Some days it seems like every gay guy on the internet is a fitness freak. And not just “works out four days a week” fit, but “230-pound Marvel superhero crossed with an Olympic athlete” fit. They’ll say it’s chicken breast and broccoli, but it’s often something extra – steroids.
From porn stars to actors to influencers, the trend for superhero bodies just keeps growing. And when it comes to feeling this pressure, queer men are more likely to use or consider using steroids than straight men. Research suggests 5-13% of queer men use them, and in one survey 25% had thought about it.
But how do they work and what are the risks? Read on for Freddie’s guide to steroids.
A note on harm reduction
The only way to avoid all the risks and harms from substances is to not use them. This includes steroids taken without a prescription.
At Freddie, we understand that some people will choose to take steroids. If you do, we’re here to support you and give you information to help reduce the risks. This approach is known as harm reduction.
What are steroids?
Steroids are substances that mimic hormones naturally produced by your body, like testosterone or human growth hormone (HGH). Their proper name is “anabolic steroids” or “anabolic-androgenic steroids (AAS)”.
Doctors can prescribe these drugs for medical conditions like hormone deficiencies. They can also be taken by otherwise healthy people to build muscle and improve sport performance. This use is “off-label” (in other words, it’s not what they’re meant for). Using steroids this way often means getting them without a prescription.
There are many kinds of steroids. Some of these are real medications that have been “diverted” or taken out from the legitimate supply chain. Others are black market versions that have been made by illegal suppliers. These may be made to look like real medications, or they may have no branding at all.
When you buy steroids without a prescription there is no way to know what is in them. This means they could have harmful ingredients.
Are steroids legal?
In Canada, steroids are a “Controlled Substance”. This means it is illegal to manufacture, import, export or sell them outside of their proper medical use. However, it is not illegal to possess them for personal use without a prescription.
In the USA, steroids are a “Schedule 3” substance under the Controlled Substances Act. This means it is illegal to manufacture, import, export or sell them. It is also illegal to possess them.
What about online testosterone clinics?
There are some private online clinics that advertise “testosterone replacement therapy” and other hormone treatments. These clinics will order lab tests and can then prescribe testosterone or other medications if you have low hormone levels.
When someone uses these clinics they will receive real medication. This is because they are given a prescription they can take to a pharmacy. Getting medication this way avoids some of the risks that come with “black market” or street steroids, where you don’t know what’s in them.
Online healthcare is generally just as safe and high-quality as in-person care. However, the quality of care provided through online testosterone clinics can vary. Some will give prescriptions to patients who do not need them (in other words, people who are using steroids for muscle growth). They may not be as careful with monitoring for side effects or drug interactions.
It is important to note that testosterone and other drugs from these clinics can have the same side effects as illegal steroids. The risk of these side effects can vary depending on your dose, genetics and other factors.
What are the risks of steroids?
Using steroids can have physical and mental health risks. Some of these can be reversible after stopping steroid use, but some can be permanent.
Risks include:
- High blood pressure
- Heart attack
- Elevated cholesterol
- Increased risk of prostate cancer
- Sleep apnea
- Mood changes – paranoia, anxiety, depression, aggression (“roid rage”)
- Erectile dysfunction
- Infertility
- Testicular shrinkage
- Gynecomastia (breast tissue growth)
- Acne
- Hair loss
Some of these side effects, like gynecomastia, acne or hair loss, can be irritating but are not a risk to your health. Other side effects, like increased risk of cancer and heart attack, are more serious. In some cases they can be fatal. If you have a family history of conditions like prostate cancer or cardiovascular disease then this can raise your risk.
Physical dependence
Since steroids supply testosterone from an outside source, your body stops producing as much while you’re on them. This can cause your testicles to shrink because they do not need to produce testosterone as normal. Penis size is not affected.
When you stop steroids, there is a risk your natural testosterone production may not return to normal.
How do I make steroid use safer?
The safest way to grow muscles is through diet and exercise. If you’re going to use steroids, there are ways to reduce some of the health risks.
Talk to your healthcare provider
Let your healthcare provider know about any steroids you are using and your dose. They can monitor you for side effects and help you manage them. They can also ensure you stay healthy and can help you avoid medication interactions. Talking with your provider is important because some side effects from steroids, like heart issues, can be serious.
In Canada it’s safe to tell your clinician about steroid use because it’s not illegal to possess or take them (only to make, sell or import and export them).
Safer injecting
If you inject steroids, never share or re-use a needle. Sharing needles can transmit infections like HIV and hepatitis C.
Always dispose of used needles in proper containers like a sharps bin. If you don’t have a sharps bin, you can use a hard laundry detergent bottle with a cap.
Do not throw used needles in the garbage. Some gyms will have sharps bins in their locker rooms or washrooms.
This video from Freddie’s sibling service, Foria, describes safer injecting practices for people who use hormones for gender-affirming care. It will tell you how to do intramuscular or subcutaneous injections safely. Note that the doses described here may be different than using steroids for muscle growth.
