Talk of testosterone deficiency is hard to escape these days, with podcasters and politicians obsessing over how to avoid a “low T” lifestyle.
As the hormone’s cultural salience deepens, demand is growing. In a timely move, telehealth giant Hims just launched a testosterone replacement therapy service for cisgender men.
The direct-to-consumer juggernaut will offer two types of injectable treatments, as well as an oral pill option that can be sent to patients after they take an at-home capillary blood test. Peter Stahl, a urologist and a senior vice president of men’s health at Hims, wants to “cast as wide a net, and get as many people tested, as possible.”
Hims, which started out selling erectile dysfunction medications, has expanded into women’s health and grown from a startup to a publicly traded company serving 2.9 million customers since it launched in 2017. Offering testosterone replacement therapy, or TRT, is both a new phase for the health platform and a doubling down on men’s health care. “When we first started, we didn’t have the capabilities to take care of a complex condition like testosterone deficiency,” Stahl says. “We’ve finally grown up.”
The company will compete with a wide array of online clinics offering testosterone therapy, many of which have cropped up in the past few years using turnkey telehealth services to launch quickly. Many of these services market the medication as a lifestyle enhancer or anti-aging solution.
Stahl sees testosterone deficiency as a medical condition that’s “really underdiagnosed” and “really misunderstood.” Testosterone became a controlled substance following the 1990 Anabolic Steroids Control Act, and for decades, taking it has carried an association with muscle-obsessed gym rats. “That created a lot of stigma,” he says. Older research also showed that testosterone therapy came with cardiovascular risks, though more recent findings suggest those concerns were overestimated.
Testosterone levels have become a MAGA fixation. This fall, Pentagon chief Pete Hegseth announced a mandatory testosterone deficiency screening for most male troops in the US armed services. Texas Republicans have been hurling the phrase “low T” as a masculinity-questioning insult in a hotly contested Senate midterm race between Ken Paxton and James Talarico.
A survey of 2,000 American men this summer commissioned by Hims indicates that they are increasingly willing to talk to one another about testosterone treatment, but the stigma persists around taking medication to address low levels.
Because testosterone is a controlled substance, it can’t be dispensed like many other treatments popular with digital clinics. Unlike GLP-1s and estrogen-based hormone replacement therapy, which are now often prescribed by clinicians after patients simply fill out a quick questionnaire, TRT requires “synchronous” care. That means any would-be users have to have a video chat with a clinician before getting a prescription, and for ongoing monitoring.