The pen injector photograph they showed is not new - several homebrewers have made attempts over the years to produce compounding and packaging into 3mL plunger vials with mixed success and notable unresolved issues. That photo was originally taken and shared by a US based compounder who is believed to work alongside 4TV, several years ago as a prototype product.

There's a few issues with pen injectors and HRT - pens, like other insulin medical devices are built with aqueous medication in mind. Destruction of the shroud piece holding the vial in the pen from priming and use, flow issues due to viscosity (even when using MCT oil) remain issues for users.

For compounders, filling the container is difficult and wasteful - such vials in factory are filled in vacuum which is difficult to reproduce in self-compounding setups, so overfilling or other techniques that run the risk of explosion or leaking can happen. Yield rates compared to bottle vials are always considerably lower.

A huge part of the talk was dedicated to testing of raw, yet-to-be compounded esters. Whilst testing and verifying drugs is important, unlike recreational drugs the number of sellers of raw hormones are limited and fakes/contaminants from them are unheard of.

Instead, the risks greater lie with the final products compounders themselves give or sell to people for use - are there any unwanted contaminants? Were they using appropriate techniques? Did they include sufficient Benzyl Alcohol? 4ATV's described tests aren't appropriate for compounded products.

This talk also misses the existing lab testing, reviews, and verification that happens within community and arguably sows distrust into them. These are not as public or accessible due to their nature, but they exist to keep some accountability. For androgens, these processes are far more mature. For estrogens there is more work to do, but already people are leaning on the services and knowledge available.

There was some harm reduction in this talk, steering people who may choose self-compounding towards transdermal over injection but saying "Take as much T as you want, though... maybe" falls short. High levels of T is known to bring increased risk of polycythemia, which is commonly mitigated by lowering dose, blood donation/letting.