An Era Where "Masculinity" Can Be Bought with a Click? The Light and Shadow of the "Rejuvenation Business" Promoted by Online Medical Consultations

Introduction: Why Testosterone is Making Headlines Now

In November 2025, the U.S. NPR-affiliated radio program "Here & Now" aired a special feature titled "Testosterone therapy is on the rise." Annalisa Merelli, a reporter from the medical media outlet STAT, appeared on the program, stating, "The expansion of the online market is drawing countless men into testosterone treatment."WBUR

Fatigue, decreased concentration, reduced libido... These are familiar concerns for men in middle age and beyond. However, in the U.S. today, there is a growing trend to label these symptoms as "Low-T" (testosterone deficiency) and attempt to solve them quickly with hormone replacement.

Behind this trend is the rapid expansion of online medical consultations and home delivery pharmaceutical services, as well as the spread of information through social media claiming "boosting testosterone will change your life." Meanwhile, experts are sounding the alarm, questioning "Is it really hormones causing the issue?" and "Has long-term safety been adequately verified?"STAT

In this article, we will use the program and STAT's reports as clues to organize the reality of the testosterone therapy boom and the swirling social media opinions surrounding it.

1. The "Rejuvenation Subscription" That Starts with a Click

In the U.S., where Merelli conducted her research, online clinics with names clearly targeting men, such as "DudeMeds," "Maximus," and "Titan," are emerging one after another. Users answer a simple questionnaire via the web or an app, and in some cases, use a blood collection kit at home. Based on the results, testosterone is regularly delivered to them.STAT

Monthly fees range from under $100 to several hundred dollars, but many men pay as a form of "self-investment," similar to gym or supplement subscriptions. Testosterone injections or gels can be administered at home, with follow-ups conducted online. This likely appeals to busy businessmen.

In fact, in the U.S., the number of prescriptions for testosterone injections is expected to double from 2019 to 2025, with the market size reaching approximately $2.5 billion.STAT

However, this "convenience" is precisely the most precarious point from a medical perspective.

2. What is Genuine Testosterone Replacement Therapy?

Testosterone replacement therapy (TRT) has long been a legitimate treatment for cases where "male hormones are clearly low, causing health issues."

According to the guidelines of the Endocrine Society,

• repeatedly low testosterone levels

• and corresponding symptoms (such as decreased libido, erectile dysfunction, and muscle weakness)
  are the criteria for recommending replacement therapy, limited to men who meet both conditions.Endocrine Society

Furthermore, the American Urological Association (AUA) also calls for accurate blood tests and diagnoses, as well as careful consideration of cardiovascular disease and prostate cancer risks.AUA

In other words, administering hormones without proper blood tests for reasons like
"I just feel tired lately" or "I want to build muscle quickly at the gym"
is outside the realm of proper medical practice.

3. Why Online Clinics are Still Popular

So why are many men turning to online clinics? Based on STAT's article and the program's content, the reasons can be broadly categorized into three.STAT

(1) The "Coldness" of Primary Care

Even when complaining of fatigue or mood swings, many men report being dismissed by their primary care physicians with comments like "It's just your age" or "Try harder with exercise and dieting." Some were even told there was no need for testing because they didn't have erectile dysfunction, preventing them from getting a blood test.

Patients feel frustrated that their struggles aren't taken seriously, and after extensive online searches, they end up at online clinics specializing in testosterone.

(2) Divergent "Philosophies of Treatment" Among Doctors

While some endocrinologists adhere strictly to guidelines and numerical criteria, some urologists believe that if symptoms are severe, treatment should be considered even if levels are borderline.STAT

In cases where other factors like obesity or sleep apnea are behind low testosterone, lifestyle improvements should be prioritized. However, there is a strong opinion that "it's harsh to be told to lose weight first when that's the problem they can't solve."

(3) Pressure of "Masculinity" and Influencer Culture

On social media, videos of muscular influencers claiming "optimizing testosterone will make everything in work and love go well" are constantly circulating. The thickness of one's beard, muscle mass, and libido are often linked to "a man's worth," and Low-T is sometimes discussed as a "loser's mark."

In this culture, testosterone therapy is marketed not just as a medical act but as "self-investment to reclaim masculinity."

4. Overlooked Risks and Uncertainties

Here, let's also outline the representative risks associated with testosterone therapy.

• Reduced Spermatogenesis and Infertility: Introducing testosterone externally suppresses hormone secretion within the body, reducing sperm count. This is a significant issue for young men who wish to have children in the future.STAT

• Increased Risk of Blood Clots Due to Elevated Red Blood Cells: Hematocrit levels may rise, increasing the risk of thrombosis, necessitating regular blood checks.Endocrine Society

• Breast Swelling or Enlargement (Gynecomastia): Hormonal balance changes can stimulate the mammary glands, causing concerns about appearance.STAT

• Potential Cardiovascular Events: Recent large-scale trials have not shown clear evidence of significantly increased risks of myocardial infarction or stroke, but it is not yet at a stage where it can be declared completely safe.New England Journal of Medicine

Many online consultation advertisements emphasize benefits like "relieving fatigue" and "increasing concentration" without adequately explaining these risks.

Guidelines repeatedly emphasize the importance of "carefully discussing risks and benefits before starting treatment and ensuring regular follow-ups."Endocrine Society

5. The Swirling Debate on Social Media

The debate over testosterone therapy is becoming a major point of contention not only in the medical world but also on social media. Here, we introduce three typical perspectives, along with fictional post examples.

(1) The Saved Camp: "Without This, My Life Would Have Been Over"

"Since starting TRT, it's been easier to get up in the morning, and my work motivation has returned.
If I could change this much in my 40s, I wish I had done it sooner."

Such posts are frequently seen on forums like X (formerly Twitter) and Reddit. Many tell stories of struggling with long-standing fatigue or depression, having visited numerous medical institutions before finally discovering testosterone therapy.STAT

For them, TRT is the "last bastion" that saved them from being neglected by the medical system, and their gratitude and excitement are visible in their highly enthusiastic posts.

(2) The Concerned Camp: "Medicine is Being Swallowed by Subscription Business"

"A 20-second consultation and 'Your numbers are OK, let's order'... This isn't medicine; it's mail order."

Users of online clinics often express dissatisfaction with the extremely simplified consultations and explanations, as well as criticism of difficult-to-cancel pricing structures.STAT

From the medical side, there are also numerous criticisms, such as "administering testosterone for 'relatively low' levels within the normal range lacks evidence" and "there is insufficient data on long-term adverse events."E-ENM

(3) Criticism from a Gender Perspective: "Just Overwriting the Curse of Masculinity with Hormones"

Recently, there has been criticism from gender studies and mental health experts questioning whether the testosterone therapy boom is reinforcing the pressure of masculinity.

"If every time you feel 'tired' or 'insecure,' you think 'it's because I'm low on hormones,'
you lose sight of the real issues like work, household and childcare burdens, unstable employment, etc."

Posts like these attract a lot of empathy and counterarguments. While testosterone levels are indeed one aspect of health, they don't solely determine a person's worth or happiness. Yet, influencer videos continue to suggest that raising these numbers will dramatically change one's life.

6. How to Update "Men's Health"

As we have seen, the testosterone therapy boom is not merely a pharmaceutical trend.

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