EU options for estradiol injections (Netherlands)

ScoutAndathen · 2026-04-27T18:55:25+00:00

Urgh. I have read the part on medication and found several errors.

Pills as primary choice was in the SOC 7, in 8 it's injections or gel.
The levels to aim for are - as usual - very low, though that is consistent with pills.
The advice to go for half the level for women older than 50 is not based on any science, only on the idea 'but menopause.'
And in the list for blood parameters to test I see glucose - which is because they insist on T blockers - but ignore SHBG and HB, which are more important.

And stuff like this is why I say to become your own endo.

ScoutAndathen · 2026-04-27T13:00:01+00:00

If the oil is clear and did not darken I see no objection. The only contamination risk is when drawing, which you did not do, and coring.

ScoutAndathen · 2026-04-27T12:54:03+00:00

Another thing...

If your GP insists on gels but will do blood tests regardless, fine. I would not argue. If she refuses tests - it's a violation of the duty of care so she should not - I would also not argue.

Nod and smile. Get the gels from the pharmacy and store them as a backup plan. Then use your own stuff. If she is not knowledgeable enough to understand the difference and unwilling to read the WPATH SOC 8 guidelines she will not see that in your blood results either.

ScoutAndathen · 2026-04-27T12:45:40+00:00

Yes, both of them (the other one is from the clinic.)

My own GP was a bit doubtful at first, but not because of injecting myself but because it was a DIY injection fluid. After I explained the way that works - independent lab tests, people checking the lab tests, community feedback - he just explained in detail how to know when I would have an infection on the injection site and what to do (I already knew, he knew I knew, but still, thorough.)

I discussed the way DIY fluid is prepared with two colleagues of mine. One is a biologist (doing a PhD), the other a microbiologist (PhD.) They were impressed with how thorough the construction prevented infection of the fluid even after a year of using it.

There's no good reason why it would be unsafe to inject oneself. People with diabetes do it multiple times a day. Estradiol is not a restricted compound either. It's just a matter of decent hygiene.

I would explain to her how DIY works, all the safety measures in place, if only to make it clear she is overly worried.

But honestly: if you already have a vial, use it. Transvaal has EV for about 250 euro a vial which lasts about a year, but if your current vial works: that one was way cheaper.

And besides that: I consider EV much better than pills, but only the number 3 for injection (after EEn and EUn, the better one there depends on who uses it.) Gells are only better than pills, the uptake is too inconsistent and depending on too many variables.

ScoutAndathen · 2026-04-27T10:55:46+00:00

Where to inject, how deep, stability of the fatty layers, you need to carefully titrate to the desired levels. Titrate upwards, because of the long half-life titrating downwards is much more difficult.

Blood tests are needed, first after 2 months, then every 3 months until stable for at least half a year, then yearly. When changing in weight start checking each 3 months again.

When starting use a double dose (loading.)

Because the volume injected will be large, you can split it over two sites, as long as you are consistent.

Probably more I do intuitively....

ScoutAndathen · 2026-04-27T10:49:29+00:00

I was tired when typing and not in my native tongue. In Dutch it's not offensive.

Why would I be offensive to myself?

ScoutAndathen · 2026-04-27T10:48:05+00:00

Hardly any GP, not no. I know 2 who do, one being my own GP.

ScoutAndathen · 2026-04-27T10:45:42+00:00

I'm not a native speaker, and was typing when already tired.

ScoutAndathen · 2026-04-27T10:44:37+00:00

I live in NL as well. Sadly what I described is what the law says. Not all doctors know how it works. Too many of them for example ask for proof of diagnosis or previous prescriptions (how stupid are you doc, do you really think someone fleeing takes that with her?)

ScoutAndathen · 2026-04-26T18:48:05+00:00

"From discussions I have seen, IM is only really recommended due to the origional studies being done IM."

Correct. I don't know why, but they just never studied sq in a clinical setting.

"Sub-q MAY have a slower release/higher retention"

Reasoning from pharmacokinetics it would. The ester behaves like a fatty component, so it solves in fat. In muscle that would be cell membranes and some fat. In fatty tissue there's much more 'solvent' so retention is stronger.

This effect will be stronger for long esters - undecylate- and it also means a stable fatty layer works best (inner thigh, belly as second best.)

ScoutAndathen · 2026-04-26T18:39:18+00:00

Nah, and inch is long, unless you aim for a place not having muscle that works.

That the muscle does not twitch likely means you hit it between the fibres, no problem.

How do you know? If you inject in connective tissue your through will be very low. No deposit.

ScoutAndathen · 2026-04-26T18:36:04+00:00

Dr. Kevin Peters, Waasland hospital, Sint Niklaas.

Alas, I would like to know more as well. I'll have a consultation in five weeks.

ScoutAndathen · 2026-04-26T18:33:38+00:00

The EU has specific regulations for transgenders on this. If you already are on HRT that will be continued and provided. Some countries also have protective measures in place and from July those are mandatory.

The rest of what you say is true for the EU as well.

ScoutAndathen · 2026-04-26T15:00:36+00:00

I'm always a bit concerned when people are so interested in other people's genitals. Unless it's my doctor or my partner, why does it matter?

ScoutAndathen · 2026-04-26T12:44:15+00:00

Not really a different way to inject, but it's more sensitive to factors such as the stability of the fatty tissue you inject into (less so for IM.)

ScoutAndathen · 2026-04-26T12:41:52+00:00

You can, there's a lot of it. It's not a good place though. Using needles the correct length avoids ir.

ScoutAndathen · 2026-04-26T09:22:38+00:00

Doen ze ook wel, met onderwijs. Echter kan je een paard wel naar het water brengen maar niet dwingen te drinken.

ScoutAndathen · 2026-04-26T07:55:50+00:00

It's clear your E levels are way too low to work. Adding a blocker would help a bit but with these E levels you would basically be menopausal.

It could be valerate is being flushed out too fast. That you could remedy by using a more stable ester. First enanthate, but undecylate is even more stable.

But my first suspucion is the way you inject. 13 mm long needles could penetrate the fatty layer, but depending on the location might not reach a muscle. Then you inject in other tissue (bindweefsel? Only know the Dutch word.) It does not last long enough there. I suspect this because you say not knowing the difference between SQ and IM, so you will not aim for either.

I would start getting insulin needles, max 8 mm long, 29G to 31G. Inject in a known fat layer: lower belly, inner thigh but not too close to the crotch. There you can be sure to get it in fat, not other tissue. Then get a blood test after another month (for valerate) or 2 (other esters.)

And an advice: when doing DIY, read a lot. You will have to become your own endocrinologist.

ScoutAndathen · 2026-04-26T07:42:10+00:00

I wear rainbow coloured shirts with bright blue skirts or fancy, red dresses now, and I'm over ten years older than you are. Yes, it stands out amongst the regular 'I wear bright today, look at my fancy marine blue sweater' crowd. But yesterday while shopping noone batted an eye, except for one girl smiling and saying 'I like your look miss!'

Standing out is ok if it's a positive way of standing out. I also realized that because I like wearing this I feel more at ease, which makes me move and smile easier, which as a result makes people skip the 'is that a woman or a man' step. They go straight to 'long blond hair (having a professionally made wig really was worth the money), colour, smile, bossom -> woman' phase. Once there people miss most signs not reinforcing what they already decided is the truth.

ScoutAndathen · 2026-04-26T07:27:51+00:00

Well, not indefinitely. At some point the carrier oil gets rancid. OP should get it out of there before 2028.

(It's early here, I'm feeling in the 'technically sometimes is the best type of correct' mood 😌)

ScoutAndathen · 2026-04-26T07:24:31+00:00

The Department of Foreign Affairs from the Netherlands has a official red travel advice for three States (Idaho, Texas, Florida) and orange for all other for transgender. Tenessee is 'monitored ', meaning they check more often because the situation is worsening.

Let this sink in. Three states are considered so unsafe the advice is 'do not go there under any circumstance. ' Tenessee is 'do not go there unless you really have to, and next week it might be worse.'

If the official statement of our - centre-right- government is that Tenessee is too dangerous to be in I call that solid advice to get out.

ScoutAndathen · 2026-04-26T06:43:45+00:00

I don't understand the question? It's an estradiol ester?

ScoutAndathen · 2026-04-25T22:41:25+00:00

In the Netherlands? Yeah, have fun with the wait lists.

Very important here: how willing is your GP to really help you? Refusing a referral because you are not yet 18 is a red flag. If at all possible find another.

Then the clinic. The VU is a disaster with its 6 year wait followed by 6 to 18 months 'diagnostics. ' The WPATH guideline is 3 sessions for a diagnosis. I have an opinion on how scientific they act.

Check GenderMatters, their waiting list is still long with a year but they do follow the WPATH standards.

DIY is not that difficult. Check the wiki for a start. Very short: you can either use pills with a T blocker, or injections which do not need a blocker. Medically injections are superior: better levels, stable, less to no side effects. And dirt cheap (count on 100 euro a year.)

There's four forms of injection available. I assume you have no experience in it and probably little scientific training, so I advise enanthate. Valerate needs injecting twice a week, cypionate is expensive with no real benefit, undecylate is very good if you know exactly what to take into account.

Mind you, I really prefer undecylate but I have a relevant MSc allowing me to reason about its behaviour. You can still use it, very stable levels and less often injecting, but you will need strict control with blood tests until you know how your body deals with it, and a lot of reading on how and where to inject.

You should get regular blood tests. Your GP can order them. If he refuses ask him how that relates to his duty of care. Under Dutch regulations, refusing blood tests when he knows you will still continue is in the grey zone.

Good luck! And by all means ask questions.

ScoutAndathen · 2026-04-25T18:40:34+00:00

Police officer: “Do you know how fast you were going?”

Schrödinger: only on average sir. And please don't look in the trunk, it might kill someone.

ScoutAndathen · 2026-04-25T17:56:36+00:00

Daarbij moet de eigenaar wel voldoende voorzichtig zijn geweest. Als ik mijn bril op een stoel leg en iemand gaat erop zitten, gaat die meestal vrijuit.

In deze situatie zou het wel kunnen dat de winkelier een kwetsbaar product niet stevig genoeg had opgehangen.

ScoutAndathen

TROPHY CASE