Shot Day Anxiety: 11 Tips to Make Testosterone Injections Easier

It's shot day and you're a wreck. You've been sweating since yesterday, putting off the inevitable. After a lot of stalling, you finally load a syringe. But even with everything ready, you just can't do it.

Sound familiar? You're not alone. About 20% of people are afraid of needles, which makes it one of the 10 most common fears in the US.

I didn't get shot day anxiety until about 6 months into HRT. At first I was so focused on a deeper voice and a beard that I didn't think about what I was doing. My doctor taught me the 1-2-3-stab method, and I did it like clockwork every two weeks. Once the excitement of being on T wore off, giving myself shots got harder and harder.

There are lots of ways to make testosterone injections easier. I can't promise you'll ever love them, but these tips help.

1. Focus on the goal

When something scary is staring you in the face, it's hard to think about anything else. But you're not doing this for fun. Focus on the why, not the how. Picture yourself with some hair on your face, or using your voice with more confidence. Whatever made you want HRT, focus on that.

If that's hard: synthetic testosterone wasn't created until 1935, and it wasn't until the 70s that some doctors let some trans people get hormones. In some countries, trans healthcare still doesn't exist. You've got a vial with your name on it. While you warm it up before your shot, hold it and think about how lucky you are to have it. Feeling grateful really does help calm an anxious mind.

2. Ask about a shorter needle

For intramuscular shots, your doctor probably recommended 1.5" needles. Depending on your injection site, a 1" needle might work instead. If you're scared of needles, that half inch can feel huge. Ask your doctor if a shorter needle is right for your body.

3. Ask about SubQ shots

If your doctor insists on 1.5", ask about subcutaneous (SubQ) injections. IM shots go into muscle, so they need a longer needle. SubQ shots go into the fatty tissue just under your skin and often only need a 5/8" needle, less than half the length.

Research shows SubQ testosterone works just as well as IM. For most people, absorption is steadier and the site hurts less, and lots of people say switching was one of the best changes they made.

• IM (intramuscular): 1"–1.5" needle, into muscle like the thigh or glute. Faster initial absorption.
• SubQ: 5/8" needle, into fatty tissue like the belly or outer thigh. Slower, steadier absorption.

Both work for testosterone HRT. Talk with your prescriber about which is right for your formulation and dose. More in how to make SubQ shots easier.

4. Try quick or slow insertion

Some people insert the needle quickly, others go slowly. Try both and do what feels better for you. How fast the needle goes in doesn't change how well your shot works.

About 6 months on T, I just couldn't do the 1-2-3-stab anymore. Another trans guy suggested pushing the needle in slowly instead. Next shot, I rested the needle tip against my leg and slowly applied pressure. For me it was so much easier, and it's still how I do it. If the quick way works for you, stick with it.

5. Try the Inject-Ease

Already on SubQ and even the short needle is too much? The Sub-Q Inject-Ease is a reusable, spring-loaded auto-injector. Load your syringe, hold the tip flush to your skin, and press the button. The needle goes in on its own, then you push the plunger at your own pace. It works with 25–26 gauge, 5/8" needles and 1 mL Slip Tip syringes, and it's for SubQ shots only.

6. Make shot day a ritual

A friend of mine makes a whole ritual out of his shot. He sets aside plenty of time and puts on relaxing music, lights a candle, and sometimes does a face mask or a shave first. That way he's in a chill, self-care headspace instead of a scared one.

Set up your space on purpose. Clean and clear the bathroom, and keep your supplies together. A TGS Shot Kit, a hard case that keeps your vials, syringes, and supplies in one place, can help. Try some positive affirmations, or whatever grounds you. The point is to turn shot day into something you do for yourself.

7. Give yourself a time limit

For some people, going slow just gives anxiety more room. If you've stood there with a syringe for 15–20 minutes and still haven't done it, set it down, leave the room, and come back later.

A lot of people find a set window of 10–15 minutes helps. Try timing your shot right before you have somewhere to be. 15 minutes is plenty to do it carefully, and having somewhere to go can cut through the spiral.

8. Pair shot day with a reward

Reward yourself every time you do something hard, and that hard thing starts to feel better. I plan my shot right before my weekly cheat meal: pizza, tater tots, ice cream. I'm so excited for that meal that I forget to be scared. Pick something you really look forward to, and no reward until the shot's done.

9. Use your body to trick your mind

When you're scared, your body hunches, tenses, and grimaces. It works the other way too. Before your shot, stand up straight, shoulders back, and smile for 15 seconds, even if you don't feel like it. Research shows smiling triggers a chemical reaction that releases dopamine and serotonin, which are linked to less anxiety. It sounds ridiculous. It works anyway.

10. Get used to the needle

If even seeing a needle spikes your heart rate, keep a capped, unused one somewhere you'll see it every day, like the bathroom counter. Over time it stops setting off your fear. This is called desensitization. It takes a while, but it's worth trying if the sight of it is part of the problem.

11. Try numbing cream

If it's the pain, not the needle, that stops you, numbing cream might help. You can get over-the-counter numbing creams at most pharmacies, or ask your doctor about EMLA cream.

It takes about an hour to kick in. Put it on your injection site an hour before your shot and cover it with an airtight dressing. When the spot is numb, wash and swab it before injecting as usual. Don't get the cream on your hands, and wash them right away if you do. Ask your pharmacist or prescriber how to apply it.

Shot day gets easier. Not all at once, but it does. Find the mix of tips that works for your brain and your body, and keep going.

Keep reading: easier SubQ shots, testosterone injection pain, and testosterone syringes and needles.