“TRT TikTalk: Medicalized Masculinity in the Age of Biohacking.”
In September 2024, a Bloomberg article entitled “The Worrisome ‘Wild West’ of Testosterone Hacking” described the growth of medical prescribing of testosterone replacement therapy (TRT) through online clinics, which have proliferated in recent years in the United States due to loosened digital health policies during the COVID-19 pandemic. In the U.S., testosterone replacement therapy (TRT) is a Schedule III controlled substance and currently only an approved therapy for clinical hypogonadism. Online “Low T” clinics, however, cater to cisgender men looking to “optimize” hormones and achieve a variety of aesthetic and performance-enhancing effects, conflating a hyper-masculine physique and, we argue, a neoliberal ethic of productivity with health. In conjunction with the growth of “low T” clinics, a prominent discursive community centered around TRT has formed on the social media platform TikTok. On TikTok, TRT influencers partner with clinics while touting the benefits of testosterone.
To understand this phenomenon, we employ Jordan-Young and Karkazis’ (2019) critical framework “T Talk,” which denotes the co-constitutive scientific and cultural production of testosterone. We refer to the emergence of TRT on TikTok as “TRT TikTalk.” T Talk encapsulates how T is interpreted as a unilaterally masculinizing molecule—despite its diverse functions in all bodies—and naturalizes male domination over women through its depiction in a totalizing biological narrative of human bodies (Lorber, 1993). TRT TikTalk represents such interpretations of T. It also constitutes a form of “biohacking”, or the application of biomedical interventions to achieve desired physiological and mental enhancement, challenging traditional hierarchies of scientific expertise and establishing an alternative, DIY epistemic process (Grewe-Salfeld, 2021). In this way, TRT TikTalk pushes potential patient-consumers as participants in an emergent masculinity that inserts masculinity as the result of biological modulation. We take TRT TikTalk as a case to investigate the construction of masculinity through the influence of biohacking sex hormones. We propose that TRT TikTalk fortifies the relationship between neoliberal subjecthood and the construction of masculinity, specifically focusing on the manipulation of testosterone to achieve this relation.
Drawing from literature in feminist STS, communications, and governmentality, we foreground our object of analysis with scholarship on neoliberalism and masculinity to clarify TRT TikTalk as a discourse of masculine and neoliberal reproduction. We perform a qualitative content analysis of the top 100 videos for the search “TRT” on TikTok (collected in October, 2024). The sample reflects an algorithmically assembled discursive community that contains content attributes which TikTok prioritizes to users, representing the TRT information users are most likely to come across. Our analysis finds that TRT TikTalk conflates disease with perceived mediocrity and interprets productivity as an attribute of testosterone and thereby masculinity. It therefore creates a diagnostic criteria for low T so vague that it absorbs general discontent under capitalism, but that can be circumvented through taking TRT. This study illustrates how sex hormones, masculinity, health, and biohacking evolve as key properties of capitalist discontent.
By: Edith Hollander, Gwendolyn Berumen, and Andréa Becker.
Forthcoming Chapter in Hormonal Studies: Science, Culture, and Pedagogy eds. Nayantara Sheoran Appleton, Celia Roberts, Charlotte Halmø, and Karen Hvidtfeldt.
An early version of this paper was presented at the 2023 4S Annual Meeting in Honolulu, HI.