DIYHRT

Open source gender

Being trans is all about being your own doctor/technician. This page will host my notes and methods on DIY HRT. I’ve been fully on DIY for about 3 years at this point, and I’ve collected lots of great resources I wanna share.

My areas of research are:

  • DIY HRT, HRT sourcing, guaranteed HRT access
  • DIY hormone level measurement techniques
  • DIY vial and gel compounding protocols
  • DIY hormone synthesis / bioextraction

Basics

  • DIY.HRT wiki for basic info on sourcing, dosage, and testing.
  • HRT.MOM for info on homebrewing vials. This is by far the best guide on aseptic technique and proper sterilization methods!
  • HRT Cafe has a great list of HRT sources. DragonOrdinance is my preferred site for sourcing raws to the US.

Not medical advice but

A brief overview of different forms of HRT, usage, sourcing, equipment, etc. This is my opinionated overview of DIYHRT from my few years of experience transitioning this way.

Trans femme HRT:

Estrogen:

Tbh you only really need estrogen to have happy and effective transition so long as you get effective T suppression from E mono therapy (most do with injections). I’ve been on E mono therapy for the bulk of my transition and I’ve been pretty happy with it.

Estrogen Pills:

  • This is the standard form of estrogen in many countries. Make sure you take pills sublingually, don’t just swallow them! You can buy 17b estradiol powder in bulk and press your own pills at a pretty huge discount. Dosing of pills can actually be pretty difficult to dial in initially, make sure to get regularly blood work early on and take them around the same time every day.

Injectable Estrogen:

  • Double check the vial concentration (eg 20mg/mL, 40mg/mL). Each estrogen compound has a different half life, and requires a different injection interval. This simulator from transfemmescience.org estimates circulating levels given dosage, injection frequency, and estrogen compound. (Take this lightly) Injections are probably the most effective form of administration sorry not sorry.

Transdermal Estrogen Gel:

  • Estrogen gel is a fairly common route of administration for menopause patients. It is typically significantly more expensive than injections and pills, but has a number of potential benefits for some people, eg lower risk of blood clots. You put it in like lotion once a day and it dries after a few minutes. Efficacy is on par with pills. One interesting note is that due to the low cost of raw estrogen powder and ease of compounding gel at home, this is likely a very convenient form of E for those interested in stockpiling years of hormones. You can also get patches dosed with transdermal gel prescribed in some countries or from a few DIY suppliers.

Progesterone:

As I understand it, there is some debate as to whether or not taking prog actually does much or if it is even worthwhile. Some doctors are hesitant to prescribe it, citing potential side effects and lack of evidence demonstrating efficacy as HRT. Despite this, many trans people are very insistent for a mix of anecdotal and quasi scientific reasons that it does meaningfully assist with breast development and can significantly affect your mood, and I’m inclined to believe them.

Progesterone Capsules:

  • Many people seem to think the best method is to poke a hole in the prog and boof it. You can probably just eat the pills, though it is commonly reported to cause drowsiness when compared to.. other methods.

Transdermal Progesterone Gel:

  • This is becoming more and more widely available through DIY sources. There isn’t a ton of research on it’s use, but it seems to work. It can be pretty expensive, but it’s very easy to brew at home from raw progesterone powder

Progesterone Injections:

  • This is a thing you can do. I have never met someone that actually does this tho. It seems insane to me, as it requires daily injections. It seems to be the best way to administer prog effectively, but there isn’t much evidence to suggest prog is especially impactful on your transition anyways. But this is a thing you can do.

Tblockers (Pills):

There are different types of tblocker. Some of them block the production of testoterone, some of them block the mode of action. There are very different side effect profiles related with different drugs. Please research accordingly. Overtime, most people get effective T suppression from injectable estrogen monotherapy alone.

Sodium Bicalutamide:

  • This is the preferred tblocker with the least side effects commonly available online/in US pharmacies as far as I know. It’s common for people to start off taking tblockers for a while to help with initial T suppression before eventually transitioning to estrogen monotherapy. You should monitor your levels when taking these. Note your levels of circulating T might actually go up for a bit, as bica blocks the mechanism of action of T, not production, but it will go down after a while.

Spironolactone:

  • Spironolactone has a reputation for having more/worse side effects and being less effective overall compared to newer tblockers, like bica. Nonetheless, it is still commonly prescribed in the US. It works. Although side effects are more common, nearly everyone reports it works fine for t suppression and few have any issues with it. It can be slightly cheaper depending on your insurance. But if possible, try to opt for alternatives.

Cyproterone Acetate/GnRH Agonists:

  • These are compounds that exist for T suppression and are increasingly available via DIY sources. I don’t know much about them besides that they exist and some people are very convinced they have a number of benefits compared to bica or spironolactone.

Reproductive options:

One of the hardest things about the choice to start HRT is the potential impact on your capacity to have children. Luckily, preserving DNA isn fairly affordable and easy. Though, it does require some planning and forethought. The longer you are on HRT, the more difficult it will be to produce viable DNA samples for preservation, and the longer you will have to be off HRT to do so. Many people require many months off HRT for this, which only becomes more unpleasant the longer you wait. For these reasons, it is often recommended to take action to preserve DNA early on in transition to avoid having so many issues later.

Trans masc HRT:

  • I am significantly less knowledgable about trans masc HRT compared to trans femme HRT. This section is much less opinionate and should be taken with even more grains of salt than the rest of this page of Not Medical Advice.

Testosterone:

WARNING: Testosterone is a scheduled compound in the United States. Acquiring testosterone without a prescription is illegal and carries potentially serious legal ramifications. Because of this, there is a relatively sparse amount of information on trans masc DIYHRT, and people seem to be a bit squeamish about the subjet overall. Many people are truly best off getting a T script for legal reasons. That said, the actual risk involved in DIY testosterone therapy is genuinely quite low. This is obviously quite a hard and sad game to be playing given the severity of the consequences of incarceration as a trans person, especially in states where you are unlikely to be housed in proper facilities. But, really and truly, there are ways to do DIYHRT as a trans masc that shield you from the bulk of the risk. To cover some common concerns:

  • You are EXTREMELY unlikely to suffer any sort of legal consequences as a result of receiving small quantities of testosterone powder in the mail. If your package does happen to be seized, you are almost certainly just not going to receive in. Some sellers, like Dragon Ordinance, will even allegedly reimburse you for your lost and reship. Don’t stress. However, it’s probably best not to ship large quantities.
  • You should be careful traveling with vials/needles, there have been a number of arrests resulting from trans men traveling with DIYHRT.
  • The medical risk involved with taking T is very low for most people, you will be fine so long as you have your levels checked regularly.

Injectable:

  • This is the standard option for T. It’s the cheapest and most widely available route by far.

Transdermal:

  • This is really your only options besides injections if you happen to be needle averse. Sadly, sourcing tgel can be pretty hard. Luckily, making your own gel from testosterone powder (easy to source) is pretty simple.

A guide to injections

Injections are one of the most intimidating parts of starting HRT, but once you get used to it they really aren’t that bad. Figure out if you are gonna do IM or subcutaneous injections. I prefer subcutaneous. You can find videos demoing self injection in a number of sites on YouTube. Stomach and glutes are common for subcutaneous, and thigh is common for IM. If you struggle at first, you can get help injecting at a pharmacy minute clinic or urgent care. There are also a number of autoinjector options, I’ll post more about this Soon. Lots of people still mess up injections occasionally years in, which might hurt or bleed a bit. If you hit a vein, which seems to be a pretty common anxiety, it will hurt really really really bad and bleed a lot. Otherwise, you’re fine. Please be mindful when sourcing needles. If you get inflammation around injection sites that lasts for days after injections, it’s possible your needles are shitty (dull/non-sterile).

Supplies

  • 70% isopropyl alcohol wipes
  • 1mL syringes (notes the needle attachment style, eg Luer lock)
  • 18G drawing needles, used to collect medication into the syringe
  • 5/8in 25G-27G needles for subcutaneous injections / 1-1.5in 22G-23G needles for intramuscular injections
  • Sharps disposal container

DIY level monitoring

I have found three promising alternatives to traditional blood tests thus far:

  • 1) Urinalysis based fertility monitors: I use a smart device called Inito. There is a camera system that attaches to the back of my phone and test strips that cost a few bucks each. This measures secondary metabolites in urine, and is thus note especially accurate. It’s made to be tracking periods, which leads to some annoyances in with the UX. But I have found this reliable gives me a good insight into the state of my levels.

  • 2) Saliva based fertility analyzers: Ovul is a good option. These are electronic tongue fertility analyzers which measure estrogen metabolites in saliva. I haven’t tried them yet, but they seem like a pretty good option for rough level tracking.

  • 3) DIY UV-VIS Absorbtion Spectroscopy with ELISA assay kits: The standard lab technique to measure estrogen levels in blood is to mix a tiny amount of blood into a solution containing an assay which changes the optical absorption of the solution according to the level of estrogen present. This is typically done with 96 well plate readers with many samples at a time, which makes DIY testing quite impractical. But recently, I’ve been working on a DIY UV-VIS spectrometer system optimized for small batch testing with single plates at a time. I am currently testing with my Ocean Optics USB2000+ UV-NIR spectrophotometer, but I will eventually produce a 3D printable unit which uses low cost photodiodes for the absorption measurement. I have been looking at a variety of low cost ELISA test kits, like this one, which comes to roughly ~$5 per test if all works out well.

Gel compounding

Tgel and Egel are very easy to DIY from raws!!

I will post more info on this Soon.

In the meantime, check out this patent containing an ingredient list and methods of Tgel

Compounding vials from raws

Equipment:

  • Dry sterilizer (I use an Omniclave, an oven will do)
  • Still air box
  • Vials + vial crimp
  • .22uM PTFE filters
  • Benzyl Alcohol
  • Benzyl Benzoate
  • Raws (Estrodial Enanthate, Valerate, or Cypionate)
  • Carrier oil (MCT oil)
  • Scale (>.001g resolution)

We sterilize our raws by baking the powder, and we sterilize our liquids with our sub micron filter. You need perform a bubble point test on the filters!!

If you are compounding at any reasonable scale, you should really test your aseptic technique. The standard method is to run a test batch and periodically touch each finger to an agar plate as you work to identify if and when contamination is introduced.

For small batches, this is much less sensitive, but as a rule the longer your vials are stored and the larger quantity you brew in, the more perfect your aseptic technique must be.