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7 Tips For Overcoming Fear of Self-Injection

Self-injecting medication can be scary for anyone pursuing hormone replacement therapy. Here are some tips to help transgender and non-binary people on HRT combat their injection anxiety and needle-phobia.

Needle for self-injecting HRT

Illustrations by Leo Mateus.

The very idea of injecting needles into our bodies can be terrifying for many. Especially when a 22G needle is staring you down, the fear can hit harder. Getting or doing a shot is not really something that many people look forward to. Having a fear of needles—called trypanophobia—is one of the most common phobias in the United States. 


Whether you just find self-injecting daunting or you are afraid of needles, there are things that can help. For those who pursue estrogen or testosterone hormone replacement therapy, a routine self-injection shot can be something that you might look forward to (as well as dread). To help you overcome any fear or anxiety you might have, we’ve compiled a list of helpful tips to guide you through the process with ease.

Set the mood

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Every time you do a testosterone or estrogen shot, you are setting aside time to show up for yourself. Creating a gentle, soothing environment can help set a mood and vibe for your injection. Developing a dependable routine or ritual that integrates pleasure can help ease injection anxiety.

Plan in advance to set up a ritual space for your injection that feels sacred or special. Make sure your space is clean and clear for setting up your supplies (and make sure you have the right supplies in advance!). Maybe you have a certain artist or song that you listen to every time you do your HRT shot, or you can make your own playlist, stock up on candles or essential oils, prepare an altar space, and anything else that will help you set the vibe.


Practice deep breathing

Breathing exercises can help combat anxiety of all kinds. Before starting your injection, take a moment to pause and regulate your nervous system. Some different kinds of breathing techniques include alternate-nostril breathing, diaphragmatic or belly breathing, 4-7-8 breathing, and more. There are a number of meditation apps that offer breathing-based guided meditations, such as Headspace, Calm, and Balance. You can just keep it simple by taking ten deep breaths as well to center yourself before your injection. Experiment with different types of breathing until you find the right technique for you.


Try reciting some affirmations

Affirmations give us the opportunity to practice self-validation and self-trust. Consider saying some affirmations out loud during or before your routine self-injection. While we encourage you to create your own, here are some example affirmations if you need some inspiration: 

  • I am worthy of love.
  • I am becoming the best version of myself.
  • This is not just medication. This is a life-affirming practice. 
  • I give myself the care, love, and attention I deserve.
  • I am connected to all trans people. We deserve everything.


Remember why you’re doing this 

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Don’t lose touch with your reasons for being on hormone therapy. You’re embarking on an exciting journey of gender-affirming care and recommitting to yourself every time you take this medication. Remind yourself of this when the going gets tough on shot days. Though it’s understandable to be caught up in injection anxiety, embrace the moment to accept and feel the wide range of your emotions rather than suppress them; chances are, you’ll find your own acceptance along the way.


Inject with confidence

When injecting any medication, especially HRT, it’s important to do so with confidence. Although it’s normal to feel apprehensive, injecting slowly can cause pain, lead to mistakes, and draw out the overall process, all of which will make you feel that much more overwhelmed.

While there isn’t an exact recipe for confidence, there are ways to set yourself up for success, from day one. Sometimes confidence can be a trick you play on yourself, until it becomes natural.Take a deep breath and give yourself a time limit—the longer you linger, the more your anxiety will build. It’s important not to rush yourself, but be intentional about the lead up to your injection. Consider setting a timer. You could even put on a song and challenge yourself to finish your shot before the end of it.

Although the first few injections may be the most anxiety-inducing, remember to be patient with yourself. Many of us gain confidence over time and with experience, and while it might not get any easier, you will become better and more skilled at self-injecting


Find community support

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Remember that you can always count on others for support when you are having a difficult time self-injecting your HRT. For instance, you can demonstrate to a loved one in your life—a trusted partner, friend, roommate, family member, etc.—how to administer your shot when you can't bring yourself to do it. That way, you’ll still be able to get your medication on time consistently, even when or if you’re overcome with injection anxiety.


Reward yourself

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Being on testosterone or estrogen hormone replacement therapy can be a reward in itself, but finding ways to reward yourself for injecting successfully can help associate positive feelings to your weekly shot. Just like any other goal, we set ourselves up for success when we incorporate elements of joy into our progress; we’re also more likely to have a good association with our overall goals. If you’re struggling to find ways to reward yourself, here are some suggestions:

  • Go for a walk outdoors
  • Treat yourself to a gift or your favorite snack
  • Drink a bubbly water or take a bath
  • Schedule social time with a loved one

If you need a refresher on how to give yourself an injection, find our step-by-step self-injection guide and our subcutaneous (SubQ) and intramuscular (IM) videos. If you are ready to start your HRT journey with FOLX, you can get started here. If you have more questions, feel free to check out our other articles in The Library or schedule a virtual visit with a FOLX clinician.