaneous (subq) — pinchable fat:

• Upper outer thigh
• Abdomen / belly, but stay at least ~5 cm (2 in) away from the navel

Intramuscular (IM) — large muscles:

• Ventrogluteal (side of the hip) — often considered the safest IM site
• Vastus lateralis (outer thigh)
• Deltoid (upper arm) — only for small volumes

Avoid areas with bruising, veins, moles, scars, or irritation.

Step-by-step

1. Prepare

1. Work on a clean surface in good light. Wash your hands thoroughly with soap and water.
2. Lay out your supplies. Check the vial: correct medication, not expired, liquid is clear (some settling is normal — do not use if cloudy/discoloured for a clear product).
3. Wipe the rubber top of the vial with an alcohol pad and let it air-dry.

2. Draw up the dose

4. Attach the drawing needle (22–23 g) to the syringe.
5. Optionally draw air equal to your dose and inject it into the vial (this makes drawing easier). Turn the vial upside-down, keep the needle tip in the liquid, and pull back to slightly past your dose.
6. Remove air bubbles: tap the syringe so bubbles rise to the top, then gently push the plunger until the air is out and you are exactly at your dose.
7. Remove the drawing needle and attach a new, sterile injecting needle (25 g for IM, 27 g for subq). A drop at the tip is fine.

3. Clean the site

8. Wipe the chosen site with a fresh alcohol pad in one direction and let it air-dry (injecting through wet alcohol stings).

4. Inject

9. Subq: gently pinch a fold of fat. Insert the needle at 45–90° in one smooth motion. IM: hold the skin taut. Insert the needle at 90° (straight in), quickly and fully.
10. Aspiration (optional/debated): modern guidance says it is not needed for subq and generally not for the ventrogluteal IM site. Some people still pull back slightly on the plunger for a second: if blood appears, withdraw, discard, and start over with a new needle at a new spot. If no blood, continue.
11. Press the plunger slowly and steadily to inject all the medication.
12. Wait a second or two, then withdraw the needle at the same angle you inserted it.

5. Aftercare & disposal

13. Apply gentle pressure with sterile gauze; add a bandage if needed. Do not rub hard.
14. Immediately drop the whole syringe/needle into your sharps container — never recap by hand. Seal it when full and dispose of it per local rules.
15. Mild soreness, small bruises, or a little redness for a day is normal. Watch for infection (spreading redness, warmth, pus, fever) and seek care if it appears.

Common problems

• It hurts a lot going in — injecting through wet alcohol, a dull/reused needle, or going too slowly. Use a fresh sharp needle and let alcohol dry.
• Bleeding or bruising — you nicked a small vessel; apply pressure. Rotate sites.
• Post-injection soreness (esp. IM with homebrew) — benzyl benzoate solvent can irritate; IM often hurts less afterwards than subq for these.

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See also: Blood Testing · Transfeminine HRT · Transmasculine HRT. Supplies sourced from the DIY HRT Directory.