@modernwellnessclinic's TRT claims need more context

What did @modernwellnessclinic actually say?

The creator walked through a subcutaneous-adjacent intramuscular glute injection of testosterone, start to finish, in front of 419,000 viewers. The key procedural claims were: use an 18-gauge needle to draw oil-based testosterone, swap to a 25-gauge 1-inch needle to inject, target the upper outer gluteal quadrant using a visual "L trick," aspirate before injecting, and treat an air bubble in the syringe as confirmation you're in muscle. They also said that pulling back blood means you've "gone through a little vein" and that it "won't hurt you."

This is direct patient instruction for a prescription medication, delivered without any visible clinical context, patient history, or informed consent framing. The creator ends with a product call to action: "Click the link in my bio and subscribe to order your testosterone." That last sentence is doing a lot of work.

Does the science back this up?

The injection mechanics are partially correct, but two specific claims contradict decades of established nursing and pharmacy literature. The aspiration guidance is the biggest problem here.

The 18-gauge draw, 25-gauge inject needle swap is standard practice and well-supported. Oil-based testosterone esters like cypionate and enanthate have viscosities that make drawing through a smaller gauge slow and potentially disruptive to the preparation. Needle-swap protocols are endorsed by clinical compounding and injection technique guidelines.

The glute localization using the ventrogluteal or dorsogluteal region is also sound in principle. The "L trick" the creator describes maps roughly to the dorsogluteal site, though the ventrogluteal site (iliac crest, anterior superior iliac spine landmark) is now preferred by most injection technique literature because it avoids the superior gluteal nerve and artery. Wynaden et al. (2005, Journal of Advanced Nursing) found the ventrogluteal site had significantly fewer complications than dorsogluteal in adults.

The aspiration claim, however, is where the science diverges sharply from what the creator says.

What did they get wrong (or right)?

The aspiration claim is wrong, and it matters. The creator says "you'll see an air bubble in the needle, that means you're in the muscle." This is not how aspiration works. An air bubble displaced in the syringe barrel indicates nothing clinically useful about vessel placement. What you're actually looking for during aspiration is blood in the syringe, not air movement.

More importantly, the World Health Organization's 2015 injection safety guidelines explicitly recommend against aspiration for intramuscular injections in most anatomical sites because the gluteal region's vessels are not large enough to produce meaningful aspiration returns, and forced aspiration increases tissue trauma. The CDC and most current nursing protocols have moved away from routine aspiration. Cocoman and Murray (2008, Journal of Clinical Nursing) reviewed the evidence and concluded aspiration before IM injection is not supported by evidence for most sites.

What the creator got right: needle gauge swap, letting alcohol dry before injection, the general anatomical region, and the practical guidance on what to do if you aspirate blood (change the needle, restart). That last point is accurate.

What should you actually know?

If you are self-administering testosterone under physician supervision, a few things this video omits are worth knowing. First, the ventrogluteal site now has stronger evidence behind it than the dorsogluteal approach the creator demonstrates. Second, 25-gauge 1-inch may be insufficient depth for individuals with higher body fat, where a 1.5-inch needle is often prescribed instead. Needle length should be determined by a clinician based on your anatomy, not a TikTok default.

Third, the aspiration guidance in this video is outdated. Following it as described will not confirm intramuscular placement. Current clinical guidance says inject slowly, use correct landmarks, and avoid large vessels by using established anatomical reference points rather than relying on aspiration.

Finally, testosterone is a Schedule III controlled substance in the United States. Ordering it via a bio link without a valid prescriber relationship and proper lab evaluation is illegal and potentially unsafe. Any platform offering testosterone without documented hypogonadism diagnosis (typically two morning total testosterone measurements below 300 ng/dL per the American Urological Association 2018 guidelines) is operating outside standard of care.