It’s safe to say testosterone is widely misunderstood. This hormone is essential for a wide array of body functions and has a huge impact on health and identity. But how it’s understood — as an aid to athletic prowess, a creator of masculine norms, and a reason to take away transgender women’s rights — repeatedly misses the mark.
More often than not, the “testosterone card” is used to give a biological explanation to what are actually social problems. “T can be a convenient distraction. For instance, talk of ‘too much testosterone on Wall Street’ distracts from the complex regulatory, policy, and culture failures,” says Cordelia Fine, Ph.D.a philosopher of science and author of the book Testosterone Rex: Myths of Sex, Science, and Society. Chalking complex events up to biology makes it seem like patriarchy is a result of nature, not something built into a system and allowed by our culture.
All of this leads to a lot of misinformation about testosterone being thrown around. Here, we debunk seven of those myths.
Myth #1: Testosterone is a male sex hormone
Sure, testosterone aids in the development of children assigned male at birth who go through their natural puberty. It’s produced in the tests and responsible for producing sperm, and contributes to the growth of muscle, facial hair, and a deep voice, as well as some mood and behavior changes. But testosterone isn’t a “male sex hormone.” It’s actually prominent in all bodies.
Testosterone is produced in the ovaries and supports ovulation. In fact, it’s one of the most important hormones for people with ovaries, and it’s much more abundant in their bodies than estrogen. It’s just that, in comparison, there’s less testosterone in bodies with ovaries than those with testes.
In general, however, testosterone does so much for the human body and is so essential for the proper growth of embryos, muscles, brains, and red blood cells that it’s not entirely accurate to brand it as the “masculine” hormone.
Myth #2: Testosterone leads to risk-taking, competitiveness, and aggression
There doesn’t appear to be a simple “more testosterone, more masculinity” relationship in humans when it comes to risk-taking or competitiveness, Fine says. Reality is much more complex. Testosterone does affect the brain, but a lot of factors affect how that translates into behaviour. “Testosterone is also just one of many factors that feeds into decision-making,” she says.
Links between testosterone and physical aggression in humans are at best, unclear, contested, and contingent, Fine says. Placebo-controlled trials have shown that even the highest levels of testosterone don’t necessarily increase aggression or hostility in men. Taking it a step further, a meta-analysis of multiple studies found that there’s no correlation between aggression and testosterone. And some other studies have shown that testosterone in men can be linked with both aggressive traits and more prosocial behaviors like generosity.
This myth, though, can have real repercussions on the way society understands differences between men and women. Ideas about how testosterone fuels risk-taking and aggressiveness are often used to explain why we see fewer women in competitive roles of leadership and at the top of occupational hierarchies, Fine says. It’s also used to explain away problematic behavior from boys and men, such as fights on the schoolyard or sexual harassment of women.
Myth #3: More testosterone makes you better at sports
There isn’t a straightforward link between testosterone and athletic performance, according to Testosterone: An Unauthorized Biographya book by gender studies scholar Rebecca Jordan-Young and cultural anthropologist Katrina Karkazis. Testosterone is correlated with parameters related to athleticism, such as the size of your muscles, how much oxygen you can take in, and how many sugars you burn while exercising. But that isn’t an automatic correlation with how good you are at sports.
Overall, it’s not a particularly clean-cut relationship, and it’s definitely not an end-all be-all, according to Jordan-Young and Karkazis. “T is involved in many of the processes that underlie athletic performance for most people, but it should come as no surprise that it’s neither a sufficient nor even necessary ingredient,” the book states.
THe link between testosterone and sports often varies between studies, even though T is widely used for doping across sports. For example, this study conducted on Olympic weightlifters found no correlation between higher testosterone and better performance for male participants. It also found that sometimes female weightlifters with lower testosterone levels lifted more. Rather than testosterone, the best predictor of strength was actually lean body mass.
Another study found that after ten weeks, cis women taking pharmaceutical testosterone had more muscle than their counterparts and could run for longer. However, they didn’t have more muscle power or sprinting power. In another studycis women with the lowest testosterone levels performed the best in three out of 11 running competitions. Studies like this are the reason medical scholars have, in the past, penned letters noting that trying to measure a direct correlation between testosterone and athleticism alone is unscientific.
Myth #4: Higher testosterone makes you good in bed
Testosterone is often touted as the messiah of roaring libido and breath-taking sex for men. But as much as testosterone is necessary for sexual functioning in cis men, The relationships between testosterone levels and sexual performance and drive are weak, some research has found. So long as you don’t have clinically low levels of testosterone — meaning that you have enough T to get an erection — more and more of the hormone isn’t going to make your better at sex.
“Testosterone levels have a fairly wide normal range, and its effects within this range are similar,” says Christian Pike, Ph.D., a professor of gerontology at the University of Southern California. “In my experience, the most significant misconception about testosterone is that it is some sort of drug that improves outcomes and wonder performance across a wide range of measures.”
Myth #5: Testosterone levels should be the same for every man, and should stay the same forever
Levels of testosterone vary throughout one’s lifetime, and they begin to naturally decline around age 30. Levels even vary throughout the day, and they’re affected by everything from body mass and nutrition to alcohol consumption and medication.
Testosterone levels vary between men too. Recently, the Endocrine Society recommended that a natural level of testosterone for cis men, measured through a blood test, ranges from 264 to 916 nanograms per deciliter for those under the age of 40. That’s a huge range.
Myth #6: Testosterone treatment causes prostate cancer and heart disease
In the past, some studies have correlated testosterone treatment with an increased risk of prostate cancer and heart disease. The original studies have since been refuted, but research in this field continues to find varying results. One study found the opposite — that there’s a link between low testosterone and prostate cancer. And this meta-analysis found no link between T and prostate cancer. So we don’t know what the true relationship is between testosterone and prostate cancer.
The same goes for heart health. “The evidence of increased cardiovascular disease is mixed,” Pike says. “And the extent to which testosterone significantly increased cardiovascular disease events has been debated.” Testosterone treatment increases red blood cells, hemoglobin, and hematocrit levels. These can result in increased viscosity of the blood, which in theory could increase risk of cardiovascular events, according to Pike. However, there’s an absence of convincing evidence that this actually the case, she says. This 2014 study found that even older men who received testosterone injections didn’t have an increased risk of heart problems. This 2017 review found no link between heart problems and testosterone.
In fact, some research has found that more testosterone is linked to better heart health, such as this studywhich found that lower testosterone was actually linked with poor cardiovascular health.
Myth #7: If your testosterone is low, you should supplement it
About 35% of men older than 45 have clinically low testosterone, a condition called male hypogonadism. For men with obesity or diabetes, that goes up to 50%, according to the Endocrine Society. Symptoms of clinically low testosterone include everything from fatigue, apathy, difficulty concentrating, weight gain, reduced bone mass, depression, sleep disturbances, and increased risk for metabolic and cardiovascular disease.
When facing health issues, including any of the above symptoms, many men blame low testosterone. The obvious fix? Try and boost it. There are various treatments for low or declining testosterone levels, from clinical Testosterone Replacement Therapy (also known as TRT, which can be carried out through injections, gel applications, orally, or through implants) to over-the-counter supplements and boosters.
And although a provider may recommend TRT if you have male hypogonadism, experts suggest avoiding the DIY stuff. “The testosterone boosters that are on the market are bad. They don’t work,” says Tracy Gapin, MD, a urologist and surgeon specializing in men’s health, referring to over-the-counter boosters. “They’re all based on marketing, and the ingredients don’t really have much validity to them.” Studies have shown that there just isn’t enough evidence to prove that over-the-counter testosterone boosters work, or that they’re even made of what they say they’re made of.
Even if over-the-counter boosters did work, they wouldn’t be an end-all solution. Neither is TRT. “If you’re just giving testosterone, what you’re doing is masking the problem. You’re giving him the formula that his body is not making, but you’re not addressing the underlying causes,” Gapin says.
Rather than just starting testosterone therapy, men with hypogonadism need to shift to a healthier lifestyle. “You do need proper sleep, proper nutrition. Stress can definitely affect testosterone as well,” Gapin says. You also need to be making sure you’re getting enough zinc and vitamin D.
Rather than taking testosterone injections, “it should be more about correcting their nutrition, their blood sugar regulation, fixing their sleep, fixing the way they handle stress, fixing their detox pathways, and helping them avoid a lot of the toxins which we’re exposed to that cause endocrine disruption,” Gapin says. Having adequate levels of testosterone is just one element of overall health, but it’s very reliant on having overall health. So, instead of targeting one single health marker, try tackling the bigger picture.