As a man in my early twenties, I found myself with a sexual partner for the first time and was dismayed to find that I couldn't achieve orgasm through intercourse. I asked a doctor and he found my testosterone to be very low, well below the "normal range" cutoffs. I was prescribed testosterone replacement therapy (TRT), where I would inject myself every other week with testosterone, not unlike body builders though with the goal of obtaining normal levels not supraphysiological ones. According to bloodwork, that goal was met (which means if my T levels were now normal in the middle of the two weeks that they were certainly well above the normal range for the first day or two after an injection).

However, I felt no effects of the hormone. It did not solve the original problem - my libido was flat, my erections still adequate but no more energized than before, my intercourse still failing to stimulate me to orgasm. But I had also read the literature ahead of time and had come with expectations of many other side-effects that sounded great: the obvious muscle and strength effects, increased alertness or energy, decreased fat percentage. It seemed like everything that could be improved, was! (Except infertility and a chance to grow boobs in an ironic twist of stereotypes.) But I didn't see any of those effects - my numbers at the gym were still unremarkable, I still sometimes felt tired for no reason, my body looked the same. As far as I could tell, I was on placebo - except the bloodwork confirmed its effects. (I think I experienced more spontaneous nighttime erections, something that I only naturally got sporadically and considered more of a nuisance than a benefit.)

This was extremely disheartening. I stopped taking it after half a year when my relationship died in large part due to lack of good sex.

I say this mostly because all accounts of TRT seem to skew towards the miraculous. Like all things, its effects vary from person to person. Had I had tempered expectations, maybe I would not have been so discouraged. Maybe I would have tried alternative approaches to solving my problems. I don't know.

Some years later, I finally had satisfying sex. No medication involved, just a little persistence and finding the right person. I still struggle with not climaxing every time and sometimes am fantasizing that I could go back onto T and fix that. Maybe I'll try it again with expectations for a small, incremental improvement. Or maybe not.

So while this article is being met with a fairly negative reception in this comments, I actually found it a breath of fresh air. Had I read it ahead of time, I might have had more realistic expectations! I didn't really read it as giving a stamp of approval to attempts to over-state the sociological and gender studies points of view (it seems fairly critical of those, opting more to just say that it was too complex a hormone to sum up as a miraculously masculine molecule). Those using it to reshape society seem to be criticized by the article as possibly relying mostly on placebo effects, on society's expectations for what testosterone should do, ironically.

Also, the literature on TRT is surprisingly limited. I thought that young males with below normal levels, as one of the most approved recipients of TRT, would have been a large portion of the studies. Instead, I struggled to find ones that studied my cohort. Older men with dropping T levels (which is entirely normal) were often the subjects, presumably because that's where the money is these days. I worry also that the increasing use of it in young transgender people may be equally poorly studied.