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The truth you always knew about testosterone

Carole Hooven’s T: The Story of Testosterone, the Hormone that Dominates and Divides Us is well written. I recommend it to everyone. There are lots of little details that make the book shine, but, I have to be honest and say that’s it’s not really changing my priors. I have a biological science education and I was always taught that testosterone was a big deal.

But things have changed since the early 2010’s. For example, Testosterone: An Unauthorized Biography and Testosterone Rex: Myths of Sex, Science, and Society have both been published to great acclaim in the last five years, transforming the ideas of well-informed people about the importance (or lack thereof) of testosterone. Testosterone Rex won an award from The Royal Society. Testosterone: An Unauthorized Biography has endorsements from Robert Sapolsky, John Ioannidis (back when he was good actually!), and Nature.

In other words, if you are not a biologist you can reasonably assert that testosterone doesn’t make a huge difference. If you are a biologist and not focused on hormones, you can reasonably say that the science “community” has changed its views on the topic. But at best these books are probably misleading, and at worst they are perpetuating people lying to themselves.

Unfortunately, the only thing that Hooven’s book is convincing me that I shouldn’t trust anyone because they’re all liars and/or self-deluded.

8 thoughts on “The truth you always knew about testosterone

  1. Razib: This post was little too self referential.

    Is it a good book?

    Do you think Ms. Hooven is among the “liars and/or self-deluded”?

  2. I’m confused. You start by saying you recommend the book to everyone. You end by saying unfortunately it’s convincing you shouldn’t trust anyone as they’re all self deluded, by which I assume you mean the author of this book?

  3. Sapolsky wrote a book about stress titled “Why Zebras Don’t Get Ulcers” after Barry Marshall had already found the actual cause of ulcers.

  4. i trust carole

    the point is that a lot of people in academia i know personally are not pushing stuff that’s bullshit that i think they know is bullshit since they converted in the last 5 years.

  5. Barry Marshall found the cause of 90% of ulcers, not all of them.

    I don’t need books to tell me what testosterone does. I have seen what happens to female body builders when they inject themselves with it. To any female weight trainers reading this: don’t do it, it is a very bad idea.

    Anecdote for entertainment: at the teaching hospital where Barry Marshall works, all of the reserved car parking spaces have the doctors’ names painted on them. Marshall’s space is directly opposite the main entrance and has his name plus a big yellow star painted on it. In this era of ubiquitous bullshitters, maybe I better add that I know that because I have been there and seen it with my own eyes, and I don’t tell lies or make stuff up.

  6. @Michelle Ann – Truth = testosterone is a big deal.

    As far as I can gather from the synopses on Amazon, the first two books say it is not. I don’t know the first author, but Cordelia Fine is known to me and she is full of it.

    And as far as I can gather, Carole Hooven’s book is saying that testosterone *is* a big deal, which it is. Differences between men and women are real and physiological, not just cultural.

    It feels really dumb to have to assert what is intuitively blindingly obvious, but that is where we have got to.

  7. Just to wade in as a urologist.
    On one hand I prescribe a lot of testosterone to men where it is low, on the other I block testosterone till it’s non existent for prostate cancer patients. Urologists and pediatric endocrinologists are the only specialties that have questions about disorders of sexual development on their boards.
    Any scientist who tells you testosterone isn’t important likely has no first hand experience with testosterone.
    These types of discussions have taken place for years at the annual Sexual Medicine Society meeting. A bunch of academic psychologists, urologists and lost gynecologists.
    The psychologists are always throwing out somewhat crazy concepts regarding sexuality. The urologists are always asking them how many patients have they actually seen or treated (typically laughably small sample sizes compared to the urologists).
    In the current environment public discussion seems focused on the experience of “tail” curve cases, not the vast majority.

  8. Test matters a lot. I wonder how long the current TRT binge that the general American public is going on will go, that and SARMs. Use of anabolics is skyrocketing. This is coming from someone who’s a medical resident and also in the strength training world. The data is there. The stuff works. On good doses, the average man will gain more muscle in even the intermediate term, if they are naive to it, with no working out compared to even working out without it. The stuff is magical in that sense. I’d wait on more long term data, especially in the context of cardiovascular outcomes (critical for S Asians), before jumping on it though, even at replacement doses. Good thing I likely have a couple decades to go before I expect my T levels to fall to the level to consider it.

    What’s interesting is that strength gains on it tend to not be as dramatic, like 15-20% for most people. Btw, most people who go into those pop-up TRT clinics are not on replacement doses. I know some people that went to some clinics, basically got fake results, and are put on supraphysiologic doses. It’s just a legal way to deal anabolics at some point. Now, some people certainly use it responsibly. But it is always interesting to see men who are on the borderline to qualify and the aggressive arguments that ensue with endocrine/urology, especially when the specialist says “no.”

    Btw, SARMs are not benign. Enough reported liver adverse effects with them and shutting down native test production. They aren’t some magical solution.

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