The “Low T” business, or how to sell testosterone like candy

Testosterone holds a special place in the sporting and medical imagination. It is associated with strength, vitality, libido, muscle mass, and, more broadly, a certain representation of masculine power. In the fitness world, this hormone often transcends its biological status: it becomes a symbolic marker of performance, discipline, and personal worth. This shift is particularly evident on social media, where short-form content easily transforms a complex physiological concept into a simple, memorable, and commercially exploitable message.

Testosterone deficiency is a real condition and may require medical treatment when it fits within a coherent clinical picture. But the line between a medical indication and a narrative of constant optimization can blur very quickly. Fatigue, decreased motivation, training plateaus, low libido, or body dissatisfaction can be presented as signs of a hormonal problem that needs to be corrected. The risk, therefore, is not only in promoting a test or treatment, but in painting a distorted picture of the “normal” man. Thus, how do Instagram and TikTok content dedicated to testosterone testing and treatment represent masculinity, and how might these representations contribute to the medicalization of the male body?

The Study

To answer these questions, researchers conducted a qualitative content analysis of Instagram and TikTok posts dedicated to testosterone testing or treatment. For testosterone, the initial corpus comprised 200 posts, with 100 from Instagram and 100 from TikTok, identified in January 2024 using the search terms “low testosterone test” and “testosterone testing” .

Only English-language posts from accounts with more than 1,000 followers were included, with this threshold serving as a proxy for influencer status. Data collection was conducted using a new, dedicated account with no prior interaction history to minimize the influence of personalized recommendations. The account was located in Australia, which may have skewed the corpus toward English-language and predominantly Western content.

To address the specific question regarding representations of gender and masculinity, the authors then selected a subsample of 46 posts mentioning sexual symptoms or elements related to masculinity. This content came from posts published online between June 2018 and January 2024. Each post was analyzed using a multimodal approach: displayed text, caption, audio, spoken language, video, visuals, attitude, clothing, emotional tone, and promotional context.

The researchers also noted simple quantitative indicators: number of likes, number of followers, presence of a financial interest, link to an action or purchase, account type, and whether the author was presented as a doctor. The qualitative analysis then identified codes related to sexual performance, the gym, health optimization, appeals to young men, comparisons with women, or norms of “true” masculinity. These codes were grouped into four major themes, constructed using a theoretical framework centered on medicalization, biomedicalization, and gender performativity.

Results & Analysis

The first significant finding concerns the very structure of the corpus. Of the 46 posts analyzed, 30 came from Instagram and 16 from TikTok. Together, they accumulated 659,001 likes, an average of 14,326 likes per post, and the accounts in question had a total of 6,830,214 followers. This content was therefore not marginal in terms of potential exposure: it circulated in digital spaces capable of reaching a wide audience.

The other key finding is the commercial dimension. Seventy-two percent of the accounts had a financial interest, for example by selling testosterone tests, treatments, implants (small tablets of pure testosterone implanted under the skin), consultations, or testosterone-related wellness products. Sixty-seven percent of the posts included a call-to-action or purchase link, such as booking an appointment, a promotional code, or access to a clinic. The majority of the accounts were individual profiles, and 12 of the 39 individuals presented themselves as doctors. No post provided scientific evidence to support its claims.

The main finding of the study is that “Low T” was frequently portrayed as a crisis of masculinity, specifically a crisis of male sexuality. The content linked low testosterone to problems with erections, libido, erection quality, energy, motivation, or confidence. The key point is that the posts often reduced complex experiences to a simple hormonal cause, then directed readers toward a test or treatment.

This framing transforms male sexuality into a quasi-biological indicator of conformity. Reduced sexual performance, the absence of morning erections, or a decline in desire are no longer merely phenomena that may depend on sleep, stress, medication, relationships, mental health, or age. They become warning signs, or even implicit evidence of a masculine deficit. The norm is shifting: being a healthy man means maintaining a high-performing, stable, visible, and measurable sexuality.

The second theme shows a broadening of the target population. Historically, declining testosterone has mainly been discussed in the context of male aging. In these materials, it is reframed as a potential problem for young men, sometimes in their twenties or thirties. The message is no longer simply that testosterone declines with age, but that any young man who lacks energy, muscle, or performance might be wise to check his levels.

This reframing draws heavily on fitness tropes. The posts feature young, muscular bodies, sometimes scantily clad, associated with promises of transformation, gym results, or the restoration of an ideal masculine appearance. Testosterone is thus no longer merely a medical treatment within a specific clinical setting; it becomes a potential tool for self-improvement, situated at the intersection of health, aesthetics, performance, and identity.

The third theme extends this logic: the study shows that certain content does not merely present a return to normal as the goal. It suggests that the lower end of the norm is already insufficient. Biological values within the range considered normal may be described as undesirable if they do not correspond to optimal performance or sensation. The goal then becomes less the correction of a pathology and more the continuous optimization of a measurable body.

This logic is significant for sports and health professionals, as it resembles other self-quantification dynamics: tracking one’s workouts, calories, sleep, heart rate, or blood markers can be useful in certain contexts, but can also become a constant imperative to correct oneself. Here, testosterone becomes a language of self-control. Measuring one’s hormone levels and optimizing them are presented as acts of personal responsibility, sometimes independent of genuine clinical reasoning.

The fourth theme concerns the construction of an opposition between the “real man” and the feminine. Several posts associated low testosterone with weakness, softness, a lack of character, a lack of motivation, or a loss of attractiveness to women. Some messages explicitly compared men’s testosterone levels to women’s, or used derogatory language targeting traits perceived as feminine. In this logic, testosterone becomes a symbolic boundary: it separates the legitimate male body from the male body deemed insufficient.

The mechanistic interpretation proposed by the authors is social, discursive, and commercial. These posts do more than simply inform about a hormone; they help produce a norm. Images of muscular bodies, personal testimonials, calls to get tested, commercial links, and transformation stories come together to create a persuasive chain: insecurity, hormonal explanation, measurement, solution. This mechanism is all the more powerful because it draws on the vocabulary of individual responsibility and regaining control.

Practical Applications

When a man mentions low testosterone because he feels tired, less capable, less motivated, or less satisfied with his appearance, the answer does not necessarily lie in a specific hormone, and even if testosterone is involved, the underlying factors are numerous and complex. Sleep, training load, energy levels, stress, anxiety or depressive disorders, medications, diet, alcohol, medical history, and sexual health must all be addressed.

Stagnation in the gym is not sufficient grounds to suspect a hormonal deficiency. A decrease in libido on its own is also not enough to conclude there is a testosterone problem. These signs may warrant a medical evaluation when they are persistent, associated with other symptoms, contextualized, and interpreted with appropriate tests by healthcare professionals.

When discussing testosterone, we must avoid oversimplifications that conflate masculinity, sexual performance, personal worth, and hormonal status. Messages such as “normal isn’t enough,” “get tested to become a real man,” or “your poor gym results may be due to your low T” can increase body and medical anxiety, especially when linked to a commercial offer. The credentials of those promoting this kind of discourse, transparency regarding conflicts of interest, the limitations of claims, and the lack of direct evidence should be systematically scrutinized very carefully.

Encouraging a man to take his health seriously is positive. But encouraging him to perceive himself as deficient as soon as he does not conform to a “hypermasculine” standard established by the profit motives of unscrupulous individuals whose scientific credentials are clearly questionable is not.

It should be noted, however, that the study is limited to 46 English-language publications from two platforms, selected through specific searches and an account based in Australia. The results therefore do not describe the entire global ecosystem of content on testosterone. Furthermore, the analysis is qualitative: it identifies representations and discursive mechanisms, but does not quantify their actual prevalence or their effect on user behavior.

Reference

Gram EG, Mintzes B, Copp T, Moynihan R, Brown A, Shih P, Nickel B. Selling masculinity – A qualitative analysis of gender representations in social media content about “low T”. Soc Sci Med 2026 Mar;393:118903.