Whether it is puberty blockers or weekly hormones, shots can be a pain. Literally.
Here are some techniques to make them less uncomfortable. These can be used independently or in combination with other strategies.
A lot of these techniques are more accessible when you have stable housing, some expendable income, and a helper. If the cost of injection supplies limits your access to gender care, reach out to the Trans Needle Exchange who will send you supplies for free. For people under the age of 30, Trans Family Support Services’ Gender Junk program offers free gender affirming items and might supply any of the following recommended items.
Race, like gender, is a social construct, so these strategies should be applicable for all bodies.
Interestingly, hormones change the sensitivity and thickness of our skin:
- Estrogen tends to make skin softer and more sensitive.
- Testosterone tends to make skin thicker and less sensitive.
Each individual may respond differently to each of these techniques. Body size, sensory processing, and disabilities might make some of them more or less accessible or effective. For example, Dr. Beal is scent-sensitive and tends to find vibrations on their skin cause a lot of intolerable itching (they can’t use a Theragun or Magic Wand).
Getting Ready For Your Injection
- Prep your area to decrease anxiety:
- Clean the counter
- Wash your hands
- Get all of your supplies out and ready
- Create a soothing environment:
- Play gentle music or soothing sounds
- Consider calming aromatherapy with scents like lavender, bergamot, sweet orange, and/or ylang ylang. We like this product from Soothing Scents. There are also a few trans-owned candle makers:
- Queer Candle Co
- Clean Candle Therapy
- We Live in Truth! (Black and trans owned)
- Dim the lights – not so low that you can’t see, but not raging bright.
- Get the right temperature for your comfort.
Managing Anxiety or Pain With Injections
- Consider acetaminophen, ibuprofen, or naproxen (Aleve) about 45-60 minutes before the injection, taken with some food.
- Acetaminophen should be avoided by folx taking bicalutamide.
- Topical numbing cream can help. You can get 5% lidocaine over the counter or stronger prescriptions from your clinician.
- Topical numbing cream was found to be equally effective on skin of all pigmentation levels.
- Premedication with anti-anxiety prescriptions might be helpful for some people. Or even supplements like herbal teas. Yogi Tea makes Calming which you can find at a lot of grocery stores. Also, some trans-owned tea companies to check out:
- Phoenix Pearl Tea Company
- Black and queer owned: Sis Got Tea
Emotional, Physical, and Sensory Support During Injections
- A support person can help during your injection:
- Cold sprays, like this one, can be sprayed on the skin just before and during the injection to help with discomfort.
- Buzzing devices like this can minimize discomfort. You may want to try a vibrator first if you already have one!
- A support person can distract you during your injection or give you the injection so that you can distract yourself with blowing bubbles, solving a visual puzzle, or playing a game on an electronic device.
- Personal note: The least painful injection I ever experienced was from a nurse who asked me to tell them how many dogs were on a poster right before they poked me. They made my brain too busy to process the pain signals from my body and thus- NO pain!!!!! -Dr. Crystal Beal
- Holding a pet or emotional support animal can be very supportive.
Automate Your Injection
- Auto-injectors can help as well with discomfort or anxiety. Check these out:
- Xyosted: testosterone that comes in a pre-filled auto-injector that has to be prescribed by your clinician; the dose is not adjustable. May not be covered by insurance.
- Union Medico Super Grip
- Personalizable! You can choose your color and needle/syringe sizes
- Can order extra syringes and needles with your injector
- Compatible with 25G 5/8″ needles and 1mL syringes, which we recommend
- Company is based in Europe, but does ship to the USA
- Watch a demo video by uppercaseChase
- Autoject 2
- not compatible with 5/8″ needles
Aftercare
- Heat or ice after the injection – pick which one feels best for you. We like reusable products for the environment like:
- Heating pad
- Rechargeable hand warmers
- Hot water bottle (we don’t love Amazon, but for a while, they had a TRANS FLAG one)
- Ice packs
- That said, disposable products like Little Hotties or HotHands hand warmers or instant ice packs are really helpful if you have less stable housing, and are often available in large quantities at warehouse stores.
Are you concerned about fainting after an injection?
- Make sure you have eaten about an hour prior to your injection.
- At the time of your injection suck on a hard candy or drink a small glass of juice just before your injection.
- Squeeze your hands into really tight fists (if you aren’t injecting into an arm). Squeeze your thigh muscles tightly (if you aren’t injecting into your legs). This helps reduce your risk of fainting.
- Plan for fainting by positioning yourself semi-reclined and well-supported, so if you faint you don’t fall.
- You can also try different injection locations on your body, especially if someone else can give you your injection. You can read more on our Self-Injections page.
References:
- Riendeau LA, Bennett D, Black-Noller G, Fan L, Scavone JM. Evaluation of the analgesic efficacy of EMLA cream in volunteers with differing skin pigmentation undergoing venipuncture. Reg Anesth Pain Med. 1999 Mar-Apr;24(2):165-9. doi: 10.1016/s1098-7339(99)90079-2. PMID: 10204904.
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