It's shot day and you're a wreck. You've been sweating since yesterday, and putting off the inevitable. After much avoidance, you finally force yourself to load a syringe. But even with everything ready you just can't bring yourself to do it.
Well, you're not alone. According to statistics, fear of needles affects roughly 20 percent of the population. This makes needle phobia one of the top 10 most common fears in the US.
Personally, I didn't develop any anxiety around shot day until about 6 months into my HRT journey. In the beginning, I was so focused on wanting a deeper voice and a beard, I didn't stop to think about what I was doing.
My doctor had taught me the 1-2-3-stab method and I was diligently complying every two weeks. But once the initial excitement of being on T wore off, giving myself shots became harder and harder.
Fortunately for me, I've found there are lots of ways to help reduce your needle anxiety. Of course, I can't guarantee you'll ever love shot day. But hopefully, these tips will make it all a little easier.
1. FOCUS ON THE GOAL
When you have something scary staring you in the face, it can be hard to think about anything else. But you aren't sticking yourself with needles just for the fun of it. To help ease your mind a bit, try focusing on the Why instead of the How.
Imagine how much you'll enjoy looking in the mirror and seeing some hair on your face. Imagine yourself using your voice with more confidence. Whatever it is that drives you to be on HRT, focus on that end result. Make a picture in your mind of the future you. The you that HRT will help bring about.
Of course, this practice is especially effective for guys new to HRT. But folks who have been on T for a long time can also benefit from a focus shift. Try to bring back those feelings of gratitude you felt early in your journey. Maybe even say "thank you" out loud. Thank the universe for giving you access to the things you need to make you feel more at home in your body.
If you're finding that difficult, here are some potentially helpful stats. Synthetic testosterone wasn't created until 1935. And it wasn't until the 70s that some doctors allowed some trans people access to hormones. Today, there are still loads of countries where trans health care is completely non-existent. And even in places where there is trans care, access to hormones can sometimes take YEARS.
But you, you've got a vial of testosterone with your name on it. While you're warming up your T before your shot, hold it in your hand. Try to direct thoughts of love and gratitude into the vial. It's yours and it's helping you be the person you know yourself to be. Everyone deserves access to competent and compassionate health-care. But an attitude of gratitude can help calm an anxious mind.
2. USE A SHORTER NEEDLE
If you're doing intramuscular shots, chances are your doc recommended 1.5" needles. However, depending on the thickness of your shot site, you may be able to use a 1" needle instead. For someone with needle phobia, that .5 inches can make a huge difference. If that 1.5-inch needle looks scary and intimidating to you, ask your doc if it’s ok to use a shorter needle.
3. SWITCH TO SUBCUTANEOUS SHOTS
If your doc insists you need 1.5" needles, ask if you can switch to subcutaneous (sub-q) injections. Intramuscular shots are delivered into muscle. Therefore the needles you use for intramuscular shots need to be long enough to reach the muscle. Sub-q shots, on the other hand, are delivered into fatty tissue just below your skin. For sub-q, oftentimes a 5/8" needle is all that is required. Historically, doctors believed that intramuscular T shots were more effective. It's true that medicine is absorbed faster with intramuscular shots. However, a new study now shows that sub-q shots are every bit at potent and powerful when it comes to T delivery.
4. DON'T STAB
As I said before, when I started HRT in 2004, my doc taught me the 1-2-3-stab method. After about 6 months on T, I came to a point where I just couldn't bring myself to do it. I talked with other trans men about my issue and one of them recommended pushing the needle in slowly instead.
Next time I had to give myself a shot, I gently placed the needle tip again my leg and slowly applied force. I found it much easier to do this and this is the method I use to this day. Turns out, the speed with which you push the needle into your skin will not affect the efficacy of your shot. If stabbing yourself feels impossible, give it a try.
5. TRY AN INJECT-EASE
Are you already doing sub-q shots, but even the shorter needle is too much for you? Well, this device may be a godsend. Essentially you load your syringe into the device, hold it up against your skin and simply press a button. The Inject Ease does the injecting for you and you still have control over how fast your T is administered. For a full tutorial on how to use an Inject Ease, check out this helpful video:
6. CREATE AN ATMOSPHERE OF CALM SELF CARE
I have a friend who likes to make a whole ritual out of giving himself his shot. He carves out lots of time and sets a mood. For him, giving himself his shot is part of his self-care routine. He'll turn on some relaxing spa music and light a candle. Sometimes he'll even start by shaving or doing a face mask.
Doing all this creates lots of space for him to get into a relaxed, self-care mindset. If you're having trouble giving yourself shots, try creating a handsome environment.
Start by making sure your bathroom is clean and uncluttered. After that, maybe splurge on a sexy shot kit. When I'm not traveling, I keep my shot supplies in a handsome, wooden box. When I'm on the road, I use my Stealth Bros Dopp Kit. I especially love the warrior symbol print in the dopp kit's lining. It makes me feel like what I'm doing connects me to a community of folks on a similar path to mine.
If candles aren't your thing, find a scent you love and spread it throughout your space. Personally, I keep incense matches in my bathroom. I love the way they smell and they don't create a lot of smoke.
To top it all off, try to get into the mood with some positive affirmations. I won't pretend like this video isn't cheesy AF, but I also can't deny that watching this video puts me in a good place mentally.
7. GIVE YOURSELF A FINITE AMOUNT OF TIME
On the flip some, for some folks, giving themselves lots of time and taking it slow, doesn't seem to work for them. If you've been in the bathroom, syringe in hand for more 15-20 minutes, maybe it's time to set it down.
Leave the room and do something else for a minute. Come back in half an hour and try again. We've heard lots of guys recommend giving yourself a 10-15 minute window to give yourself a shot. It makes sense. Creating a finite timeline in which you MUST do a task often means it will get done within that timeline.
Try waiting until you're about 15 minutes from having to leave the house. Maybe you have to go to work or have to meet a friend for coffee. Of course, you don't want to rush through anything that involves sharp objects. But 15 minutes is more than enough time to do the thing carefully and properly.
8. ASSOCIATE SHOT DAY WITH ANOTHER REWARD
Giving yourself a reward each time you complete a task will help create positive feelings for that task. Knowing that there is a reward on the other side of an anxiety-inducing experience can be just enough to get you through.
Personally, I plan my shot time right before my weekly "cheat meal." For me, this generally means pizza, tatter tots and ice cream. After a week of eating clean, I get super excited about getting to have all the foods I crave. The anticipation completely eclipses any fear I may have about giving myself a shot.
Of course, you don't have to go whole hog like I do. Find something that you can really look forward to and plan to do it right after you do your shot. Don't let yourself have the reward without the shot. And it doesn't have to be junk food either. Maybe you really, really like going to the pet store to look at puppies. Whatever you pick, just make sure it's something that truly makes you happy and excited.
9. USE YOUR BODY TO TRICK YOUR MIND
Studies have shown that there is a distinct physiology to fear. Chances are if you're having a lot of anxiety about something, your body is tense. Maybe your shoulders are stooped and you've twisted your face into a grimace. While your emotions affect how you carry yourself, how you carry yourself can also affect your emotions.
Next time you have to give yourself a shot, try this: stand up straight, with your shoulders back. Take a couple of slow deep breaths and smile. Smile even if you don't feel like smiling and hold it for 15 seconds. This will actually induce a chemical reaction in the brain that releases dopamine and serotonin. These chemicals are associated with increased happiness and lower feelings of anxiety. The more you have in your system, the easier it will be to do the deed.
10. NORMALIZE THE NEEDLE
Immersion therapy is a classic fear-busting tactic. If the sight of a needle is enough to elevate your heart rate, try keeping one in a place that you will see every day. The idea is that eventually seeing the needle will become commonplace. You will become desensitized to looking at it and will stop eliciting a fear response. This may take some time to achieve but it’s absolutely worth trying if looking at a syringe has you sweating.
11. USE A NUMBING CREAM
If it's fear of pain and not fear of needles that keeps you from giving yourself your shot, numbing cream might be a good option for you. You can buy over the counter numbing cream or ask your doctor to prescribe you EMLA cream. Numbing cream usually takes an hour to fully kick in. Apply some to your shot spot an hour before you self-administer.
Be careful not to get the EMLA cream on your hands. If you do, wash them right away to be sure that your hands don’t become numb. Cover the cream with an air-tight, water-tight (occlusive) dressing. Once the spot is good and numb, wash and swab the area before you inject you T. For a full tutorial on how to use EMLA cream, check out these helpful directions.
I hope these tips were helpful for you in your attempt to reduce your shot anxiety. If you have tips that weren't mentioned here, help your trans fam out and please do leave a comment.