How influencers, clinics, and online masculinity culture are turning “low T” into a crisis, and creating a profitable medical marketplace for men seeking to measure up.
Study: Selling masculinity – A qualitative analysis of gender representations in social media content about “low T”. Image credit: PeopleImages/Shutterstock.com
Social media often emphasizes masculinity as the essence of being male. Low testosterone levels are represented as a sign of diminished masculinity. These narratives are increasingly linked to the monetization of testosterone testing and treatment. A recent study in the journal Social Science & Medicine explores the depiction of masculinity in social media posts relating to low testosterone (often referred to as “low T”).
How testosterone became shorthand for modern masculinity
Over the decades, testosterone, the male sex hormone, has been the subject of social messaging that correlates it with masculinity. This, in turn, is linked to male attributes of strength, sexual virility, and vitality.
Traditional attitudes towards gender treat men as being biologically designed for strength, dominance, and sexual prowess. In this view, testosterone drives masculinity. Building on this narrow and historically entrenched perspective, testosterone testing and treatment are often presented as being essential to real manhood.
Apart from presenting such concepts, social media heavily circulates and reinforces these ideas by promoting and selling tips and tricks for masculinity. Social media platforms, including TikTok and Instagram, greatly enhance the spread and visibility of these messages.
The manosphere is the network of online communities that echoes, amplifies, and reinforces rigid ideas of masculinity while promoting similarly backward-looking attitudes towards femininity. These communities are frequently described in the academic literature as perpetuating regressive gender-related social constructs of male hegemony.
Manosphere-related posts commonly relay misinformation about men’s health and fitness. They frequently revolve around specious links to medical and biological facts to drive profitable marketing. Thus, social media posts promoting testosterone have been associated with testosterone therapy sales of over 400 million USD in the United States.
The risks of such practices include the potential for overdiagnosis of low testosterone in healthy men and the use of testosterone replacement therapy (TRT) without sufficient clinical indication. TRT has been associated in prior research with multiple harms, including cardiovascular issues, male infertility, acute renal injury, pulmonary embolism, loss of libido, and erectile dysfunction. These concerns motivated the current study.
Analysing Instagram and TikTok’s testosterone narratives
The investigators conducted a qualitative study of posts on Instagram and TikTok, drawing on performativity theory, a social theory that explores the formation of identity through repeated actions and narratives.
Their sample consisted of 200 posts, including 100 from each platform. From this broader sample, the authors conducted an in-depth qualitative analysis of a subset of 46 posts that explicitly addressed masculinity or sexual performance. They found that 46% related to testosterone. Financial interests were present in 72% of the accounts, such as owning a wellness brand that sold testosterone tests or therapies, or being sponsored by a pharmaceutical company.
Commercial links, including links to clinic consultations, were included in 67% of posts. About one in three individual accounts was ostensibly owned by a medical doctor. The study notes that none of the posts provided evidence to support their claims. The authors also note that the sample was limited to English-language posts and may reflect an Anglo-centric social media environment, and they explicitly discuss their own positionality and interpretive role as researchers.
How “low T” reshapes male identity online
Qualitative analysis generated four themes:
1. Low testosterone is represented as a medical issue that endangers masculinity and sexual virility. Social media content often frames this as a crisis of being less than masculine by idealizing stereotypical traits as mandatory. This framing helps legitimize medical treatment, including testosterone testing and therapy, as an urgent intervention to attain what is presented as “normal.”
2. Low testosterone rebranding occurs, shifting from being an issue mostly associated with older men to being framed as a potential problem in active younger men. This group is typified as being muscular, energetic, confident, and easily aroused. Variations from this ideal are attributed to low T. According to the authors, such tactics expand the potential audience and may increase demand for testing and treatment.
3. Clichéd ideas of masculinity become the grounds for subtly demanding self-optimization by linking them to high testosterone. The threshold for what is considered normal testosterone is pushed upward. A significant medical intervention, namely testing for and taking testosterone, is reframed as a lifestyle practice that promotes so-called normal aging.
4. Social media content frequently presents a binary construct that portrays real manhood as the opposite of femininity in biochemical and material terms. This framing can result in shaming of men who do not fit the ideal of “real men,” or who are open about vulnerability or mental health needs.
When masculinity is treated as a medical condition
Social media posts included in this analysis draw on the insecurities men often feel about relationships and sexual performance. The language of these posts reflects that of empowerment and advocacy, but is frequently repurposed, according to the authors, to market testosterone-related products.
These posts often promote biomedical solutions, namely engagement with health technologies and scientific-sounding interventions. They claim that such approaches empower men to take control of their health, and the authors acknowledge that some men may experience these messages as motivating or affirming.
Biomedicalization also involves viewing medicine as a marketable product by commodifying insecurity, in this case, raising and amplifying fears about masculinity to sell testosterone-related services. Thus, low testosterone is framed as a plausible medical explanation for a wide range of mental, physical, and relational challenges, even when such links are not supported by clinical evidence.
Testosterone myths reinforce narrow masculine ideals
The authors describe how social media platforms demonstrate the interaction of language-based claims and material objects, including testosterone, diagnostic tests, and digital platforms, to reinforce masculine insecurity and narrow gender norms.
These posts also divert attention away from underlying or coexisting health conditions. As a result, they may shape how men think about their bodies, mental health, and the types of medical help they seek. Testosterone-related social media posts typically draw on manosphere-adjacent thinking to promote the idea that “real men” have high testosterone levels. This framing encourages testosterone testing as a screening tool for low T, despite the absence of evidence supporting population-level screening benefits.
The high cost of monetising male identity
Social media platforms bring together influencers, clinics, and health-related companies in ways that contribute to the transformation of masculinity into a marketable commodity. These online discussions frame “real manhood” using regressive and stereotyped ideals that shape how men perceive themselves and how they interact with healthcare systems.
Social media discourse also medicalizes normal aging in men, contributing to the expansion of a lucrative market for testosterone-related products. The authors emphasize that their analysis does not criticize men who choose to use testosterone therapies, but rather examines the broader social, cultural, and commercial forces shaping these choices.
Biomedicine in the age of social media appears to govern not only ideals about the normal body, but also sexual subjectivity and encroaches into the gendered self for profit.
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