What is the correct dosing for testosterone (T) gel application in female-to-male (FTM) transgender care?

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Last updated: May 27, 2025View editorial policy

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From the Research

For transgender men (female-to-male) using testosterone gel, the typical starting dose is 50 mg (one packet or pump of 1% gel) applied once daily to clean, dry, intact skin of the shoulders, upper arms, or abdomen, as supported by the most recent and highest quality study 1. The dose may be adjusted based on testosterone levels and clinical response, with a typical range of 50-100 mg daily. Key considerations for testosterone gel application include:

  • Applying the gel after showering to clean, dry skin
  • Allowing the gel to dry completely before dressing
  • Washing hands thoroughly after application
  • Avoiding skin-to-skin contact with others at the application site for at least 2-4 hours to prevent testosterone transfer Blood tests should be performed every 3 months initially, then every 6-12 months once stable, aiming for testosterone levels in the male reference range (400-700 ng/dL) 2. Results develop gradually over months, with voice deepening, increased muscle mass, and facial/body hair growth occurring over 1-2 years. Testosterone gel is preferred by some patients for its steady hormone levels and ease of use compared to injections, though it requires daily application and careful handling to prevent transfer to others 3. Regular monitoring of lipid profile, evaluation of BMI and hematocrit, adherence to a healthy lifestyle, and avoidance of excessive daily calorie intake can limit risks linked to long-term testosterone administration 2. Overall, testosterone gel is a safe and effective treatment option for transgender men, with significant improvements in mental health outcomes, including reduction in depression, anxiety, and gender dysphoria 1, 3.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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