This TikTok's TRT injection guide needs a reality check

What did @harleymeds.com actually say?

The creator walked viewers through locating the upper outer quadrant of the glute for intramuscular testosterone injections. The method: thumb on the hip bone, fingers rotated back to grab the glute, inject underneath that area. They called it the "upper outer quadrant" and also referred to it as the "ventral glute," which is actually a separate site. The video ends with a pitch for their clinic.

To be fair, the physical landmark technique they described, anchoring from the iliac crest and moving outward, is a real and commonly taught approach. But the video conflates two different injection sites and leaves out safety information that matters when you're sticking a needle into your body. More on that below.

Does the science back this up?

Partially, yes. The upper outer quadrant of the gluteus maximus is a long-established intramuscular injection site, taught in nursing and medical training for decades. A 2015 review by Ogston-Tuck in the British Journal of Nursing confirmed it as acceptable for IM injections, though it noted the ventrogluteal site, which is genuinely different from what the creator described, is now preferred in clinical practice due to lower complication rates.

The landmark technique using the posterior superior iliac spine and greater trochanter as reference points is legitimate. However, research by Wynaden et al. (2006, International Journal of Mental Health Nursing) found that self-injection technique errors are common, and videos that skip depth, angle, and aspiration guidance contribute to that problem. A 2021 paper by Cook and Collins in the Journal of Clinical Nursing noted that ventrogluteal injection has a lower risk of hitting the sciatic nerve compared to dorsogluteal, which is the site the creator actually demonstrated.

What did they get wrong, or right?

Here is where it gets specific. The creator uses "upper outer quadrant of your glute" and "ventral glute" interchangeably. These are not the same thing. The dorsogluteal site, which is the upper outer quadrant of the gluteus maximus, carries a non-trivial risk of sciatic nerve injury if the landmarks are off. The ventrogluteal site, located over the gluteus medius and minimus, is a different location entirely and is what most current clinical guidelines actually recommend.

What they got right: the general principle of avoiding the medial and lower portions of the glute is correct. Using a body landmark rather than just eyeballing it is the right approach. And for someone already on TRT who has been coached by a provider, this video is a reasonable reminder, not a replacement for proper training.

What they got wrong: the terminology mix-up is not minor. Someone new to injections who follows this and hits the wrong spot could genuinely cause nerve damage. The video also skips injection angle, needle length guidance beyond "inch," and what to do if you aspirate blood.

What should you actually know?

If you are self-injecting testosterone cypionate at home, here is what this video does not cover but your provider should have told you.

• The ventrogluteal site, not the dorsogluteal, is the current preferred site in most nursing and pharmacy guidelines because it is farther from the sciatic nerve and major blood vessels.
• Needle length for IM glute injections is typically 1 to 1.5 inches depending on body composition. "An inch" is not a universal answer.
• Injection angle should be 90 degrees to the skin surface for IM administration.
• Rotating sites matters. Repeated injection into the same location causes lipohypertrophy and can affect absorption of your testosterone dose over time.
• Any self-injection protocol should be taught by a licensed provider, not learned from a TikTok video posted by a clinic with a financial interest in recruiting patients.

The clinical guidance here is not complicated, but it requires specificity the creator did not provide. The landmark technique shown is a starting point, not a complete protocol.