It happens to many of us, especially if we've been on injectable gender-affirming hormone therapy (GAHT, also known as HRT) for a long time.
Maybe you've been on injectable gender-affirming hormone therapy (GAHT, also known as HRT) for a long time. You've been able to do your regular shots, even if it's been hard at times. But you've did it: you're in a rhythm with your medication.
Then, something changes. The thought of giving yourself a shot suddenly feels like this impossible task.
Needle fatigue is defined as "a waning commitment to continue with the prescribed long-term injectable treatment." If you're finding it's taking a long time to will yourself to do your shot, or if you're skipping shots altogether, you might be experiencing it. It’s often described as exhaustion, feeling like a pincushion, or simply not wanting to do it anymore.
If you’re navigating this feeling, you’re not alone. Here are some ideas that may help:
Be open with your healthcare provider so they can support you. Sometimes there are alternatives: trying a different injection method (like switching from intramuscular to subcutaneous), reducing frequency if possible, or exploring other delivery methods such as gels, patches, or pills. Even if you decide to stick with injections, your doctor might have suggestions for easing discomfort or managing anxiety around the process.
Sometimes structure helps. Try making your shot time part of a ritual you actually look forward to: light a candle, play your favorite song, or set up a cozy space with a blanket and warm tea. Having these comforting cues can shift your mindset and make the injection feel like less of a chore and more of an act of self-care.
Distraction is a powerful tool. Put on a funny video, scroll through social media, or call a friend while you prep. Some folks like to count backwards, sing along to a song, or practice deep breathing as they're prepping or administering their shot. The goal isn’t to make the discomfort disappear, but to redirect your focus so the process feels a little less daunting.
It’s okay to bribe yourself a little! Plan a small treat after each shot—whether that’s a favorite snack, watching an episode of a show you love, or stepping outside for a walk. Linking your injection to a positive reward can help retrain your brain to associate the task with something good.
Needle fatigue can feel harder if injections are physically difficult or if you’re carrying the burden all by yourself. If you deal with mobility issues, tremors, chronic pain, or dexterity challenges, there are tools that may help—like auto-injector devices, different needle lengths, or adaptive supplies your doctor or pharmacist can recommend.
Support doesn’t always have to come from equipment, though. A trusted friend, partner, or family member might be able to sit with you for moral support, or even help administer your shot if that feels right for you. Sometimes just having someone present can ease the pressure. Remember: needing accommodations or support doesn’t make you any less capable or valid.
There’s so much comfort in knowing you’re not the only one. Online trans communities, forums, or support groups often share tips and encouragement around needle fatigue. Talking openly about it can remind you that many people go through the same thing, find ways to manage, and thrive.
Motivation naturally ebbs and flows, especially with something so long-term like HRT. You may go through stretches where doing your shot feels easy, and other times where it feels overwhelming. That doesn’t mean you’re failing—it just means you’re human. Naming these “slumps” for what they are can actually make them easier to move through. And when you’re in one, lean on the strategies above, and remember: this low period will pass.
It’s okay if shot day feels tough. It doesn’t mean you’re failing, or that you don’t want or deserve your transition. Needle fatigue is common, and it makes sense: taking injectable medication for years, even when it’s life-affirming, can still be exhausting.
If you’re experiencing it, try out these strategies, reach out for support, and most importantly: be gentle with yourself. You've got this.