DIY HRT (Trans Female)
What Is DIY HRT?
DIY (Do-It-Yourself) HRT means obtaining and administering feminising hormones without a prescription or direct medical supervision. This typically involves:
- Ordering medications from online pharmacies or homebrew suppliers
- Self-determining dosage based on community knowledge and published guidelines
- Self-monitoring via private blood tests
- Managing side effects and dose adjustments independently
Why People Choose DIY HRT
| Reason | Explanation |
|---|---|
| Waiting lists | Prescribed care can take years to access in many countries |
| Gatekeeping | Some providers impose unnecessary barriers or have outdated views |
| Cost | Private care can be prohibitively expensive; DIY is often cheaper |
| Control | Full control over your regimen, dosing, and choice of medications |
| Stealth | Avoids having a formal diagnosis on medical records |
| Access | Injectable estradiol or specific anti-androgens may not be available locally |
Common DIY Medications
| Medication | Typical Dose | Notes |
|---|---|---|
| Estradiol valerate (injectable) | 2–8 mg every 5 days | Most common DIY injectable |
| Estradiol enanthate (injectable) | 3–8 mg every 7 days | Longer half-life than EV |
| Estradiol cypionate (injectable) | 1–5 mg every 7 days | Longer half-life than EV; lower dosing needed |
| Estradiol hemihydrate (pills) | 2–8 mg/day (sublingual preferred) | Bioidentical estradiol |
| Estradiol gel | 1–4 mg/day (2–8 pumps) | Transdermal, steady levels |
| Bicalutamide | 25–50 mg/day | Androgen receptor blocker |
| Cyproterone acetate | 10–12.5 mg/day | Testosterone production suppressor |
| Progesterone (micronised) | 100–200 mg/day (oral or rectal) | Optional, for breast maturation |
Risks of DIY HRT
| Risk | Details | Mitigation |
|---|---|---|
| No medical oversight | No professional to catch issues early | Regular blood tests (every 3 months min) |
| Variable product quality | Risk of under/over-dosed or counterfeit products | Use trusted, verified sources |
| Incorrect dosing | Too high = increased risk; too low = no results | Follow established guidelines; test levels |
| Blood clot risk (VTE) | Particularly with oral estrogen at high doses | Use transdermal/injectable; avoid smoking |
| Legal consequences | Importing prescription meds may be illegal | Know your country's laws |
| No fertility preservation | Many don't consider this before starting | Bank sperm before starting if desired |
| Contamination (homebrew) | Homebrew injectables carry infection risk | Use sterile technique; buy from reputable brewers |
Requirements for Safe DIY HRT
Minimum requirements for DIY HRT
- Blood tests every 3 months — at minimum E2, T, SHBG, CBC, metabolic panel
- Validated sources — from the community-vetted vendor list (see Sources section)
- Dose education — understand starting doses, adjustment principles, and target ranges
- Emergency awareness — know the signs of DVT, pulmonary embolism, stroke, and meningioma
- Backup plan — have a plan for if you need to stop or switch to prescribed care
Recommended but not strictly required
- Baseline blood test before starting HRT (to establish your natural levels)
- Blood pressure monitor at home
- Knowledge of your family medical history (clotting disorders, breast cancer, etc.)
- A supportive GP or clinic you can access in an emergency
Cost Comparison: DIY vs Prescribed
| Item | DIY Cost Range | Prescribed Cost Range |
|---|---|---|
| Estradiol (monthly) | $5–30 | $10–60 (may be covered by insurance) |
| Anti-androgen (monthly) | $5–25 | $10–50 |
| Blood tests (per test) | $40–150 (private) | $0–50 (with insurance/GP referral) |
| Shipping | $5–15 | N/A |
| Clinic visits | N/A | $50–300 per visit (without insurance) |
Resources for DIY HRT
- Dosage guides — See the Dosing section of this wiki
- Source validation — See the Sources section for trusted vendors
- Blood test guides — See Blood Testing for how to order your own labs
- Community support — See the Community section for forums and Discord servers
References
UCSF Transgender Care. Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People. https://transcare.ucsf.edu/guidelines
WPATH (2022). Standards of Care, Version 8. https://www.tandfonline.com/doi/full/10.1080/26895269.2022.2100644