Episode Overview

Title: Everyone is on Testosterone
Podcast: Today, Explained (Vox)
Date: October 31, 2025
Hosts: Noel King, Sean Rameswaram
Guests: Susan Dominus (New York Times Magazine), Rebecca Jackson (The Economist)

Theme:
This episode explores the surging use of testosterone therapy across America—its benefits, dangers, cultural significance, and business side. Both men and women are increasingly seeking out testosterone, with its promise of renewed vitality, energy, and libido. The episode delves into medical, personal, social, and even political facets surrounding this hormonal trend.

Key Discussion Points & Insights

1. Testosterone: Who Wants It and Why?

• Testosterone is for everyone: Though naturally higher in men, women are increasingly seeking testosterone therapy.
  • [00:11] Susan Dominus: “You know what I’m talking about. Testosterone.”
• Prescription trends:
  • 11 million prescriptions written in the U.S. last year (up from 7.3 million five years prior).
  • Not just via doctors—med spas, wellness centers, and influencers are pushing testosterone.

2. Women & Testosterone Therapy

• Testosterone in women's bodies:

  • Both sexes produce it, but men have roughly 10x more.
  • Declines with age; in women by 60, about half as much as in early adulthood.
  • Women can experience low libido, mood shifts, and energy dips as levels drop.
    • [03:37] Susan Dominus: “Men have literally 10 times the amount… it declines gradually in men… in women, who have much less, it diminishes even more dramatically.”

• Reported benefits:

  • Modest dose (approximating a healthy 30-something woman): mild increase in libido, better mood, some more energy.
  • Higher, non-recommended doses: increased sex drive, occasional irritability/rage, unwanted hair growth, acne.
    • [05:41] Susan Dominus: "It's not that you have this crazy high sex drive. It's just that I can lay in bed normal."
    • [06:23] Rebecca Jackson: "I once got dosed with a man's amount of testosterone on accident... I start looking at my boss and my coworkers..."
  • Risks: irreversible effects like hair loss, facial hair, acne.
    • [06:55] Rebecca Jackson: “So you’ve got hair on your face… My biggest complaint with taking testosterone is the appearance of zits that I used to never get…”

• Unregulated space:

  • No FDA approval for women, insurance doesn’t cover it, and "wellness" providers charge high prices.
  • [07:21] Susan Dominus: "...it's not even FDA approved for women in any dose... so insurance definitely does not cover any of this for women."

• Hard sell & profit:

  • Clinics incentivize nurses, push hotel getaways with a “hard sell.”
  • [08:13] Susan Dominus: “A job listing offering nurses $100 per shot of testosterone they gave women... so the nurse is highly incentivized to provide it.”

• Personal story:

  • Business owner, mom of four, lost 40% of her hair but gained energy and earned a PhD—she’d do it again.
    • [13:07] Susan Dominus: “It is true that she lost her hair... But that initial burst of energy gave her the inspiration... she then took on getting a PhD…”

Notable Quote

• [04:57] Susan Dominus: “There's really two very different [experiences]... a standard dose... those women report a minimal but meaningful restoration of their libido... [at higher doses]... unpredictable but fairly dramatic results.”

3. Testosterone and Gender Politics

• Overlap with transgender health:
  • High-dose prescribing to women (sometimes conservative or religious) parallels gender-affirming hormone care.
  • Cultural irony: conservative communities using high-dose testosterone, sometimes approaching doses for gender transition, yet not connecting their use to gender-affirming care debates.
    • [11:25] Susan Dominus: “It actually is a hormone that has typically been associated with... masculinity. So it just to me kicks up all kinds of interesting questions.”

4. Men & the “Testosterone Boom”

• Rising demand:

  • Not just older men; young men (20s and 30s) are flocking to clinics.
    • [18:53] Rebecca Jackson: "The people who are taking testosterone fastest now are not guys in their seventies, but men in their twenties and thirties."
  • Massive expansion of clinics like Game Day Men’s Health: 50 locations in April, now over 375 in 14 months.
    • [18:15] Rebecca Jackson: “When they opened in April of last year... since they opened another 325 testosterone clinics...”

• Influencer marketing:

  • Podcasters and online personalities (e.g., Joe Rogan, Dax Shepard) promote testosterone’s benefits:
    • [20:10] Joe Rogan (quoted): “It makes your body work way better…”
    • [20:32] Dax Shepard (quoted): “I spent my whole life as a medium boy, and now I’m a big boy, and I like it.”
  • TikTok, podcasts, social media drive demand—“gym bros” are key targets.

• Dangers & drawbacks:

  • Short-term: “roid rage” (aggression), insomnia, blood pressure, hair loss.
  • Long-term: Infertility—sometimes only partially reversible.
    • [21:11] Rebecca Jackson: “If it's not taken with a cocktail of other hormones... it can actually make you infertile...”
  • Clinics may inject first dose within the hour—mixed medical oversight.
    • [23:48] Rebecca Jackson: “Some of these clinics will also inject you with your first dose of testosterone within an hour of coming in.”

• Stigma & secrecy:

  • Many men are hesitant to talk about their use.
    • [24:00] Rebecca Jackson: "I tried... people were very cagey about it... I got the impression that, you know, probably a lot of people that I know are doing this but didn’t want to talk about it."

5. Business & Societal Trends

• Testosterone clinics everywhere:
  • Growing like fast-food franchises, targeting urban and suburban communities.
  • [25:16] Rebecca Jackson: “I think we're already there. I'm inundated... these clinics are everywhere.”
• Endless industry:
  • Like Ozempic, ongoing use is required for continued effects, ensuring recurring revenue.
  • [25:16] Rebecca Jackson: “Also like Ozempic, it’s an industry that is not going anywhere... the cash here is kind of just endless.”

Notable Quotes & Memorable Moments

• “When that testosterone kicks in, I’m bringing sexy back.”
  — Susan Dominus [06:34]
• “I think perhaps most alarmingly, some of these clinics will also inject you with your first dose of testosterone within an hour of coming in.”
  — Rebecca Jackson [23:48]
• “Even when there are negative side effects, it’s very hard to give it up. This reminds me to some degree of Ozempic.”
  — Noel King [24:41]

Important Timestamps

• [02:23] – Prescription stats reveal testosterone’s explosive growth in the US.
• [03:33] – Breakdown of testosterone’s effects, production, and what declines do to women.
• [05:00]–[07:13] – Women’s personal experiences, from benefits to physical and emotional side effects.
• [09:20] – Why the FDA hasn’t approved T therapy for women—cancer risk fears, lack of long-term data.
• [11:25] – Complex cultural politics of women on high-dose testosterone.
• [13:07] – Story of the woman who lost her hair but gained new drive and ambition.
• [17:08] – Testosterone’s popularity spike among young men; urology stories and industry expansion.
• [20:10]–[20:37] – Influencer and celebrity impacts; direct quotes from Joe Rogan, Dax Shepard.
• [21:11] – Medical risks including infertility.
• [23:48] – The business model; first-dose injections, aggressive marketing.
• [25:16] – Clinics are everywhere; testosterone is the new Ozempic—no end in sight.

Conclusions

• Demand for testosterone—from women and especially young men—is being driven as much by influencers and aggressive marketing as by medical need.
• The lack of FDA oversight for women and profit incentives has created a largely unregulated gray market.
• Both benefits and risks are often dramatic and life-altering, creating a population that struggles to quit even when side effects or medical complications arise.
• The trend reflects deeper societal anxieties about aging, vitality, and gender—and has business parallels to recent weight-loss drug fads.
• Testosterone is quietly and rapidly changing how millions of Americans relate to their bodies, each other, and to the concept of gender itself.

For Listeners:

This episode highlights a booming industry, the medical and cultural fascination with testosterone, and the complicated balance of hopes, risks, and realities that come with biohacking our bodies. Whether you’re curious about the science, the business, or the personal stories, this episode gives you a vivid sense of why “everyone is on testosterone”—and what that means for the rest of us.