Why So Many Men Are Obsessed With Testosterone
From the Trump administration to online influencers, the hormone is increasingly seen as the key to achieving a new male ideal.
Azeen Ghorayshi covers science and culture for The Times. For this article, she interviewed a senior Trump administration health official, urologists and endocrinologists, and 14 men taking testosterone.
In January, Health Secretary Robert F. Kennedy Jr. joined Katie Miller, the wife of Stephen Miller, the White House deputy chief of staff for policy, on her podcast. He was there to celebrate his MAHA victories, but he soon veered into the singular, seemingly indestructible biology of President Donald J. Trump. “He has the constitution of a deity,” Kennedy marveled.
And the key to the president’s inexplicable vigor, Kennedy suggested, could be found in his hormones. Dr. Mehmet Oz, the Centers for Medicare and Medicaid Services administrator, had reviewed the president’s medical records, Kennedy said, and found that he had “the highest testosterone levels that he’s ever seen for an individual over 70.” As Miller laughed awkwardly, Kennedy leaned in with the air of a man sharing a locker room secret: “I know the president will be happy that I repeat that.”
This overt fixation on masculinity is by now a familiar feature of the Trump administration. On the campaign trail, Trump cast himself as a virile foil to Joe Biden’s frail, “woke” leadership, calling the election a “choice between strength and weakness.” Days before Defense Secretary Pete Hegseth ordered strikes on Iran in February, the Department of Defense posted a video of him bench-pressing while flanked by roaring members of his former infantry unit. But it is Kennedy who has most equated musclebound manliness with wellness, posting videos of his own impossibly ripped septuagenarian physique as he does cold plunges and push-ups, often in nothing but a pair of jeans.
Central to Kennedy’s image of male health — and his view of the health of the nation — is testosterone, the hormone that is a cultural proxy for masculinity. Testosterone levels have been slowly declining worldwide over recent decades, a trend that Kennedy has called an “existential” threat to humanity. Accordingly, his new federal nutritional guidelines suggest that men consider taking fish oil and vitamin D supplements to boost their testosterone levels.
He himself goes a step further. Appearing on the “Lex Fridman Podcast” in 2023, when he was running for president, Kennedy answered a question about being in “great shape” by expounding on his diet and exercise regimen — and an “anti-aging protocol” including T.R.T., or testosterone replacement therapy. Administered as a topical gel, injection, pill, patch or pellet, T.R.T. replaces the body’s own production with a higher supply of lab-produced testosterone.
For decades, the Food and Drug Administration has said that T.R.T. should be prescribed only to men with clear medical problems affecting testosterone production — either in the brain structures that signal the body to make the hormone, or in the testicles, which produce it. But in December, the health agency hosted a panel of doctors arguing for policy changes to expand access to T.R.T. In April, the F.D.A. took the first step toward making that a reality, saying it would broaden the criteria to include men with low testosterone levels for any reason, as well as low libido, which could open the drug to a much larger market.
For the top officials at the health department, the issue of T.R.T. is personal: Kennedy’s assistant secretary for health, Dr. Brian Christine, is a urologist who is leading the department’s efforts on testosterone as part of a broader push to establish an Office of Men’s Health. He told me that he, too, has been on T.R.T. for the past decade, an intervention he credits for being able to fulfill the demanding job of serving the president.
“It can be transformative,” Christine told me in March during an interview at the agency in Washington. “Am I 40 years old again? No. But I do think I feel better and perform better in a variety of ways as a 62-year-old man with a good testosterone level, as opposed to a 62-year-old man with a really low testosterone level.”
A clinically low level of testosterone can cause muscle loss, fatigue, obesity and sexual dysfunction, and is linked to other serious health problems, including diabetes, cardiovascular disease, osteoporosis and depression. It is also underdiagnosed: Roughly 5.6 percent of men between 30 and 79 have testosterone deficiency — a prevalence that goes up significantly in older men — but only 1 in 5 of those men, at most, gets treated for it.
Increasingly, however, many men without low testosterone seem to be getting on T.R.T. Use of “T,” as many people call it, has skyrocketed, growing to nearly 12 million prescriptions in 2025 from fewer than 1 million in 2000, according to data provided to The Times by the market research firm IQVIA. That increase accelerated during the pandemic, jumping 154 percent since 2020.
Those numbers are undoubtedly an underestimate, since more men are now getting testosterone from less traditional sources. Prescriptions are rising most rapidly among men ages 35 to 44, powered in large part by a surge in direct-to-consumer online clinics often marketing testosterone as a lifestyle product rather than a treatment for disease. The American Urological Association reports that roughly a third of men who are prescribed the drug do not meet the criteria for a diagnosis of testosterone deficiency, leading some critics to argue that this has created a legal market for low-grade steroids. (Testosterone is, after all, what’s known as a steroid hormone. What most people think of as “steroids” are often derivatives of testosterone tweaked to enhance its effects on muscle cells in particular and taken at extremely high doses.)
The Trump administration’s spotlight on testosterone and its increasing availability through online clinics come at a time when exaggerated, uncompromising, even aggressive masculinity is in vogue in Hollywood and online in the so-called manosphere. Wildly popular figures like Joe Rogan and Andrew Huberman have spoken about their own use of T.R.T., framing it as a medical treatment for aging.
But many influencers go much further, amplifying the message that being “low T” is synonymous with low status, weakness and sexual inadequacy — and often profiting off promotional links to T.R.T. clinics, or even starting their own. That message seems to be reaching younger men in particular. Clavicular, the 20-year-old streamer who popularized the “looksmaxxing” subculture, which casts the relentless pursuit of physical attractiveness as the clearest route to social capital, has said that he started using testosterone at age 14 to achieve “a more dimorphic look.”
Advertisement
I interviewed 14 men who are on testosterone — getting it from doctors, online clinics and even unregulated underground labs — about their anxieties and motivations and how the social and political culture is influencing them. I also spoke to prominent urologists and endocrinologists across the country who are using T.R.T. to treat men. The doctors were concerned that many men with low testosterone are going untreated, but they had reason to be hopeful: Recent data have challenged long-running concerns about some of the most serious health risks of T.R.T. at the same time that an explicitly pro-T administration is taking steps to broaden its use.
But many clinicians are also concerned that the rising fanaticism around testosterone ignores what are still the known risks, most notably to sperm production and fertility — and that as virility and jacked gym bodies become the ideal, men are being driven toward unrealistic, and even unhealthy, expectations. And while the president sits ringside at U.F.C. fights with Rogan, and Elon Musk, Peter Thiel and other influential figures deride “low T” liberals and “soy boys,” T is becoming increasingly right-coded.
All of this prompts a question: If one of the defining stories of the 2024 election was that young men swung to Trump in part because they felt masculinity had been demonized, what does it mean that so many men now believe they need to take testosterone to feel more like men?
Video
CreditCredit...Illustration by James Kerr / Scorpion Dagger
The origin story of testosterone as a wonder drug to enhance and restore manhood begins in Paris in the late 19th century. Scientists had long observed the behavior of castrated farm animals — fat, subdued, impotent — and a physiologist named Charles-Édouard Brown-Séquard theorized about how this might apply to men, concluding that the testicles must contain some powerful substance tied to male vigor.
Advertisement
Brown-Séquard was yearning for a bit of that vigor himself. At 72, he despaired that his most prolific research days were behind him. Previously able to spend long days in the lab, he now grew tired after two or three hours. Too depleted to write after dinner, he was often unable to get a good night’s sleep.
He decided to conduct an unorthodox experiment, injecting himself with substances he made from crushed dog or guinea pig testicles. The results were clear within days. “A radical change took place in me,” Brown-Séquard wrote. “I had regained at least all the strength I possessed a good many years ago.” He spent many energetic hours working in the lab, had a burst of writing after dinnertime and could bound up the stairs with no trouble. Even the “length of the jet” of his urine was 25 percent longer than it was before. The secretions, he concluded, were indeed “a liquid endowed with very great power.”
Given the low concentrations of testosterone present in his concoctions, we now know that Brown-Séquard’s experiment was instead a powerful demonstration of the placebo effect. But it nevertheless caused a sensation: Thousands of doctors in Europe and the United States began injecting patients with similar testicular elixirs, trying to cure a wide range of male afflictions.
The promise of these early experiments was finally realized decades later in 1935, when testosterone was isolated and reproduced in the lab. The newly synthesized hormone quickly attracted an eager market seeking to correct perceived deficits of masculinity. A doctor in Philadelphia reported that testosterone allowed older men to fulfill their “social and economic responsibilities.” Newsweek reported that the hormone could prevent “feminine characteristics in men.” Time magazine declared that companies were manufacturing a substance that could “revitalize old men” and “cure homosexuals.” It was a preview of the T craze we find ourselves in today.
But just as testosterone was being heralded as a drug with the potential to not just cure but improve men, its trajectory was halted. In 1941, a scientific paper was published suggesting — based on clinical observations of a single patient treated with testosterone — that the hormone could cause prostate cancer.
Advertisement
Despite the anecdotal nature of the study, it had a seismic impact on medical practice. Most doctors stopped prescribing testosterone, cautioning that the risk of prostate cancer was too high. That prohibition lasted for the remainder of the 20th century. For roughly 60 years, “there was almost no testosterone given anywhere in this world,” says Dr. Abe Morgentaler, a urologist at Harvard Medical School. When he was a medical student in the 1980s, Morgentaler told me, “I was taught that if a healthy man received testosterone today, he would come back in one month with aggressive prostate cancer.”
Morgentaler, however, was curious about the hormone’s potential. As an undergraduate conducting research, he found that when castrated lizards were given testosterone, their mating dances were restored. Once he was practicing as a urologist, men started coming to him complaining of sexual problems. It was a decade before the arrival of Viagra, and doctors had little to offer. “I thought, Maybe guys are like my lizards,” Morgentaler says. He started prescribing testosterone to a small group of patients, warning them that it could increase their risk of prostate cancer. Desperate, most men went ahead anyway.
To his surprise, many of his patients reported that not only were they now having lots of sex but also that other aspects of their lives had improved. “They’d say, ‘My wife likes me again,’” he recalls. “Another says, ‘I wake up in the morning, I swing my legs over the side of the bed, I have optimism for my day. I haven’t felt that way in 15 years.’” Over the next decade, as Morgentaler spoke about his patients’ positive outcomes at conferences, including preliminary data suggesting no increase in the incidence of prostate cancer, more doctors began following his lead.
But soon after Morgentaler began treating his patients, a new obstacle arose. Doping scandals swept the world of sports, where athletes trying to set records and win Olympic medals were caught taking testosterone and other anabolic steroids at doses much higher than what Morgentaler was giving his patients. In 1990, Congress passed a law adding steroids, including testosterone, to the Drug Enforcement Administration’s list of controlled substances — making the hormone illegal without a prescription and adding new restrictions for doctors.
Then, after a few studies published in the early 2010s suggested that T.R.T. was associated with a potential increase in heart attacks and strokes, the F.D.A. issued a warning label for testosterone products. As part of the warning, the agency required drug makers to fund what would become the largest randomized, placebo-controlled trial to investigate the risks and benefits of T.R.T.
Advertisement
That study, published in 2023, began to rehabilitate T.R.T.’s damaged reputation. In a group of 5,200 men ages 45 to 80 with elevated risk or a history of heart problems and clinically low testosterone, there was no difference in rates of heart attacks, strokes or prostate cancer in patients treated with either a testosterone gel or a placebo. The trial also found that testosterone improved sex drive (but not erectile dysfunction) and was associated with modest decreases in depression after two years. The F.D.A. removed the warning label in February 2025.
In his 2005 book, “Testosterone Dreams,” the historian John Hoberman predicted that, despite the many stops and starts in the history of the hormone’s medical use, testosterone would inevitably go mainstream — as elite athletes had shown, the possibility for male enhancement was too tantalizing to remain walled off from the public. Now, he told me, that is clearly happening.
“The question is,” Hoberman said, “is this for good or for ill?”
Video
CreditCredit...Illustration by James Kerr / Scorpion Dagger
Like many of the men I spoke with, Todd, a 42-year-old in Canada, first went down the rabbit hole of pursuing T.R.T. during the pandemic. He watched “hundreds” of YouTube videos. Some were older guys talking about their anti-aging protocols, he said, but the creators he found to be the most trustworthy sources of information were amateur or former bodybuilders. To Todd, “the people in that world, they know these drugs and they know testosterone, they know blood work, they know it inside out.” (Todd asked, as did most of the men I spoke with, to be identified by only his first name to protect his privacy.)
Bodybuilding was no longer niche, as it was in the heyday of Arnold Schwarzenegger. Now its proponents were a mix of wellness and fitness influencers, championing self-improvement through strength, biohacking and optimization, as well as manosphere influencers dispensing conspiratorial political commentary alongside dating advice for lonely men.
Advertisement
Some of the videos Todd watched were by Derek Munro, a popular Canadian former bodybuilder and frequent guest on Rogan’s podcast. Munro’s show, “More Plates More Dates,” was notable for his candid disclosures about his own T.R.T. use, his deep dives on pharmacology (“meathead chemistry”) and a series called “Natty or Not,” in which he tried to deduce whether other influencers or celebrities were “natural” or were taking testosterone or other performance-enhancing drugs. And as the title of his show makes explicit (the “plates” are weight plates), Munro frequently advised his audience of men on how to optimize their appearance — getting more muscular and more lean (“In reality, 99 percent of guys just are too fat”) — to attract women, while promoting a supposedly testosterone-boosting supplement sold by his company, Gorilla Mind, and his own telehealth platform that prescribes T.R.T.
Todd had already been a gym rat for a decade and was remarkably regimented about his lifestyle: He didn’t drink or smoke; he ate the same high-protein meals in the same quantities every day — a tub of nonfat yogurt for breakfast, ground turkey for lunch, ground beef for dinner — and worked out six days a week. But in 2020, he started experiencing overwhelming bouts of anxiety for the first time. His muscle gains were stalling. He struggled with intense brain fog. He lost interest in having sex with his girlfriend and felt anxious being around her at all.
He started seeing a therapist twice a week, and tried supplements, CBD oil, breathing exercises and meditation. When his doctor ran his bloodwork, he saw that his testosterone levels had fallen significantly in just a couple of years, to just under 400 nanograms per deciliter — in the lower range of what’s considered physiologically normal — from roughly 700, in the upper range. Todd asked for T.R.T., but his doctor refused, instead writing him a prescription for an S.S.R.I., or selective serotonin reuptake inhibitor. “They don’t want to give you testosterone, but they immediately want to put you on antidepressants — that’s always what they’ll do,” Todd said. He declined to fill the prescription and instead went back online.
On Reddit, Todd saw that many men seemed to be sharing his experience. He followed along in the testosterone subreddit as men uploaded their bloodwork, asking if they were “cooked” (a lost cause), or describing how they got “dialed in” (found their sweet spot). They shared information on where they got their testosterone, how much they took, in what form and how often.
Many men shared dramatic before-and-after photos and rapturous stories of how they went from feeling run-down to feeling driven, confident and lean, often with a newly inexhaustible desire to have sex. Others talked openly about getting on T.R.T. just to bulk up, sharing the names of clinics that would prescribe the drug to men regardless of their T levels at the best price. In 2023, on the recommendations of his new friends, Todd found a telehealth provider that asked a few questions, ordered bloodwork and quickly issued him a prescription for testosterone.
“I’m not being overboard here when I say you can’t ask a doctor — they don’t know,” Todd told me. “It sounds foolish,” he acknowledged, “to say, ‘Oh, I’ve got to go on Reddit and ask some random Reddit strangers.’ It sounds stupid, but those guys are on there just to help. They’re just guys on there that are going through the same [expletive] that you’re going through, and they just want to help. That’s why I answer questions on there and talk to people and give good advice. Because I’m like: I did all this. I know how it feels.”
While guys like Todd are finding their way to testosterone for the first time, there are uncanny echoes for some of its pioneers. Back in 2000, Andrew Sullivan wrote about starting on testosterone in a story for this magazine, titled “The He Hormone,” when the treatment was still relatively obscure. Sullivan, a gay man, had survived the AIDS epidemic only to learn that his H.I.V.-positive status had caused his testosterone levels to plummet. He described the exhilarating experience that followed taking what he called his “manhood supplement”: He was able to squat 400 pounds, his lust was breathtaking and he felt “better able to recover from life’s curveballs, more persistent, more alive.”
Looking around at male bodies today, Sullivan told me, he can’t help noticing that “more and more people look like me” — from leading men in Hollywood to the suddenly bulky titans of tech. Sullivan argues that to understand our current culture’s obsession with testosterone, it’s worth looking back at the AIDS epidemic. At that time there was something of a Venn diagram of bodybuilding culture and gay men, who packed on muscle in order to dominate sexual competition with their peers, but also as a way to defy the illness that was ravaging their loved ones and themselves. “I think part of that was a psychological defense against the idea we were going to die, and weakness,” Sullivan said. “We reclaimed masculinity.”
Perhaps, he said, straight men are going through a similar ideological retrenchment today. When I asked whether he saw testosterone becoming more MAGA-coded, he agreed. “Part of it is, I think, a legitimate rebuke to some of the excesses of the other side,” he said, “which went to the length of almost denigrating men” amid a cultural reckoning over toxic masculinity. “I think that took over a lot of elite discourse and just harmed men, and boys in particular, in developing their own identities.” Maybe men are leaning more into masculinity now, he speculated, because “we need to — because in fact, we’ve neglected it.” But, Sullivan continued, “I wish you could lean into it in a way that was ennobling, than as a way which was reductive.”
Distrust of the medical system is fueling the embrace of testosterone. Many of the younger men I spoke with felt that doctors were standing between them and the treatments that could actually help. The mainstream medical establishment’s caution around testosterone was proof.
Medical guidelines specify that, in order to get a diagnosis of testosterone deficiency, men need to have blood tests showing that their levels are lower than 300 nanograms per deciliter (the normal range is 300 to 1,000). They must also have the symptoms and signs associated with it — low energy, obesity, depression, reduced sex drive, erectile dysfunction. But some of those symptoms are so vague, and that range is so broad, that many men end up wondering whether their testosterone levels are the answer to what ails them.
Adding to the confusion is the fact that common issues like obesity, diabetes, stress and poor sleep can themselves cause testosterone levels to go down, creating a self-perpetuating cycle. Many doctors urge men to try changing their diet and exercise first to see if that raises their T levels naturally before deciding whether to start on T.R.T. “T does not decline significantly with age alone,” said Dr. Mohit Khera, a urologist at Baylor College of Medicine. “A chunk of it is that we’re becoming a sicker population.”
But increasingly, younger men are impatient with that view and seeking out their own paths to information and treatment online. Mahmoud, a 28-year-old former high school wrestler on the East Coast who asked to be identified by his middle name, told me he had grown disillusioned with the medical system after a string of serious health problems, including a negative reaction to finasteride, a hair-loss medication, and a repeat A.C.L. tear that put his life on hold right when he felt like he should have been at his peak.
During the pandemic, he told his doctors that he was feeling physically and mentally burned out, anxious and emotional, and pointed to his bloodwork, which showed that his testosterone level was on the low end of normal. As with Todd, his doctors had repeatedly tried to prescribe him antidepressants, which he refused. Online, he found different answers. “A lot of the creators and a lot of the people on the internet who do some of the good work that Big Pharma doesn’t do or the F.D.A. doesn’t want to test or run trials for — because it’s going to collapse the whole system — also talk about using testosterone,” Mahmoud said.
Mahmoud told me he’d thought about testosterone “every day” since he first got his levels checked, hoping it could be the solution to his physical and emotional problems. He tried testosterone-boosting supplements he purchased from Gorilla Mind, the company founded by Derek Munro of “More Plates More Dates.” But his testosterone levels increased only slightly, not enough for him to register a difference in how he felt.
The week I spoke to Mahmoud, in April, he had just started taking the testosterone he purchased online from an underground lab, similar to the one where he had previously bought peptides, largely untested and unregulated injectable compounds also suddenly popular in bodybuilding and wellness circles. He felt confident that he could manage his bloodwork without the oversight of a doctor or even a T.R.T. clinic.
“I really have a hobby when it comes to this health and fitness stuff, and I feel I’m really good at interpreting my labs,” he said. “This is all by way of these communities, Vigorous Steve, ‘More Plates More Dates.’” (Vigorous Steve is another bodybuilding coach and influencer who features affiliate links on his site to Derek Munro’s Gorilla Mind supplements and telehealth platform.) “For all of my 20s, I felt unable, I felt weak, I felt brittle, I felt frail,” Mahmoud told me. “I want to feel strong and I want to feel able again.”
Both Mahmoud and Todd told me that, reading along on Reddit, they had grown anxious that their experiences were symptomatic of a population-level testosterone decline. That decline is real: Large studies have found that younger generations have lower testosterone levels than earlier generations did at the same age.
Kennedy and others have talked about this decline in apocalyptic terms, and it also figured prominently in Tucker Carlson’s 2022 documentary “The End of Men,” but most of the doctors I spoke with said that depiction is overblown. While they agree with Kennedy that endocrine disrupters in the environment are likely to play a role, they said that other factors, like rising obesity and increasingly sedentary lifestyles, probably explain much of the change. If an overweight man is prescribed a GLP-1 and loses 10 or 15 percent of his body weight, his testosterone levels “go up by enough to bridge that generational gap,” says Dr. Scott Selinger, a physician at the University of Texas at Austin’s Dell Medical School.
Selinger studied testosterone-prescribing trends before and after the pandemic, when legal changes allowed telehealth providers to prescribe controlled substances without seeing patients in person. His research showed a boom in younger patients who were prescribed T.R.T. during that time period. That’s concerning, Selinger said, because almost all of the data that exists on T.R.T. is for older men diagnosed with testosterone deficiency.
Observing this rising use of telehealth among men, Dr. Justin Dubin, director of the Men’s Sexual Health program at the Miami Cancer Institute, initially felt optimistic. Young men are around 80 percent less likely than young women to see a doctor for regular checkups. Maybe this would be a way for more men to engage with the health care system at all, Dubin thought.
But soon enough, he saw a notable increase in young men coming in to see him complaining of fertility issues — and whose tests showed a sperm count of zero. He learned many had been prescribed testosterone by online clinics and were never told about one of its clearest known side effects: Supplementing with testosterone sends the message to the brain that testosterone is in oversupply, shutting down the testicles’ production of testosterone and sperm. (This also causes a telltale sign of being on T.R.T.: shrunken testicles.) The hormone is so incredibly effective at decreasing sperm counts that it is being tested as a possible male contraceptive.
In a 2022 study in which Dubin went undercover as a patient himself, six out of the seven online T.R.T. clinics he approached offered him the hormone, despite the fact that he didn’t meet criteria for testosterone deficiency. They also rarely provided warnings about the fertility impacts and other side effects, such as a thickening of the blood that could cause dangerously high blood pressure.
Dubin emphasized that there was no data on the benefits of giving T.R.T. to men without an actual testosterone deficiency. The fact that the online clinics prescribe testosterone so indiscriminately means that, for those men, the only benefit will most likely be an increase in muscle mass. For many, of course, that’s more than enough. But the marketing often goes much further, telling men that testosterone could fix their minds and bodies. “Online, everyone is saying testosterone is the solution to all of your problems,” Dubin says. “And we have to be very clear that it’s not.”
The shift in male body ideals toward being more muscular has increased societal and peer pressure on men and boys, says Dr. Tom Hildebrandt, a psychiatrist who leads the Eating and Weight Disorders Program at Mount Sinai. The proportion of male patients entering his program, often for what is called muscle dysmorphia, has nearly tripled over the past 20 years. A form of body dysmorphia that is included in the Diagnostic and Statistical Manual of Mental Disorders, muscle dysmorphia often leads to obsessive dieting, exercise and dangerous substance use. Hildebrandt estimated that roughly 40 percent of the male patients entering his program for muscle dysmorphia will have used testosterone at some point.
Social media is “a constant testimonialized sales pitch for doing extreme things to alter your appearance,” Hildebrandt said. “And if you don’t do it, then you’re going to be ranked lower.”
At a December F.D.A. panel dedicated to testosterone replacement therapy, the speakers repeatedly invoked a familiar cautionary tale: hormone therapy for women.
Prescribed to replace estrogen after the precipitous hormone drop of menopause, H.R.T. was widely embraced until a major study in the early 2000s linked it to an increased risk of breast cancer, stroke and blood clots, inciting a sharp backlash. In the years since, robust research has suggested that the risks were overstated for many patients. Just a month before the December testosterone panel, the F.D.A. removed so-called black-box warnings from menopause hormone therapies — “clearing up 22 years of dogma,” the F.D.A. commissioner, Dr. Marty Makary, said in his opening remarks to the panel. The episode, he added, raised the question of whether a similar dynamic was preventing more widespread medical use of testosterone in men.
The December panelists, most of them urologists (some of whom disclosed ties to telehealth clinics and pharmaceutical companies that make testosterone products), argued that there was a crisis of underdiagnosis of low testosterone that was being ignored. They argued for two main changes: making a broader group of men eligible to be prescribed testosterone (currently 85 percent of men on T.R.T. are prescribed it off-label), and removing the hormone from the Drug Enforcement Administration’s list of Schedule III controlled substances.
“Because patients aren’t able to get it reliably without increased effort, without stigma, they essentially suffer in silence,” said Dr. Tobias Kohler, a urologist at the Mayo Clinic who was on the panel. Efforts to prevent people from abusing T.R.T. ended up just making it harder to obtain for the men who needed it — without successfully preventing abuse, Kohler argued. “People who want to abuse testosterone-like drugs, they go elsewhere,” he said. “And they get not only testosterone, they get everything else that they need from either their gym bros — or, more commonly, on the internet.”
Toward the end of the panel, Brian Christine, the assistant secretary for health, said the need for T.R.T. reflected a broader neglect of men’s health in this country that would be answered by the Trump administration. He cited dire health disparities between men and women: Life expectancy for men is six and a half to seven years shorter; 70 percent of opioid overdoses are in men; only a quarter of the estimated six million men with depression in the United States seek treatment; and four times as many men die by suicide.
And yet, he said, “there are fewer federal programs targeting men’s health concerns.” An Office on Women’s Health was established in 1991; Christine announced that the Trump administration would be making clear that men’s health was also a priority by establishing an equivalent initiative for men.
Derek Griffith, the director of the program for research on men’s health at the University of Pennsylvania, told me that men’s health “has not been something that most administrations — any administration — has really seemed to take seriously at any point in the nation’s history.”
Griffith was skeptical that T.R.T. could address the primary drivers of poor health outcomes in men. But he did think that T.R.T. could help men who actually have low T. Griffith was so impassioned about T.R.T.’s effects that, midway through our call, I asked whether he had ever been on it himself. He hadn’t planned to share his personal experience, he said, but in fact, at 55, he had been on testosterone replacement for the past 20 years. For men with low testosterone, he said, “that magic silver bullet — it can sort of be that.”
Many of the men I talked to who had low testosterone described the treatment’s impact on their lives in similar almost rhapsodic terms. They talked about having a lot more sex and gaining more muscle, sure, but also about quitting drinking, becoming better dads and husbands and generally feeling, as one told me, “part of life” for the first time in a long time.
“I’m just more happy to do things,” said Kip Granson, a 52-year-old tech worker in Indiana whose testosterone level was in the 200s before he started on T.R.T. in 2022. He no longer felt the intense, depressive pull to sit on the couch and play video games. Instead, he enthusiastically helped his wife with the farmers’ market popcorn business they run on weekends. He started fixing things in the shed behind the house. Though he had always struggled with his weight, it now felt easy — even rewarding — to exercise.
But many men I spoke with also talked about the frustration of trying to get their doctors to believe their symptoms were actually tied to their clinically low testosterone. Norman, a veteran in central California, described how despite the fact that he felt profound fatigue and had extremely low testosterone in the 90s range, one endocrinologist chided him with “You men and your testosterone.” Years later, a doctor at the Department of Veterans Affairs ordered an M.R.I. and found that the hormone-signaling part of his brain was damaged, most likely caused by a traumatic brain injury he sustained while serving in the Navy two decades earlier.
Both Norman and Granson brought up another comparison I heard frequently: that testosterone replacement therapy could be viewed as gender-affirming care for men. Norman said he found it “insulting” that “if you’re a woman wanting to transition to a man, you could get testosterone easier than I could.” Granson said that while he agreed with the administration’s moves to further open access to T.R.T., there was a clear double standard. “This is the same group of people who go [expletive] over someone who’s trans getting hormone therapy, but they’re quite all right with some 25-year-old guy that wants to get testosterone,” he said. “It should be treated the same way.”
The accounts of Norman, Granson and the other men I talked to made clear how muddled the question of medical “need” has become. For Mark, a 64-year-old businessman in Cincinnati, trying to draw that line at all is futile when men want this drug — and should be able to do with their bodies as they please. His results on T.R.T. have been fantastic, he told me. When we talked, he was preparing to go to an overseas resort with his wife, and said he finally felt confident enough to take his shirt off at the beach. “I like looking good, and I like erections, and I like feeling young and powerful,” he said. “Now I’m back to that.”
But he told me he has grown frustrated by how conservatively doctors prescribe T.R.T. While his testosterone had gone from low to squarely midrange, he wishes his doctor would aim for “optimal,” he says, rather than just “average.”
Mark told me that though he disagreed vehemently with Kennedy on many issues, including vaccines, he agreed with him wholeheartedly on the benefits of boosting testosterone. “I do like his stance — and he does look great,” Mark said. Based on the health secretary’s extremely muscular physique, Mark speculated, he was very likely taking doses of testosterone that put him well above the normal range. “And the thing is, what’s wrong with that? Why is that a bad thing?”
The Trump administration did not create the T moment. But it’s easy enough to see how it has tried to tap the energy of so many men who are fundamentally dissatisfied with so much about their lives as men — and the sense that their masculinity is not taken seriously — and tried to claim them as kindred spirits. In late October 2024, just before Election Day, JD Vance went on Rogan’s podcast. “Have you seen all these studies that basically connect testosterone levels in young men with conservative politics?” Vance asked. “If you make people less healthy, they apparently become more politically liberal.”
With Trump back in power, an administration official named Monica Crowley told the Fox host Jesse Waters last year that things were already different. “Now we’re in an era of real masculinity, thanks to the bold, muscular leadership of President Trump and our secretary of war, Pete Hegseth,” Crowley said.
When I talked with Christine, the assistant secretary for health, he was clearly in favor of reinforcing traditional views of sex and gender, telling me that “a truly feminine woman and a truly masculine man are complementary and a beautiful thing.” I asked what he thought about the new hypermasculine culture fueling the rise in testosterone use, and he initially pushed back, questioning how much the culture had changed at all. “I think men wanting to optimize their health is probably not any different now than it ever has been,” Christine said. But continuing to think about it, he acknowledged that the broader cultural backlash was real, spurred on by what he said was the sidelining of men and their problems. “‘Masculinity’ has become somehow a bad word,” he said.
As for Todd, who had gone down a rabbit hole online and emerged persuaded that his testosterone levels were the key to all that ailed him, he also believed society had lost touch with the importance of masculinity. He seemed to embody the blurry line between a medical treatment and the ideology that so often accompanies it. T.R.T. had restored him, he said, to feeling healthy: He no longer struggled with intense bouts of anxiety and brain fog, he had a strong libido and was able to build muscle at the gym.
But he wanted more. He had since doubled his dose, which he eventually obtained from an underground lab, without the supervision of a doctor, and now has a testosterone level of 1,200, well above the normal range. It’s an approach that some guys on Reddit call “T.R.T. plus,” he told me. And that was exactly where he wanted to be. It wasn’t, he said, “a bragging type of thing,” but at the age of 42, “in the gym, I’m probably going to smoke most 20-year-olds.” He shared that he was dating a lot, and also that women his age had started to seem too old for him.
I asked Todd about the fact that so much of the discussion around testosterone online seemed aimed at making men feel insecure about their own masculinity, and whether he saw this as pressuring more men — even those without low T — to feel like the drugs could help them.
“I wish I could say yeah,” he said. But in his view, there is not enough pressure on men, and too much tolerance for a kind of mass failure to live up to age-old standards. “I don’t feel like men are pressured to be manly at all anymore — I really don’t.”
He saw the fallout all around him. “Men are less interested in having a girlfriend, having sex with a girl, having a kid, creating a life,” he told me. Instead, he said, they are content to watch movies and TV and play video games. He’d been there himself.
Testosterone, he believed, really could be the solution to all that. “The marketing is like, You’ll be a better man and more masculine. And it’s funny, because it is marketing — but it’s literally all true,” he said. “That’s literally what will happen.”