Dealing with a Fear of Needles
By: Peter Buggert | Last Reviewed: 10/12/19 Last Updated: 10/12/19
The fear of needles is extremely common with an estimated 10% of Americans suffering from it to a varying degree. In its most severe form it can prevent people from getting potentially life saving vaccines and blood tests, even from seeking medical care altogether. Most people never have to inject themselves, but FtM people are quite unlucky as the best way to get testosterone into the body at reliable levels is by injection. It is also by far the cheapest, easiest to get, and least likely to affect those around you.
I had a severe fear of needles before starting testosterone. I would come into the doctors pale and shaking and if I opened my eyes and looked while they where injecting or drawing blood I would get sick and light headed. Now, after well over a year of weekly injections, things have gotten much better. I still don’t do very well at the doctors, but when I am injecting myself I don’t feel any fear or anxiety. These are my pointers for getting over your needle fear in order to inject yourself.
- If your fear is severe, consider seeing a therapist. Many people with a fear of needles would not classify it as severe, but if you would classify your fear as severe then it may be a wise choice to see a therapist. If you are already seeing a therapist (as most people need a letter from a therapist to start hormones) then it is worth bringing up. When people’s fear of needles is stopping them from transitioning or getting other medical treatment that is severe and needs to be taken care of.
- Evaluate your fear. What exactly is it that you are afraid of? You could be afraid of the doctor and not actually needles. You could be afraid of blood, but there is very little blood when injecting. You could be afraid of having your blood drawn which is not what you are doing. If you are afraid of pain there are ways to minimize it until you feel nothing more than a mosquito bite.
- Calm down. Just take a deep breath and try to relax a little bit. You are not in danger, this will only hurt a little for a short amount of time and then you will be done. Take some deep breaths and just chill for a little bit until you calm down.
- Don’t do your first few injections yourself. Many people say that their doctor has given them their first injection in order to better instruct them on how to do it as well as make sure you know what it should feel like when done correctly. I was lucky enough to have a nurse for a mom, so she gave me my first few injections. If you can find a friend or family member who can do it safely for you, that is best for the first few times. You will eventually have to learn to do it yourself, but these first few times it will be very new and scary, in the future it will become routine and not phase you any more than taking a pill.
- Remind yourself that your fear is illogical. There is nothing inside of that needle that will hurt you. Being injected is a very small amount of pain and it only lasts for a few seconds. There is very little blood. When done correctly there is very little chance of anything bad happening. Especially if you are injecting subcutaneously.
- Put numb the area. Holding an ice cube over the area that you are about to inject will numb it if pain is something you are worried about. You can also buy numbing creams online. This will only numb your skin and possibly a little below it, but it can be better than nothing. Before you inject always wipe the area with an alcohol wipe, you don’t want any of the bacteria from the ice or the numbing cream getting into your body.
- Sit someplace safe. If you are worried about passing out make sure you sit in a position that prevents you from falling and hurting yourself. Unless you are leaning back a ways, despite common belief, when you faint you are going to fall forward. This can mean sitting on a clean floor or bed with you injection supplies on a sanitary surface, leaning back in a recliner, or having an armchair with a table in front of you so you can’t fall.
- Have a comfort object (or pet) nearby. When I was doing my first few injections and nearly passing out, I trained my assistance dog to lay with me while I did it and then cuddle with me after. This grounded me and helped calm me down.
- Just get used to it. I know it probably seems impossible, but after some time you will just get used to it. Some people with different medical conditions have to give themselves multiple injections per day. You can get used to one little shot every/every-other week. Sure the first few times may be rough, but slowly it will become a mundane activity.
If you are worried about passing out you can also see this PDF for an exercise to increase blood flow to the brain and decrease the risk of passing out, and for further advice on managing your fear of needles.
Seek Other Methods
Injection is the most popular method for a good reason, but if you are really not able to do it there are other options out there.
First of all there are two distinct methods for injecting testosterone, intramuscular and subcutaneous. Intramuscular, as the name suggests, goes into the muscle which usually means a bigger needle, more pain, more fear, and a bigger risk of hitting something you shouldn’t. For years it was thought that you could only inject testosterone into the muscle, but recent studies have found that it is just effective and much less risky to inject subcutaneously. Subcutaneous injections go under your skin and into the layer of fat below. The needle is much smaller, there is less pain, it is easier to do, and you are much less likely to hit an organ, blood vessel, or nerve because they rarely exist in the fat and around subcue injection sites. If you are currently doing your injections into the muscle, it is worth having the conversation about switching.
There are also methods that don’t involve needles at all. There are gels and foams that will absorb through your skin as well as patches. Recently companies have started selling tabs that go in the mouth and testosterone is absorbed through the gums. There is also the option of having these sort of capsules implanted into your tissue every six months to slowly release testosterone.
One of the most common methods that therapists use to help people get over phobias is to slowly introduce them to the thing that they are scared of using exposure therapy. Usually when you are exposed to a needle it is very quickly and you have no control. By controlling your exposure and taking it in slow easy steps you may be able to overcome your fear.
- Get an extra needle and syringe. Usually when you get needles and syringes with your testosterone they give you way more than you need. You can also ask your doctor if they have one that you can practice with before you get your testosterone, or if they give the the exact number you need ask the pharmacist for an extra one. They probably wont question it and just give it to you, but if they do just tell the truth and they will probably oblige.
- Wipe your skin with an alcohol wipe. Just the feeling of being wiped with a cold alcohol wipe is enough to cause anxiety for some people. By just wiping yourself with alcohol wipes (which are very cheap especially if bought in bulk) you are slowly going to get used to them and take down one little part of your fear.
- Get to know the syringe. There’s nothing scary about a syringe without a needle right? You literally cannot hurt yourself with it. Do whatever you want with it, hold it, move the plunger up and down, draw up some water and squirt it back out. Do this for a few days until you don’t feel any anxiety about it and it becomes mundane. Even if you feel fine immediately give it a few days. DO NOT use this syringe for an actual injection as it is now contaminated. Keep this someplace safe as your practice syringe.
- Get to know the needle. These are objects you usually have only encountered when someone else is manipulating them. In your brain they are tied to fear and pain. Take a needle and syringe and just allow yourself to touch them and hold them, maybe even draw up some water and squirt it back out. Stab a teddy bear, feel how thin and small the needle really is (but please be careful and don’t hurt yourself). Just let yourself handle them until they stop bringing you anxiety. Do this a few times over at least a few days. DO NOT inject yourself using this needle and syringe as they are now contaminated. You should only inject with sterile needles and syringes you just took out of their individual packages. Keep these in a safe place as your practice needle and syringe.
- Draw up some olive oil. Testosterone is very very thick, it has the consistency and color of olive oil. Draw up some olive oil and push it back out again just to get used to what it feels and looks like. For the love of god do not inject yourself with olive oil.
- Practice swings. Keeping the cap on your unsanitary needle so that you cannot actually stab yourself, pretend to inject yourself. Injecting hurts less if you insert the needles quickly. If you go fast enough (but not to fast) you body doesn’t really have time to notice this tiny needle entering your skin. Stabbing ourselves and purposely causing pain goes against our natural instincts. You will have to learn to overcome them and practice swings are a great way to do that. Taking a few practice swings with the cap on before doing an actual injection can also be helpful.
- Watch other people be injected. There are thousands of videos out there of people giving and receiving injections for educational purposes. In fact it is rather easy to find videos of FtM people doing their testosterone injections. Watching videos will just get you one step closer to realizing that injections are nothing to fear and expose you to them.
- Get injected. Have someone that knows how to properly do an injection inject you. Don’t watch them do it the first time just breath and let it happen. Eventually you will need to learn to do injections on your own, but for most people there isn’t a rush to get there. Next you can watch them do it, then help, then do it on your own.
Sources and Resources for More Information:
American Psychiatric Association (APA). (n.d.). What Is Exposure Therapy? Retrieved July 25, 2019, from https://www.apa.org/ptsd-guideline/patients-and-families/exposure-therapy
Anxiety UK. (2010). Injection Phobia and Needle Phobia: A Brief Guide[Pamphlet]. Manchester, UK: Anxiety UK. https://www.cnwl.nhs.uk/wp-content/uploads/Needle-Phobia-Booklet.pdf
Guy’s and St Thomas’ NHS Foundation Trust. (2017, October). Overcoming your needle phobia (fear of needles)[PDF]. National Health Service (NHS). https://www.guysandstthomas.nhs.uk/resources/patient-information/all-patients/overcoming-your-fear-of-needles.pdf