Does testosterone gel really cause slower changes than injections?

What did @blakanakin actually say?

The core claim here is that testosterone gel produces slower physical changes than injections, specifically referencing "bottom growth" and "mass" development. To their credit, they walked it back significantly: "if you have the right dosage, it'll probably work the same way as the shot." They also admitted they've only ever been on injections and were partly repeating what a prescriber told them. That context matters a lot.

The original framing was clumsy, and this video is damage control. But the underlying idea, that gel is frequently dosed more conservatively and often results in slower changes in practice, isn't entirely wrong. It's just not the whole picture, and conflating dosing strategy with the inherent capability of the delivery method created real confusion for viewers.

Does the science back this up?

Partially. When testosterone levels are matched, gel and injections produce comparable androgenic effects. That's the key phrase: when levels are matched. The problem is they often aren't matched in practice, especially in the early stages of feminizing or masculinizing HRT.

A 2010 study by Bhasin et al. in the Journal of Clinical Endocrinology and Metabolism found that transdermal testosterone achieved similar serum testosterone levels and comparable effects on lean body mass and sexual function when dosed appropriately. The catch is absorption variability. Gel absorption can range dramatically between individuals based on skin thickness, body fat distribution, application site, and sweating. Spratt et al. (2006, Journal of Clinical Endocrinology and Metabolism) documented up to 30-fold variation in serum testosterone levels from identical gel doses across different patients. Injections, by contrast, deliver a more predictable pharmacokinetic curve. So a prescriber nervous about overshooting might start gel patients at a conservative dose, which would absolutely produce slower changes. That's a clinical decision, not a property of gel itself.

What did they get wrong (or right)?

They got the mechanism wrong but stumbled onto a real-world pattern that has some basis in clinical practice. Saying gel "doesn't grow your body" the same way implies a pharmacological difference that doesn't hold up when serum levels are equivalent. That framing was inaccurate and they should own that more directly than they did.

What they got right: prescribers do sometimes dose gel more conservatively, and anecdotal reports of slower changes on gel are common enough in trans masculine communities that dismissing them entirely would be intellectually dishonest. A 2021 retrospective analysis by Cocchetti et al. in the Journal of Sexual Medicine found that trans men on gel formulations took longer on average to reach target testosterone ranges compared to those on injectable esters, partly due to dose titration practices.

The mention of "genetic history of good skin absorbency" is not a recognized clinical concept in this form, but it gestures at real interindividual variability in transdermal absorption, which is documented. Imprecise, but not fabricated.

What should you actually know?

If you're considering testosterone therapy and weighing delivery methods, here's what actually matters. Gel, injections, pellets, and patches can all achieve therapeutic testosterone levels. The delivery method is less important than whether your serum levels are being monitored and adjusted to your target range.

The reason gel gets a reputation for slower results is likely a combination of two things: conservative initial dosing by prescribers managing absorption unpredictability, and genuine variability in how well individuals absorb transdermal formulations. Neither of these is a fixed limitation of gel as a category. If you're on gel and not seeing expected results, the right conversation is with your prescriber about your lab values, not switching delivery methods based on TikTok.

Bottom growth, which in trans masculine HRT refers to clitoral hypertrophy driven by androgenic stimulation, is primarily a function of sustained testosterone exposure above a threshold. Monstrey et al. and other researchers in gender-affirming surgery literature have noted that outcomes vary significantly by individual and are not reliably tied to delivery method when serum levels are controlled. Anyone telling you categorically that gel won't produce bottom growth is overstating the evidence.

Should you take medical advice from this video?

No, and to their credit, they said exactly that. "Please consult your doctor because I'm not the one to ask." That's the right call. This video is a community member sharing personal experience and second-hand information from their prescriber. It's not clinical guidance, and it shouldn't function as a substitute for one. The problem is that on TikTok, even well-intentioned corrections spread as fast as the original claim, and both can shape decisions people make before they ever see a provider. FormBlends recommends discussing delivery method selection with a licensed clinician who can review your individual labs, absorption profile, and treatment goals.