Barriers to testosterone therapy drive men toward underground sources

Some men are resorting to obtaining testosterone replacement therapy (TRT) from underground sources due to significant barriers to accessing the therapy through formal medical channels, according to new Griffith University research.

PhD Candidate Ben Bonenti from Griffith University's School of Applied Psychology explored the experiences of men using TRT in Australia with a focus on access barriers, perceived health effects, and how men self-managed and regulated their testosterone use in practice.

"What we found was a complex picture," Mr Bonenti said.

"Men found significant barriers in accessing TRT through formal medical channels, including bureaucratic delays, financial costs, and stigma.

"Despite access challenges, TRT was widely described as transformative, with reported improvements in both physical and mental health."

The study tracked nine men, aged 18 years or older, who used TRT and documented their experiences via videoconferencing interviews.

The results raised many key issues, particularly for men who frequently described self-regulating dosages, with some even mixing prescribed testosterone with underground products to manage access gaps.

These practices reflected active, self-managed care rather than passive medical compliance.

"While TRT was framed as a medical treatment, participants' experiences showed access and use were strongly shaped by social, financial and regulatory constraints," Mr Bonenti said.

"The findings suggest the current models of TRT may not align with how men actually engage with testosterone use.

"It shows a need for adaptive, participatory harm reduction approaches which move beyond narrow biomedical frameworks and better reflect real-world practices.

"Improving access and reducing stigma may reduce reliance on informal and unregulated sources."