23-year-old Joseph Wells began testosterone-replacement therapy (TRT) when he was just 18. “I was really lanky – I’m six foot three – and very skinny before,” he says, laughing. I imagine he’s laughing because it’s difficult to imagine Wells, now a qualified personal trainer and online coach with abs like bricks, ever being described as “lanky” or “skinny”.

“I’m really pushing the boundaries with it, to be honest,” Wells says, claiming that he is currently taking a 1,000mg dose of testosterone each week, an incredibly high dosage (for context, standard doses for treating low T usually range from around 70 to 150mg per week). But despite being on TRT, Wells has never been diagnosed with low testosterone, nor has he ever experienced any symptoms of low testosterone levels (which include low mood, low sex drive, low strength, and erectile dysfunction). “I suppose it kind of was insecurity which pushed me to start [TRT]. I was pretty naïve,” he says. “I just wanted to get more jacked. But quite frankly, it’s not something I regret. It helps your recovery, build more muscle, you know.”

Wells isn’t the only young man who’s started trying to ‘boost’ his testosterone levels in recent years. Social media is awash with testosterone-related content, where swathes of young male influencers are posting about the benefits of TRT. Many of these men are under 30 and have seemingly never been diagnosed with low testosterone, a condition which typically only affects men in their 50s and older.

27-year-old James Manteit (@jamesmanteit) regularly posts to his 75,000 TikTok followers about how they can “boost” their T levels. In one video, he urges his followers to promote testosterone production by loading up on healthy fats from meat, avocado, dairy, and egg yolks. 25-year-old influencer Kade Martinelli (@kmartfit) posts similar content about the benefits of taking TRT, the warning signs of low T, and the results he’s seen after injecting himself with T over four years. “Some of the world’s best entrepreneurs [...] all take testosterone to increase their energy levels so they can accomplish their goals,” he says in one video captioned “Why high level men are on TRT”.

Testosterone has myriad functions – from glucose control, metabolism, bone health, mood, and more – but it’s most commonly known as the primary male sex hormone, responsible for the development of masculine features such as a deeper voice, body and facial hair, and muscle strength.

Many of these videos often associate having “high testosterone” with being a “high level man” or an “alpha”. Unsurprisingly so: in recent years, men in alt-right spaces have bandied about “low T” as an insult usually reserved for men who are politically left-leaning, alongside other pejorative terms like “cuck”, “soy boy” and “beta”.  In September this year, Elon Musk reposted a screenshot of a 4chan post which argued that “women and low T men” are not able to think freely because “they can’t defend themselves physically.” Perhaps it’s also telling that some of this social media content which encourages young men to pursue high T levels is posted under the hashtag #testosteronemaxxing, given that the “-maxxing” suffix originates from incel slang.

I suppose it kind of was insecurity which pushed me to start [TRT]. I was pretty naïve

According to Debbie Ging, Professor of Digital Media and Gender in the School of Communications at Dublin City University, “there is no doubt” that the growing interest in “testosterone boosting” is linked to the rise of manosphere influencers. “To be clear, in patriarchal societies there has traditionally been an onus on men to be physically strong. This had changed recently, with greater acceptance of other ‘softer’ variants of masculinity,” she explains. “The manosphere is explicitly about pushing back on what they would see as emasculated ‘soyboys’, and the focus on physical strength and prowess – under the guise of wellness – is a key part of this.”

Granted, it is true that the men of today have lower testosterone levels than the men of generations gone by. A recent study has shown that since 1987, average levels of testosterone in men have dropped by about 1 per cent each year. It’s not entirely clear why this is happening, but researchers have their theories. According to Dr Daniel Kelly, a lecturer in biochemistry at Sheffield Hallam University, the change could be due to higher stress levels, poor diet, lack of exercise and increasing obesity rates, as well as chemicals in plastics, certain pesticides and processed foods containing hormone disruptors.

It’s still too soon to say whether this decline is impacting men’s health, and even though T levels are falling, they are still within the ‘normal’ range – but it’s easy to see how figures on the right have taken this news as hard evidence that men are becoming “weaker”.

At present, TRT is currently legal in both the UK and the US, so long as it has been prescribed by a qualified doctor: but many young men who don’t have particularly low T often approach private companies who are often happy to dole out prescriptions so long as they’re making money (cruelly, however, most of these clinics do not offer services to trans men — speaking to Business Insider, the co-founder of one US TRT clinic stated that they only took on “biological men” as patients). “The major difference between getting TRT on the NHS vs private healthcare sector is simplicity,” reads a statement on the website of one UK-based TRT clinic. Wells also suggests that it’s harder to get TRT through the NHS. “Don’t get it done through a doctor – the NHS are clueless when it comes to this. I know that sounds ignorant, but you need to go to a special TRT clinic or research it yourself.” (Wells buys his own testosterone online from an ‘underground lab’).

Dr Kelly is sceptical of private TRT clinics. He stresses that it’s great to see more people talking about men’s health, but he’s worried that all the testosterone talk could end up having an adverse effect on men, with “predatory” companies happy to capitalise on men’s insecurities through offering so-called ‘T optimisation’ services. He adds that he’s also concerned about the impact the rise of TRT could be having on men’s mental health. “It can lead to unattainable ideals of manhood – which is dangerous,” he says. “It’s a bit like what we saw with size 0 female models some years back, with promoted ideals actually leading to detrimental health behaviours.”

It’s also unsurprising that swathes of young men believe they have low T levels when there’s evidence many of them are genuinely struggling with the symptoms of low T. “There are increased rates of depression in the population (including young men), anxiety is pretty much the biggest mental health issue for young men, and there are increased rates of erectile dysfunction in younger men,” Dr Kelly explains. “All these are symptoms which align with low T in older men, but are most likely not due to low T in younger men.” So, he explains, when a young man presents with one or more of these symptoms, he might be likely to think that TRT will solve the problem – even though low T is likely not the issue.

It’s worth stressing too that when used correctly, TRT can be hugely beneficial. “When TRT is used in men with low levels, they report a better quality of life,” says Dr Kelly. “But the only men that need TRT are those who demonstrably have low testosterone. To identify someone like that we need to do careful measurements. If someone suspects they may be T deficient, they need to get in contact with a healthcare professional to get proper diagnosis.”

Dr Kelly advises against young men with healthy T levels starting TRT. “It is important to say that most of the safety studies on TRT have been conducted on older men whose testosterone levels have declined with age,” he says, stressing that the effects of TRT use in young men are still uncertain and the full extent of the dangers may not yet be known. TRT can have serious side effects too, including hair loss, acne, worsening of sleep apnea, and fertility problems. It can also potentially elevate the risk of heart disease and other cardiovascular issues, as well as increase your risk of blood clots, which can be fatal. One thing is clear: as Dr Kelly says, “It is definitely possible to ‘boost’ T levels too high.”