@tikdoctony's testosterone injection technique, fact-checked

What did @tikdoctony actually say?

Dr. Tony made three core claims: inserting the needle quickly reduces pain because it limits nerve exposure time, injecting slowly into fat is less painful than muscle injections, and subcutaneous (fat) injections produce testosterone levels equivalent to intramuscular ones. He also closed with the reminder that "T is not a requirement to transition." These are specific, testable claims, and they deserve a closer look than most TikTok injection tutorials get.

The advice is framed as clinical wisdom from a practicing physician, which raises the stakes. If he's right, this is genuinely useful harm-reduction information for the millions of people self-administering testosterone. If he's wrong, or even partially wrong, people are modifying their injection technique based on a 60-second video.

Does the science back this up?

Mostly, yes, though not completely. The fast-insertion principle has real support. Research on needle insertion technique consistently finds that slower skin penetration activates more cutaneous nociceptors, which are the nerve endings that register sharp pain. A faster insertion passes through the dermis more quickly, reducing that activation window. This is why trained phlebotomists are taught not to hesitate at the skin surface.

The subcutaneous versus intramuscular equivalence claim is where things get more nuanced. Shah et al. (2019, Journal of the Endocrine Society) studied subcutaneous testosterone cypionate in hypogonadal men and found serum testosterone levels were comparable to intramuscular delivery, with potentially more stable trough levels. Olson et al. (2014, LGBT Health) found similar results in transgender men using subcutaneous injections. So the claim has backing, though "doesn't give you any better levels" is a simplification of a more complicated pharmacokinetic picture.

What did they get wrong (or right)?

He got the fast-insertion principle right. That part is well-supported and routinely taught in clinical injection training. Credit where it's due.

The subcutaneous equivalence claim is mostly right but oversimplified. The evidence supports subQ as a viable, effective route, but individual variability in absorption is real. Body composition, injection site, and volume all affect how reliably subQ delivers consistent levels. Telling a broad audience "it doesn't give you any better levels" glosses over the fact that some individuals do experience more variable levels subQ, which matters for mood stability and efficacy monitoring. Your endocrinologist or prescribing provider should be the one deciding your route, not a TikTok tutorial.

The claim that "muscle hurts" universally also deserves pushback. Many patients tolerate IM injections well, particularly with proper technique into the ventrogluteal site, which has less nerve density than the thigh. Framing IM as categorically more painful isn't accurate for everyone.

What should you actually know?

If you're self-administering testosterone, technique matters more than most people realize. A few evidence-based points worth knowing:

• Fast needle insertion through skin reduces activation of cutaneous pain receptors. This is consistent with standard injection training guidelines from organizations like the CDC and WHO.
• Slow injection of the medication itself is also correct. Rapid bolus injection into muscle causes localized pressure and can trigger pain and muscle spasm.
• Subcutaneous testosterone is a legitimate, clinically studied route, but it is not universally interchangeable with IM for every patient. Shah et al. (2019) and Olson et al. (2014) support its use, but your provider needs to assess your specific situation.
• The abdomen and thigh are common subQ sites, but fat depth varies significantly between individuals. A site that works well for one person may not give consistent absorption for another.
• "T is not a requirement to transition" is accurate and worth saying. Testosterone is one option among many in gender-affirming care, and its use should be a fully informed, autonomous decision made with qualified medical support.

Bottom line: should you change your technique based on this video?

The fast-insertion, slow-injection advice is sound and backed by basic injection science. The subQ route is legitimate and studied, not fringe. But the framing that subQ is simply better or less painful for everyone, and that IM offers no advantages, is too broad. Some patients have clinical reasons to use IM. Some have body compositions that make consistent subQ absorption harder to achieve. This video is a reasonable starting point for a conversation with your prescribing provider, not a replacement for one. If you're adjusting your injection site or technique based on social media content, loop in whoever manages your testosterone prescription first.