What DIY hormones actually are

HRT stands for hormone replacement therapy. In gender medicine it means taking the sex hormones associated with the other sex — estrogen (often with an anti-androgen) for males who want to feminise, testosterone for females who want to masculinise. Under medical supervision this is a prescription drug with blood tests, dose monitoring, and a clinician who can respond to side effects.

DIY removes the clinician. The person sources the drugs themselves and decides their own dose. There are several distinct routes, and they carry different risks:

• Overseas online pharmacies. Websites, often based in countries with loose export rules, sell estradiol, testosterone esters, and anti-androgens without a prescription. Payment is frequently by cryptocurrency.
• Homebrewers. Individuals who buy raw hormone powder — commonly from chemical suppliers in China — and compound it into injectable oil, oral tablets, or transdermal gel ("estrogel"), then distribute it to others.
• Peer-to-peer sharing. Friends, partners, or older community members passing on leftover or surplus hormones. This is how many minors first obtain them.
• Informal online clinics. Services that issue a prescription after a short video call or a questionnaire, sometimes with no blood work at all. These sit in a grey zone — technically a prescription exists, but the assessment is minimal.

There are people who compound it themselves (dubbed "homebrewers") using estrogen powder that they typically order from China. But what most people mean when they say DIY is buying it from those homebrewers or from pharmacies without a prescription (those pharmacies are usually online and overseas) —cocobolobotomy, trans-identified male.

It's just hrt but you buy the medications yourself and figure out the doses and stuff. Kinda like you being your own doctor. I buy estradiol valerate injections and needles/syringes, figure out what i should dose and how often by doing research and reading personal testimonies, and then monitor my hormone levels by taking at home blood tests regularly to see if my levels are within healthy range. —Substantial_Big_2433, trans-identified male.

Why the two sexes differ

DIY is far more common among males seeking estrogen than among females seeking testosterone. The reason is largely legal: testosterone is a controlled substance in most countries (it is an anabolic steroid), so possessing or distributing it without a prescription is a criminal offence. Estrogen is not controlled in the same way. In some jurisdictions it is not even illegal to compound estrogen at home for personal use — only to sell it.

Part of the reason these guides proliferated so much is that it's not actually illegal to synthesize estrogen at home as long as it's for personal use only. Selling it would be a crime, and synthesizing testosterone would be a crime. But just compounding it for personal use is legal —recursive-regret, detrans male.

How common is it?

Precise numbers are hard to pin down, because people are understandably reluctant to admit to an activity that may be illegal. Published estimates vary enormously by location and population:

A 2022 systematic review commissioned by the World Health Organization (Kennedy et al. 2022) searched 3,792 references and found no studies at all meeting criteria for an effectiveness or cost review of self-administered hormones. Only five studies addressed why people do it. The review concluded that "there is limited literature on self-administration of gender-affirming hormone therapy." In other words: this is a widespread practice with essentially no safety evidence base.

A 2022 study of 87 trans-identified males in Japan (Baba 2022) found that 66.7% had self-adjusted their hormone regimen against medical guidance, and that supratherapeutic (excessively high) dosing was common.

## Known risks

DIY hormone use carries two layers of risk. The first layer comes from the hormones themselves. Cross-sex estrogen, testosterone and anti-androgens have known harms even when a doctor prescribes and monitors them. These are covered in depth on the hormones, testosterone in females and estrogen and testosterone blockers in males pages. The second layer is specific to DIY: unknown products, unknown doses, no blood tests, unsafe injecting, legal exposure and no assessment. DIY doesn't replace the first layer of risk with the second. It adds the second on top of the first. This page does not give dosing or medical advice.

Unknowns. Nobody knows how many DIY users suffer serious complications, how many later detransition, or what is actually in the products sold today. The one chemical analysis in the Stanford study covered a single seller's product. People who source hormones outside medicine are invisible to the follow-up studies on which every detransition and safety estimate depends (Cohn 2023). The WHO review could not say whether self-administration is safe, because no one has studied it (Kennedy et al. 2022). Prescribed hormones for young people also rest on low or very low certainty evidence (Miroshnychenko et al. 2025). DIY is an unmonitored version of a treatment whose long-term safety has not been established even under supervision.

What detransitioners report

The table describes risks in the abstract. Detransitioners on /r/detrans describe living through them, including people who got hormones from online services that barely count as medical care. These accounts are self-selected and can't show how common each harm is, but they show what the risks look like when nobody is watching. The critiques of DIY culture are collected in Why people oppose it below.

Hormones from a website, no blood tests.

I started testosterone through one of theses sites, it was super sketchy. There was no preliminary blood work. I met with a nurse on a video call for about 10 minutes and they mailed me the testosterone. —MangoPipeBomb, detrans female

Blood, heart and clotting problems. These are the harms that monitoring exists to catch. In this first account, a doctor caught the problem through routine tests. Someone on DIY would have had no such check.

I developed high blood pressure and high cholesterol while on T to the point where they were considering putting me on medication for it. Gained a ton of weight too. Even years after stopping T my periods are irregular and I often have random aches and pains around my ovaries that I didn't use to before HRT. So no, it is not 100% safe. —snu-snu-tyme, detrans female

Too much Testosterone can thicken your blood, causing clotting issues, blood pressure, and other heart issues… All of this happened to me, and more. Nobody told me any of this was possible, and yet here we are. —PeregrinePanic, detrans female

In addition to huge medical problems I had (3 thrombotic events) the transition destroyed my mind, I was never suicidal until the transition. —SpiritedCat3844, detrans male

Injection accidents and contaminated products.

People could get seriously injured or die from injecting tainted street hrt. I've never done DIY, but I've certainly fucked up a shot and come close to a stay at the hospital. —Slow-Ad-2431, detrans female

I knew a trans woman personally who brewed bathtub estrogen and sold it. I don't think trans-ID'd kids are going to commit mass suicide like TRAs say but they may very well buy hormones online contaminated with god knows what and poison themselves. —Apart_Meringue_6913, detrans female

Some trans-identified people share the same concern about sourcing and hygiene:

I would say the risks don't only come from dosage. Proper hygiene (with needles) and getting medications from trustful sources seems like an actual big risk factor of DIY. —Chloe1779, trans woman (MTF)

Teenagers pushed towards DIY.

I still see that idea around today with some trans people pressuring teens to DIY hormones behind their parents back. I wish I was slowed down by my doctor and had gotten more support instead to being told that I seemed like a straightforward case of having gender dysphoria and benefiting from transitioning. —MangoProud3126, detrans female

I saw a lot of teens DIY it over the internet. I knew someone profoundly mentally ill who got it at 13-14 while actively psychotic, without any real parental permission though (US). —tb3_, questioning own transgender status

Looking back on the DIY "gurus".

i was pretty much convinced that these trans diy gurus were right in "endos are incompetent/old schools and give wrong doses, buy from otokonoko/whatever diy provider" and really started to consider injecting and managing transition all by myself… Now, after medically detransitioning for a year, I'm impacted the amount of bs I was assuming from general hrt regime. These are experimental drugs, do as you wish, but don't buy into anything without thinking it twice because you could do harm much quicker than if you do it with a professional. —Ok-Balance-3379, MTF, currently questioning gender

Taken together, these accounts point to one theme. The harms that worry detransitioners most are not dramatic one-off events. They are slow, silent changes (thicker blood, rising blood pressure, clots, permanent body changes) that nobody was in a position to catch. For many, there was also no point at which anyone asked why they wanted hormones in the first place. See also iatrogenic harm and testosterone cessation.

Why people do it: the trans perspective

Trans-identified people who defend or use DIY hormones are not unaware of the risks. Their argument is that the risks of not taking hormones are worse. The reasons cluster into a few themes.

Waiting lists and gatekeeping

The most common reason given is that official channels are too slow, too expensive, or too restrictive. In the UK, NHS gender clinic waiting lists can stretch to many years. Private clinics are costly and may impose their own screening requirements.

In the UK you'll be waiting maybe 10 years or so for HRT through the NHS. If you're under 18 you can't get it at all and are forced into permanent changes with the wrong puberty. [...] All this is to say, the official channels in many western countries are so poor that they kill people. DIY can save lives in these situations. —Mildly_Opinionated, trans-identified male.

DIY saved my life. I'm not on the waitlist for the gender clinic yet, which is now estimated to be around 20 years in my area, as my doctor refused to even refer me. DIY is cheap, easy to understand, easy to access, safe, and I will not give medical advice. —faithfulservantofbug, trans-identified male.

Distrust of clinicians

Many trans-identified people report that doctors know less about trans hormone regimens than the online community does, prescribe poorly, or are outright hostile.

The main reason why these discussions are held is because practitioners are, more often than not, absolutely not informed on proper trans healthcare or are outright bigots. [...] It is well known within trans communities that usually, the patient is MORE informed than the practitioner when it comes to dosage. —Sashimuu, trans-identified male.

DIY is is potentially safer than normal "official" hormone treatment if you're taking tests and taking the right stuff. Spiro has all kinds of side effects yet endos prescribe them out the wazoo. [...] DIY allows you to take your levels into your own control and alongside tests [...] is a perfectly safe method of HRT. —FarBoat503, trans-identified male.

Bodily autonomy and political fear

A third argument is simply that adults should control their own bodies, and that hostile legislation or a hostile political climate makes official medical records a liability.

I do DIY because I'm an adult that can gauge the risks and make a decision over my own body but state doesn't respect me as such. DIY is the only way I could get HRT and I'm incredibly happy for it, of course I wish I could've simply gotten a doctor's help, but the system doesn't work like that, and I refuse to give up more of my life to jump through arbitrary hoops. —AlyxNotVance, trans-identified male.

There is some truth to "DIY or die". For many people it's hard to receive gender affirming care, add on the long waitlists and the frequency of underdosing and it can be the difference between living and dying. With the current political climate I can only see these things getting more restrictive, and I personally don't want a medical record that outs me to a government that wants me dead. —Slam_Dunk_Kitten, trans-identified male.

Harm reduction

Some trans-identified people argue that since DIY will happen regardless, the responsible thing is to share accurate information rather than drive it underground.

DIY and taking ownership of our healthcare in general helps all of us access and tailor our care to our needs rather than remaining ignorant and placing ourself at risk. The less we talk about it, the worse people are going to be informed. [...] Discussion of DIY even helps those navigating "legitimate" healthcare systems, because it contextualizes dosages and helps you figure out what your levels actually mean. —Cass-not-CAS, trans-identified male.

Not all trans-identified people agree. One commenter on r/MtF pushed back directly on the idea that DIY is risk-free:

DIY hormones is not risk free, especially if you can't have the blood work done alongside it or if you don't feel like you can inform doctors that you are taking it. That doesn't mean you shouldn't do it, because the risk of not taking it can be higher. [...] But I'm uncomfortable with messaging that doing DIY hormones is risk free. The biggest risk might still be the dysphoria of not taking it, but people need to be informed as to the risk. —ottawadeveloper, trans-identified male.

Why people oppose it: the detrans perspective

Detransitioners and desisters (people who stopped identifying as trans before or without medical transition) on r/detrans are overwhelmingly critical of DIY hormones. Their objections are not primarily about legality — they are about what happens when a powerful, body-altering drug is taken without assessment, monitoring, or any check on whether the underlying distress has been properly understood.

Unregulated substances

The most immediate concern is that nobody knows what is in the vial.

this is so dangerous. and it makes me so goddamn sad. you don't know what's in it. it could be laced with anything. reasons for taking it totally aside, it's just a bad idea. anyone ordering meds or recreational drugs online from non-reputable vendors needs to be careful. there's no quality control whatsoever. —neitherdreams, desisted female.

Hormones on the black market will 1000% be cut with something else. If you're lucky it will be something your body can absorb or doesn't have detrimental health effects. If you're not lucky, well… —EricKeldrev, questioning.

This is unfortunately a common thing. It's just another way they prey on children. There used to be a lady who posted on this sub who had used "testosterone" from a drug dealer when she was younger, which turned out to be some kind of cocktail of amphetamines and steroids —WerewolfAtTheWindow, detrans female.

No monitoring

Hormones are not benign. Testosterone thickens the blood (polycythaemia), raises blood pressure, strains the liver, and can cause blood clots. Oral estrogen passes through the liver and carries cardiovascular and thrombotic risks. Without blood tests, none of this is caught.

it's p common knowledge that T can cause polycythemia and can raise bp, cause blood clots, and fuck with the liver and spleen. it's extremely common ime, i also had elevated hematocrit and rbc and if not monitored and managed it can be a real issue and even fatal. dumbass teens thinking hrt is magic and safe bc it's "natural" stuff in the human body or whatever is insane on its own but it does genuinely worry me. —mofu_mofu, detrans female.

There is a reason why people on HRT have to get bloodwork done every couple of months. There is a reason why I had to get bloodwork and a physical done before I started testosterone. You don't know how your body is going to react to those hormones, what potential hidden or underlying issues they will possibly exacerbate, or even what dose is right for your body. I was on way too high of a dose for three months and I'm still feeling the negative effects on my liver and my body - that was under (albeit negligent) doctor supervision, so I can't imagine how DIY HRT would impact the body. —Bladekind, detrans female.

Injection and infection risk

Injectable hormones require sterile technique. Detransitioners describe exactly the failures you would expect when teenagers teach themselves from the internet.

The recommended for these kids to be "Using the "leftover" T in the bottle" first of all DANGER second of all LOL because that's such a scam!!! [...] I just KNOW they be reusing needles too 🤢... All the mistakes that could happen 😞 air bubbles, infection, abscess, HIV 🤢 —feed_me_see_more, detrans female.

When I first started T at 16 it was "homemade HRT". Some older trans man sold me expired T gel sachets for months, and I didn't realise until later 🥲 This whole thing is fcked up* —idkreddituser11, detrans female.

Minors and predatory dynamics

A recurring and heated theme on r/detrans is that DIY information is circulated to children, often by adults who position themselves as community elders.

In NSFW online MTF/femboy spaces yeah. There is a whole directory of how to get grey market hormones called the diy HRT directory, passed around to minors. —BosnianSerb31, detrans male.

There's quite a seedy and underground allure attached to DIY HRT. It's almost seen as a badge of honour to be doing DIY. It's pushed by a lot of the self appointed "trans mothers" who have assumed an "elder" role within the community [...] They get off on being "in charge" and looked to for advice and knowledge, they love the power they have over the inexperienced young ones. —Hedera_Thorn, detrans male.

can you fucking imagine labs instructing diabetic patients to diy their insuline?? Asthmatic patients to DIY their ventoline? Can you imagine fucking teens seeing this and following it up, injecting themselves with god knows what, because a creep on the internet instructed them to go all Walter White on this shit? —Beneficial_Tie_4311, detrans female.

The deeper objection: DIY removes the last chance to think

Perhaps the most important detransition argument is not about pharmacology at all. Assessment — even imperfect assessment — is the one point at which someone might ask why you want this, and whether something else is going on. DIY removes that entirely. Several detransitioners describe how the urgency of transition shut down their own capacity to question.

Let's be honest... they would if they could. I would have. When I identified trans I'd have stopped at nothing to gain access to every form of treatment available as soon as it was available. I was a teenager and I knew what I wanted and I wanted it now 🙄 Part of being trans is a hyper-awareness of an ever ticking clock pushing your body away in the opposite direction to where you want it to go. It can fully override the processes for considered and rational contemplation. There's no time to consider that you might be wrong! —cagedbunny83, detrans male.

I did try seeking therapy but I was always met with the excuse that they basically didn't know how to deal with trans identifying children, and that my gender dysphoria was as they put it "Like sending an abused child back to their abusive household" as in my own body being that "abusive household" and only transition will "save" me. I'm still seeking appropriate therapy to this very day after years of transition and a year into my detransition lol —idkreddituser11, detrans female.

It's easy to say that you don't care about the health consequences now but just a few years down the line you might regret that. If you're set on doing hrt at least wait until you can have a doctor prescribe it to you and monitor your hormone levels. You can really fuck yourself up with diy. Remember that you will be in this body for the rest of your life, value yourself enough to not harm it. —cedle, detrans female.

The other end of the pipeline: when prescribed care is no better

It would be dishonest to present DIY as the only problem. Many detransitioners describe obtaining hormones through official channels with almost no assessment either. The failure is not confined to the black market.

I initially got hormones this way. One 30 minute meeting with an NP and a self administered blood pressure test and I had a full dose of hormones for a year. I didn't even have to talk about being trans. The meeting was just to determine how fast I wanted to transition. —Duchess_Rabbit, detrans female.

That is probably the worst story I have heard, and I got it after a 30 minute walk in appointment. [...] Sadly, the trans community lies about how hard it is to get hormones, because they have to perpetuate the appearance of victimhood to make their brand work. It gives us the false feeling that we somehow got lucky when what we actually just got was medical malpractice. —UniquelyDefined, detrans male.

I've been wanting to make a post like this for awhile, my process getting on t was WAYYY too easy. I'm not sure about you but I got no info or instructions about injecting, discarding needles, or side effects. I definitely never had my "t levels checked". Super bizarre that a life changing hormone can be so unregulated. —riverspiritscorpio, detrans female.

informed consent is bullshit, they don't explain the negative effects that injecting a body with the opposite sex's hormones comes with. and i send my sympathies to you as an adult who went through this, but as a teenager who also went through informed consent it's so messed up. i signed off on a paper that stated that these were experimental drugs and had no long term research at THIRTEEN. —shloogmo, detrans female.

This matters for how we think about DIY. If the official route can hand out a year of hormones after a single 30-minute appointment, the difference between "prescribed" and "DIY" is sometimes smaller than it appears. The real variable is not the paperwork — it is whether anyone has done the work of understanding what is actually driving the distress.

What the evidence shows

There is almost no safety evidence

The WHO-commissioned systematic review (Kennedy et al. 2022) is the most authoritative source on self-administered hormones. Its findings are stark:

• Zero studies met the criteria for the effectiveness review.
• Zero studies met the criteria for the cost review.
• Only five studies addressed values and preferences — all about unprescribed hormones, none about self-administration of prescribed hormones within a supportive health system.
• The reasons people self-medicate were: difficulty finding knowledgeable and non-stigmatising health workers, lack of access, cost, discomfort with health workers, and desire for a faster transition.

The review explicitly notes that "there may be better ways to support individuals to safely and effectively self-administer gender-affirming hormones" — but it could not say what those ways are, because the evidence does not exist.

Black-market drugs are genuinely unreliable

A WHO bulletin cited in reporting on this topic found that in 2010, more than half of all treatments from illicit websites — not only hormones — were counterfeit. A 2024 Stanford netnographic study (an ethnography of online communities) of DIY-HRT communities (Uttmark 2024) included chemical analysis of estradiol valerate tablets obtained from a DIY seller, and found that while communities develop sophisticated "harm reduction" practices, "concerns about the safety and purity of DIY-obtained medications persisted."

Even supervised hormones are poorly evidenced

It is worth noting that the evidence base for prescribed cross-sex hormones is also weak. A 2025 systematic review and meta-analysis (Miroshnychenko et al. 2025) of 24 studies of gender-affirming hormone therapy in under-26s found the certainty of evidence for gender dysphoria, global function, depression, and bone mineral density to be low to very low, concluding that "we cannot exclude the possibility of benefit or harm." The Cass Review 2024 reached similar conclusions about the weakness of the evidence base.

This does not make DIY safer. It means that DIY is an unregulated version of an already under-researched intervention.

Detransition rates are unknown

A 2023 paper by Cohn 2023 argues that reliable rates of detransition, regret, and discontinuation are simply unknown, because existing studies have short follow-up periods, high loss to follow-up, and non-representative samples. A 2024 systematic review by Feigerlova 2025 found hormone discontinuation rates of 1.6–9.8% across studies but rated the overall certainty as very low. A UK cohort study (Hall et al. 2021) found a 6.9% detransition rate — "notably higher than previously reported" — and noted that only 24% of detransitioners inform their clinicians, so official figures are undercounts.

None of these studies capture DIY users at all. People who source hormones outside the medical system are, almost by definition, invisible to follow-up research.

The core disagreement

The two sides are not really arguing about pharmacology. They are arguing about what a hormone prescription is.

Both sides agree on one thing: the current system is failing. They disagree completely about which direction the failure runs.

Questions worth sitting with

If you are considering DIY hormones, or you know someone who is, these are the questions detransitioners and clinicians alike would want you to answer honestly first.

• What specifically do I expect the hormones to fix? Not "everything" — what particular feeling, situation, or feature of your life? Write it down.
• What else could be driving this? Trauma, depression, anxiety, autism, OCD, an eating disorder, internalised homophobia or misogyny, discomfort with gender roles, sexual trauma. These are extremely common in the histories of people who later detransition. See the page on gender dysphoria for more.
• Am I in a state of urgency? The feeling that there is no time to think is itself a warning sign. As one detransitioner put it, the "ever ticking clock" can "fully override the processes for considered and rational contemplation."
• Who benefits if I do this? Is anyone — a community, a partner, an online "elder" — invested in me starting hormones?
• What would I do if I wanted to stop? Some effects of testosterone (voice deepening, facial hair) and some effects of estrogen (breast growth) are permanent. What is my plan if this turns out to be wrong?
• Have I actually talked to someone whose job is to ask hard questions? Not an affirming therapist who will sign a letter, but someone who will explore what is underneath.

If you are already on DIY hormones

This page does not give medical advice, and nothing here should substitute for it. But a few things are worth knowing:

• Tell a doctor. Even if you will not stop, a GP (family doctor) can run blood tests and monitor your liver, blood count, and cardiovascular risk. Many people on DIY hormones never tell any clinician, which means complications go undetected.
• Do not stop abruptly without advice. Hormones affect the endocrine system, and sudden cessation can cause significant physical and psychological effects. A clinician can help you taper safely.
• Be honest with yourself about why you started. If the reasons have changed, or if the hormones have not fixed what you hoped they would, that is worth paying attention to — not suppressing.
• There is support. The support directory lists gender-exploratory therapists and detransition support groups. You do not have to have decided anything to talk to someone.

Related pages

• Gender dysphoria — what the diagnosis means, how it evolved, and whether it is real
• Puberty blockers — the evidence for the drugs often taken before or alongside hormones
• Detransition — what it means, why people do it, and what comes after
• Born in the wrong body — the theory that underlies much of the urgency to transition
• Support directory — gender-exploratory therapy and detrans support groups

References

• Kennedy, C.E. et al. (2022). Self-administration of gender-affirming hormones: a systematic review of effectiveness, cost, and values and preferences of end-users and health workers. Sexual and Reproductive Health Matters, 29(3). source.
• Baba, T. et al. (2022). Self-administration of gender-affirming hormones and supratherapeutic dosing are relatively common in Japanese transgender women. Journal of Obstetrics and Gynaecology Research, 48(8). source.
• Uttmark, G. (2024). DIY-HRT: Do-It-Yourself Hormone Therapy, Online Community, and Grey-market Drugs. Master's thesis, Stanford University. source.
• Miroshnychenko, A. et al. (2025). Gender affirming hormone therapy for individuals with gender dysphoria aged <26 years: a systematic review and meta-analysis. Archives of Disease in Childhood. study page, source.
• Cohn, J. (2023). The Detransition Rate Is Unknown. Archives of Sexual Behavior. study page, source.
• Feigerlova, E. (2025). Prevalence of detransition in persons seeking gender-affirming hormonal treatments: a systematic review. Journal of Sexual Medicine. study page, source.
• Hall, R., Mitchell, L. & Sachdeva, J. (2021). Access to care and frequency of detransition among a cohort discharged by a UK national adult gender identity clinic. BJPsych Open. study page, source.
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• Madsen, M.C. et al. (2021). Erythrocytosis in a Large Cohort of Trans Men Using Testosterone: A Long-Term Follow-Up Study on Prevalence, Determinants, and Exposure Years. Journal of Clinical Endocrinology & Metabolism, 106(6). source.
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• Fenway Health. Transgender Health Injection Guide. source.
• Hormone replacement therapy injections and harm reduction: practices, difficulties, and transgender people's health in France (2022). Santé Publique, 34(HS2). source.
• KFF Health News. Unsterilized Hormone Needles, Unsafe Sex Spread HIV Through Transgender Community. source.
• Testosterone Enanthate Regulatory Status: US, EU, Canada, and UK. source.
• GenderGP. Spironolactone for Gender-Affirming HRT: Uses, Dosage & Side Effects. source.
• Do No Harm (2026). The Lack of Barriers to Minors Ordering Cross-Sex Hormones Online (press release). source.
• Littman, L. (2021). Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners. Archives of Sexual Behavior. study page, source.
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