Starting HRT

This information isn’t exactly our wheelhouse nor our passion. The good news is that there is SO MUCH good information online that already has all this data. Instead of us re-doing all that work this will primarily be a page of links.

Medical transition is typically a binary process. We will be using the words trans femme and MtF to indicate someone interested in feminizing therapy and trans masc and FtM to indicate someone interested in masculinization. Apologies to the folks who don’t fit into this language model.

Tbh the bulk of what we’re going to list here we will be pulling from the r/TransDIY wiki. You can also find possibly everything you need on The DIY HRT Directory.

Medical guidelines for transition

These guides are sort of written by cops, so take the info with a grain of salt. That said, there will be some good recommendations here.

Get blood work

Most people will agree that you should get blood work before you start HRT and then occasionally while you’re on it in order to make sure your hormone levels are in check.

You can use the guidelines above to determine what you want to have tested. Typically, both MtF and FtM folks will do at minimum testosterone and estrogen.

Any further information we would give you we would likely pull directly from the page below. There are links to labs where you can get this blood work done without a doctors order.

DIY blood work info from the r/TransDIY wiki

Decide what you want to take

Trans femmes typically take an anti-androgen and an estradiol, however many people believe that anti-androgens are unnecessary if taking an adequate amount of estradiol (topical or intramuscular only). Trans femmes will sometimes add progesterone after a year on estradiol, as there is a widespread belief that it helps with breast development and fat redistribution, although these claims are largely unsubstantiated. If we could redo the early days of our HRT over again, we would only add anti-androgens if mono-therapy wasn’t working.

Trans mascs typically take just testosterone, which is strong enough to block estrogens in their bodies. Some people who find themselves predisposed to genetic hair loss will take finasteride to counteract the hair loss process that taking testosterone can cause.

The medical guidelines linked above will talk about options and dosages. We also love The DIY HRT Directory for this type of info.

Obtaining your HRT

We are vastly critical of both the medical system that gatekeeps HRT as well as of the DIY producers of HRT. If you are able to use the mainstream medical system to obtain HRT, that will always be the best and safest situation. When HRT is obtained at a pharmacy there is a very high level of purity and sterility assurance. Unfortunately, this is becoming impossible for more and more people.

How to get black and grey market HRT? Injectables can be obtained from a wide variety of online sources, however we urge caution when obtaining vials that are not coming from licensed compounding pharmacies. You may be able to get estradiol that was compounded in Thailand or India from a legitimate pharmacy. In general, this may be safer than standard “home lab” injectables due to the prevalence of false information about how to sterilize vials that circulates around the trans community. Vials are cheap, effective, and you only have to use them once a week. The downsides of vials are the need to consider sterility and having to give oneself injections.

Avoiding injectables, the other DIY option is generally topicals, the simplest form of which is just hand sanitizer, orange essential oil (penetration enhancer), and your hormone of choice. This is often safer because the product does not need to be sterile. The downside of this is that 1) you need to use it every day, as opposed to once a week, and 2) it’s more expensive in the long run.

To purchase either ready-made HRT or raw hormone powders, take a look at Where to Order HRT.

Safe injection and dosing

Let’s refer back to The DIY HRT Directory or r/TransDIY wiki for dosing info and how to safely inject.

Always sanitize the vial septum with a sterile alcohol swab before drawing your hormones. Always use a clean needle to draw and a different clean needle to inject. Sterile syringes and needles are available on Amazon.

Making your own injectables and topicals

Buddy, you’re in the right place. Head on over to The Guide for instructions on how to brew your own injectables. This is the most comprehensive, well-researched guide on the English speaking internet regarding making your own injectables, or your money back.

If you want to make your own topicals, it’s super easy! We’ll have a guide on this site soon, but in the meantime take a look at the r/Estrogel wiki. The recipes here work for both estradiol and testosterone, though if using T you will need to adjust the recipe as it requires many more mg per g than E for proper dosing.

A cool trick we like is to find a commercially available medication that we want to replicate and to find its package insert online. Let’s take AndroGel for example. The package insert tells us how much T is in a typical pump/dose. We can extrapolate that information to help us adapt DIY recipes. It requires a little bit of math, but we think it’s a more reliable resource than random Reddit comments.