The Testosterone Economy and the Appeal of Simple Answers
Testosterone isn’t trending because men suddenly discovered hormones. It’s because the typical health approaches offer ambiguity—while the market promotes clarity, speed, and identity-safe care.
Curiosity hook
For a lot of men, the story starts with everyday problems: feeling tired all the time, low mood, changes in sex drive, poor sleep, trouble focusing, or a sense that their body just isn’t working the way it used to. These symptoms are common and often overlap. When men bring them to a doctor, the answer is frequently unsatisfying—tests come back “normal,” stress is blamed, or they’re told to wait and see. What’s missing is a clear explanation of what might be going on and what the next step should be.
At the same time, testosterone clinics, online ads, and media stories offer something very different. They promise clear answers and quick action. A blood test gives a number. That number gets a name—“low T.” A plan follows. News coverage and health blogs increasingly describe testosterone as a way to restore energy, confidence, and control, even while noting ongoing debates about safety and appropriate use (Scientific American, 2014; 2025; Dendy, 2022).
Seen this way, the testosterone boom is less about hormones and more about certainty. Men aren’t just looking for testosterone. They’re looking for care that feels responsive and understandable.
Define the “testosterone economy”
The “testosterone economy” isn’t just about prescriptions. It is also a growing commercial market.
Available market analyses suggest that testosterone has been a billion‑dollar business for more than a decade. Scholarly reviews and industry reporting indicate that U.S. pharmaceutical sales of testosterone products grew rapidly in the 2000s, reaching roughly $2 billion annually by the early 2010s, before the recent expansion of telemedicine and direct‑to‑consumer (DTC) models (Baillargeon et al., 2013;Baillargeon et al., 2018; Handelsman, 2013). Continued growth is projected, although the oversight of federal regulators may be limited to larger drug manufacturers and distributors and not include direct to consumer and online clinics (Woloshin et al., 2023).
This commercial growth sits alongside important clinical realities. Population studies show that a substantial share of men, particularly those over age 45, have low testosterone levels by laboratory cutoffs, with estimates ranging from ~25% in men ages 40–70 to ~35–40% in men over 45 (Araujo et al., 2004; Endocrine Society, 2022). However, only a fraction of these men meet full clinical criteria for hypogonadism—requiring both consistently low levels and specific symptoms—and only a minority of those men receive testosterone therapy in real‑world practice (Malik et al., 2015).
In news articles, clinic-produced marketing content[i], and social media, testosterone is often framed as a solution for feeling run down, aging, or falling behind physically or mentally. Recent reporting has described TRT as both a fast-growing medical treatment and a source of concern—caught between legitimate care, lifestyle optimization, and outright misinformation (The Guardian, 2025).
This economy has a few key parts. First, there are real clinical trends: large studies show testosterone prescribing has increased substantially over time, which has prompted ongoing debate among clinicians and regulators about who should receive it and how it should be monitored (Baillargeon et al., 2018; Dubin et al., 2022). Second, there are telemedicine and DTC platforms that make access much faster and easier, something journalists frequently highlight when covering the TRT boom (Liu et al., 2025; Lim et al., 2024). Third, there is the story layer—messages about masculinity, performance, and self‑improvement that frame testosterone as a proactive, responsible choice tied to self‑management and vitality, rather than a treatment of last resort (Gram et al., 2025; The Guardian, 2025).
Together, these forces turn a loose set of symptoms into a clear label, “low T”, and pair that label with a simple, measurable, and confident pathway forward. Scientific research helps us understand the medical side of this story. Media coverage helps explain why the idea spreads so quickly and feels persuasive to so many men.
Why “the T” took off
The rise of the testosterone economy isn’t just about changing biology. It reflects gaps in how care is delivered—and how those gaps are filled by clearer, more compelling narratives.
The ambiguity gap. Research shows that men presenting with fatigue, low mood, sleep problems, or sexual concerns often do not receive a clear diagnostic pathway; these symptoms are common and hard to attribute to a single cause, and men describe feeling “brushed off” or left without direction even when clinicians follow evidence‑based practice (Liu et al., 2025; David & Charles, 2024; Mascarenhas et al., 2018).
Media stories tell a much simpler story. Articles in outlets like Scientific American and clinic-produced marketing content describe testosterone as something measurable and actionable. There’s a number to check, a target to aim for, and a plan to follow, even when the article also mentions scientific uncertainty (Scientific American, n.d.). Compared to “let’s wait and see,” that clarity is powerful—especially given what we know about men’s typical health‑seeking patterns, which tend to favor concrete action, problem‑solving, and defined next steps over prolonged uncertainty or open‑ended monitoring (Addis & Mahalik, 2003; Galdas et al., 2005; Courtenay, 2000).
The friction gap. News coverage also emphasizes how easy testosterone has become to access. Journalists describe telemedicine and DTC services that allow men to get tested, prescribed, and followed remotely, sometimes within days (The Guardian, 2025).
The research literature is more cautious. Telemedicine can improve access and continuity for some men, but it also comes with limits, such as reduced opportunity for physical examination and wide variation in how carefully patients are evaluated and monitored (Dubin et al., 2022; Lim et al., 2024). What stands out, though, is that these services are predictable and easy to navigate—something many men don’t experience in traditional care.
The identity gap. Finally, testosterone is often talked about as a tool for self-improvement rather than a medical treatment for illness. Media coverage of influencers and celebrities presents TRT as a way to take responsibility, stay competitive, and avoid decline, or in other words “optimize your life”.
Qualitative research partly supports this framing. Across multiple studies, men describe wanting care that protects their dignity and avoids interactions they experience as stigmatizing, minimizing, or emasculating, particularly around mental health, aging, or sexual concerns (Liu et al., 2025; Engle et al., 2023; Gilbert et al., 2022; El‑Osta et al., 2021). At the same time, journalists and researchers warn that this same messaging can drive overuse or demand among men who may not benefit medically (The Guardian, 2025). Both underdiagnosis and overuse can exist at the same time—depending on who is being reached and how. Taken together, these findings suggest that stigma avoidance is not just an individual attitude but a design signal: men gravitate toward services that minimize judgment, offer clear scripts, and reduce the social and emotional costs of seeking help, shaping which care models succeed and which are quietly bypassed.
The hidden product: coherent care design
Empirical research helps us understand who receives testosterone and under what conditions. Media narratives help explain why the product resonates. Together, they suggest that many men are not just purchasing a hormone—they are purchasing a system that offers:
A clear label for vague symptoms
A defined pathway from testing to action
Regular touchpoints and feedback
A sense of legitimacy reinforced by media, marketing, and social proof
Clinic-produced marketing content and news features often emphasize reassurance (“this is common”), control (“optimize your levels”), and momentum (“start feeling better fast”). “Compared to ‘let’s wait and see,’ that clarity is powerful—especially given what we know about men’s typical health-seeking patterns, which tend to favor concrete action, problem-solving, and defined next steps over prolonged uncertainty or open-ended monitoring” (Addis & Mahalik, 2003; Galdas et al., 2005; Courtenay, 2000).
Relational reframing
From a relational health perspective, this matters. The testosterone economy succeeds by offering belonging, clarity, and agency. The risk is not that testosterone is discussed publicly, but that the public story narrows complex health experiences into a single explanatory frame.
The tradeoffs: where concern is warranted
A serious conversation about the testosterone economy has to acknowledge tradeoffs documented in the academic literature. The goal is not to dismiss testosterone therapy outright, nor to paint all market-based services as irresponsible, but to summarize where empirical studies and clinical guidance raise cautions when clarity and speed substitute for careful assessment.
Clinical appropriateness, diagnostic variability, and substitution risk. Clinical guidelines, observational studies, and qualitative research converge on a related set of concerns about how testosterone therapy is initiated and interpreted (Endocrine Society, 2018; Mulhall, 2018; Baillargeon et al., 2018; Mascarenhas et al., 2018). While testosterone therapy is clinically appropriate for a subset of men, the literature documents substantial variation in how men are evaluated prior to initiation. The concern raised in the literature is not overt harm or clinician negligence, but premature diagnostic closure—situations in which testosterone becomes the dominant explanatory frame before other plausible contributors are fully explored, narrowing clinical pathways early (Araujo et al., 2004; Liu et al., 2025; El‑Osta et al., 2021).
Monitoring quality and long-term risk management. The clinical literature consistently emphasizes that testosterone therapy requires ongoing monitoring, including follow-up laboratory testing and surveillance for contraindications and adverse effects (Endocrine Society, 2018; American Urological Association, 2018). Clinical guidelines and observational studies document wide variation in how consistently this monitoring occurs across practice settings. Telemedicine and subscription-based delivery models may improve continuity for some men, but published analyses note potential gaps when monitoring protocols are uneven or poorly enforced (Dubin et al., 2022; Woloshin et al., 2023; Lim et al., 2023). The concern raised in the literature is not that newer delivery models are inherently unsafe, but that variation in follow-up and oversight can introduce risk over time if monitoring expectations are unclear or inconsistently applied.
Equity and access. Research and policy commentary also point to equity implications (Baillargeon et al., 2018; Jesse et al., 2023; Dietrich et al., 2023). Subscription-based testosterone services are often more accessible to men with disposable income, stable employment, and digital literacy. This raises the possibility of a two-tier system in which some men access rapid, continuous care while others rely on more fragmented, episodic services. The concern raised in the literature is not that newer delivery models are unsafe, but that inconsistent follow-up and oversight can create problems over time when monitoring expectations are unclear or unevenly applied.
Taken together, the research suggests a central tension: the testosterone economy addresses real experience gaps in care delivery, but it may also redistribute clinical uncertainty and risk rather than fully resolving it.
What can we learn from “the T”?
The rise of the testosterone economy is not primarily a story about misguided men or predatory markets. It reflects unmet design needs in health care. Market-based testosterone services are gaining traction not because they reject medicine, but because they reliably deliver features that feel like care: clear explanations, predictable next steps, low friction, and protection from stigma. Traditional systems often deliver clinical rigor, but they do not consistently deliver these experience-level features, especially for men with ambiguous, overlapping symptoms.
Seen this way, the response should not be to lecture men about overuse or to tighten access alone. Instead, it should take seriously what men are signaling through their choices—a preference for care that offers clarity, momentum, and dignity—and ask how evidence-based systems could meet those needs earlier and more safely. From a men’s health and relational health perspective, engagement is not just about motivation or education; it is about fit. Systems that require men to tolerate prolonged uncertainty, fragmented referrals, and unclear next steps will continue to lose them to alternatives that offer structure.
The challenge for health systems, then, is not whether to copy testosterone clinics, but how to identify which features of these services address real engagement problems and integrate them into broader, more comprehensive care pathways.
Concrete takeaways
If you’re designing men’s services: 5 features the testosterone economy gets right.
The testosterone economy has grown not because it ignores medicine, but because it solves experience problems that many health systems still struggle to address. Research and reporting suggest that men are responding to how care feels just as much as what it provides. For leaders designing men’s services, the takeaway is not to replicate testosterone clinics, but to understand what they get right and integrate those features into broader, evidence‑based care.
1. Speed and low friction
Men respond to pathways that are easy to enter and quick to move. Long waits, unclear referral chains, and repeated appointments increase dropout. The safer alternative is not rushed prescribing, but faster triage: rapid‑access entry points, clear timelines, and early reassurance that concerns will be addressed.
2. Clarity and a coherent pathway
Testosterone services succeed by offering a simple story: test, interpret, act. Health systems can offer the same sense of clarity without rushing to conclusions by using clear, standard pathways for common concerns—like fatigue, mood changes, sleep problems, and sexual concerns—and by explaining in plain language what test results mean and what the next step will be.
3. Measurement and feedback loops
Men value concrete signals that something is being tracked. Market models emphasize numbers, progress, and follow‑up. Safer systems can meet this need through appropriate measurement plans, regular check‑ins, and patient‑friendly summaries that show how symptoms, labs, and goals are evolving over time.
4. Continuity and coaching
One reason testosterone platforms retain users is continuity. Men know who they are hearing from and what support looks like over time. Health systems can replicate this strength through care teams, navigation, asynchronous messaging, and coaching that helps men interpret changes rather than leaving them to connect the dots alone.
5. Identity‑safe engagement
Perhaps most importantly, the testosterone economy reduces stigma. It frames help‑seeking as proactive, responsible, and normal. Evidence from qualitative studies suggests men are more likely to engage when care protects dignity and avoids judgment. Designing services that use strengths‑based language and normalize uncertainty can reduce avoidance without overselling solutions.
The point is not to copy the testosterone economy. It is to learn from it. When health systems offer men clear paths, respectful engagement, and predictable next steps, testosterone no longer carries the burden of standing in for care itself.
References
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[i] In the academic literature, similar materials are often described as “direct-to-consumer health information,” “provider-authored patient-facing content,” or “practice-branded health messaging,” particularly when analyzing commercialization, framing, and help-seeking pathways.
