THE LIBRARY

From the "What's Whats" to the "How-To's," discover answers to your queer and trans healthcare questions from FOLX clinicians, team, and community.


The articles contained in the the FOLX Library consist of generally available information and do not constitute medical advice, diagnosis, treatment.

Hormones

BASICS

BASICS

BASICS

BASICS

BASICS

BASICS

BASICS

BASICS

BASICS

BASICS

BASICS

BASICS

Hormone Replacement Therapy (HRT), or gender affirming hormone therapy, is indicated for individuals who are seeking to alter their secondary sex characteristics for a more "masculine" or more "feminine" gender presentation. Testosterone and estrogen are the most common hormones used.  HRT is often used to help ease feelings of dysphoria, but you don’t have to have dysphoria to use HRT. We like to think of HRT as gender EMPOWERING.

HRT will bring about changes that are different for each person. Some changes can be permanent, and some changes will go away if you stop HRT. 

Testosterone is considered a controlled substance because of the potential for abuse, not because there is a high or moderate potential for physical addiction. The concern here is primarily for unsafe use by athletes or body builders, for example. Although there can be some short term withdrawal symptoms from stopping Testosterone, it generally does not cause a physical dependence.  

Estrogen is not a controlled substance and does not cause physical dependence. 

HRT & YOU

HRT & YOU

HRT & YOU

HRT & YOU

HRT & YOU

HRT & YOU

HRT & YOU

HRT & YOU

HRT & YOU

HRT & YOU

HRT & YOU

HRT & YOU

Deciding whether or not to start HRT is personal and unique to every person. It is normal and ok to feel uncertainty and take time to make your decision. It can also be normal to feel 100% certain and be ready to start ASAP. Some things that may be helpful if you aren’t feeling sure are: doing research and weighing how you feel about the possibility of permanent and nonpermanent changes you may experience, reaching out to community support groups, talking with trusted friends and mentors, or talking with an affirming counselor. We’re also here to help. 

If you experience gender dysphoria, or are seeking changes to your secondary sex characteristics, you can use hormones. You do not have to identify as transgender; plenty of people who are nonbinary, for example, use hormones. 

Yes, many nonbinary people who are seeking to be in their body exactly as they want to do use hormones.

The length of time you’ll be on hormones completely depends on your goals and desires. There may be some risks of HRT that increase as you age (especially if you have certain health issues more common when you’re older in age), but there is no defined upper age limit for stopping testosterone or estrogen. 

Most likely yes, but we need to know more about your overall health and/or conditions. In general, however, there is little reason that age should impact whether or not you can begin HRT. Starting gender-affirming hormone therapy later in life may limit the extent of your results, but in general there are not worse or more serious side effects associated with starting in your 40s, 50s… or 60s or 70s!

INJECTIONS

INJECTIONS

INJECTIONS

INJECTIONS

INJECTIONS

INJECTIONS

INJECTIONS

INJECTIONS

INJECTIONS

INJECTIONS

INJECTIONS

INJECTIONS

We’re not going to lie to you and say that sticking a needle into your body is painless. But it really depends on the type of needle, injection method, and your own tolerance for pain. Subcutaneous injections typically use a shorter needle and go into fatty tissue under the skin, whereas intramuscular injections use a longer needle and go directly into the muscle. Over time you may become used to the sensation, and if it ever hurts too much, you can use a numbing agent like Lidocaine. Pain does not equal gain when it comes to HRT. There are always options or solutions to ease this process and prioritize your comfort.

Only use your needles once! After your injection, deposit the used needle into a sharps container ( we’ll provide you one with your first delivery of hormone injection supplies). You can also reuse another hard plastic container (like an old laundry detergent bottle), just make sure it has a lid that can be secured. We don’t want any loose needles around! When you’ve filled your sharps container, take it to a safe needle disposal site.

It’s ok if you notice a little blood after giving yourself an injection. There are tiny blood vessels all over your body, so you might nick one as the needle goes into the skin--that’s ok! When this happens, you might even notice a little bruise or bump form afterwards. Here’s the link to injection training just in case you want to review all of the steps again. However, if you are experiencing any redness or swelling that lasts for days after injection, a large amount of bleeding, or are just feeling concerned about your injections, you should set up an appointment with one of our clinicians.

It is normal to get some irritation and itching at your injection site. This may last a couple of hours to a couple of days, but should be pretty minimal (meaning, you are not constantly wanting to scratch it!). If you notice intense itching, or the itching gets worse with each injection, you will need to set up an appointment to chat with your provider about next steps. It could mean switching to a different oil base for your injection. However, if itching has been getting worse with each injection or you are experiencing swelling that is getting worse or shortness of breath, you should set up an appointment with one of our clinicians.

You may notice some clear fluid seeping out of your skin after you remove the needle--this is ok! This fluid is the medication. A lot of people get worried about having any medication leak out since they want to make sure they get their full dose. One way to help make sure medication doesn’t leak out is to depress the plunger really slowly to give the medication time to release into your body. Also, changing the location of where you give yourself an injection can help as well. You can read more about proper injection technique here. However, if you're worried about how much medication is seeping out or want a refresher on self-injections, FOLX members can set up an appointment with one of our clinicians.

You should inject the medication at a 90° angle into an area of your body that has a good sized muscle like your thigh or buttocks. The best place to do this You can read more about IM vs subcutaneous (SubQ) injections here.

You should inject the medication at a 45° angle into an area of your body where there is some fatty tissue like the belly or inner thigh. You can read more about IM vs subcutaneous (SubQ) injections here.

Sometimes the sensation of giving yourself an injection can change from week to week. It may feel like nothing one week and then feel pretty painful another week. If you're experiencing consistent pain, FOLX members can schedule time to talk this through a clinician.

Interested in starting with FOLX?
vector/handPerson with dreamy expressionPerson with dreamy expression

More questions? We've got answers.