Injections, Patches, Gels, Pills… Which HRT Type Is Right for Me?

When people talk about gender-affirming hormone therapy (GAHT, often called HRT), the focus is usually on which hormones someone takes—estrogen, testosterone, or blockers. But how those hormones are delivered can matter just as much.

This guide walks through the most common HRT delivery methods—injections, patches, gels, and pills—to help you understand your options and consider what might work best for you.

Note: This article is for informational purposes only. We’re not healthcare providers, and any specific questions about HRT should be discussed with a qualified medical professional.

A Quick Note on Popularity (and Why It Varies)

You may notice that certain delivery methods are more commonly discussed depending on the hormone:

• Testosterone is often prescribed via injections or topical gels
• Estrogen is commonly taken as pills, patches, gels, or injections

Many trans and gender-diverse people switch methods over time as their needs, access, or health considerations change.

There’s no single “best” HRT method. Bodies respond differently, access varies widely, and personal comfort plays a big role. Some delivery methods are more common for certain hormones, but none are inherently better or more valid than others.

1. Injections

Hormone injections deliver medication directly into the body, typically into muscle (intramuscular) or fatty tissue (subcutaneous). They’re usually done weekly, biweekly, or on another set schedule.

Commonly used for:

• Testosterone
• Estrogen (less commonly, but still widely used)

Potential Benefits

• Less frequent dosing than daily methods
• Often more affordable and widely covered by insurance
• Reliable absorption and measurable hormone levels
• Long history of use in trans healthcare

Things to Consider

• Requires comfort with needles and proper technique
• Some people experience hormone “peaks and troughs” between doses
• Injection-site soreness or bruising can occur

2. Gels (Topical Hormones)

Hormone gels are applied directly to the skin, usually once a day. The hormone is absorbed through the skin and enters the bloodstream gradually.

Commonly used for:

• Testosterone
• Estrogen

Potential Benefits

• Needle-free option
• Daily dosing may support more consistent hormone levels
• Often feels more gradual or “gentle” for some people
• Easier to fine-tune dosage in some cases

Things to Consider

• Requires consistent daily application
• There's the risk of hormone transfer through skin-to-skin contact
• Absorption can vary by individual and application site
• May be more expensive than other medication types, depending on insurance coverage/self-pay options

3. Patches

Hormone patches adhere to the skin and release medication steadily over time. They are typically changed once or twice per week, depending on the prescription.

Commonly used for:

• Estrogen

Potential Benefits

• Provides steady hormone delivery
• Avoids first-pass metabolism through the liver, which can be helpful for people who need or prefer options that place less strain on the liver
• Less frequent dosing than daily pills or gels

Things to Consider

• Skin irritation or adhesive sensitivity can occur
• Patches may be visible on the body
• Adhesion can be affected by sweating, swimming, or body hair
• Not commonly prescribed for testosterone

4. Pills (Oral Tablets)

Oral hormones are taken by mouth, usually once or twice daily. Pills are often one of the most familiar and widely prescribed forms of medication.

Commonly used for:

• Estrogen
• Testosterone blockers

Potential Benefits

• Widely available and familiar
• Easy to take
• Often covered by insurance
• No needles or topical application required

Things to Consider

• Daily dosing is required
• Oral estrogen is processed through the liver, which can increase certain health risks for some people
• May not be recommended for folks with specific medical conditions
• Hormone levels may fluctuate more for some individuals

Other Delivery Methods

You may also consider other, less common hormone delivery methods, depending on your location, your health needs, provider experience, and insurance coverage. These methods include:

• Sublingual tablets (dissolved under the tongue)
• Creams or compounded topical formulations
• Implants or pellets placed under the skin

Availability for these methods can vary widely by region and by provider, and they may be more expensive or less likely to be covered by insurance. Because some of these options are longer-acting or compounded, making dosage adjustments can be more limited compared to other delivery methods. Talk to your doctor to learn if one of these methods is a better fit for your needs!

A Quick Reminder

Hormone therapy affects everyone differently, and the safest and most effective option depends on your individual health history, goals, and access to care. If you have specific questions about HRT delivery methods, dosages, or risks, a healthcare provider with experience in gender-affirming care can help.

Wherever you are in your journey, we hope you’re able to find care that feels affirming, accessible, and right for you!