Low T: A Tale of Two Hormones (Gender Analysis 01)


Hi, welcome to Gender Analysis. In recent years, prescription testosterone has become a booming industry around the world. From 2001 to 2011, the percentage of men over 40 in the US who were prescribed testosterone replacement grew from about 0.8% to 2.9% – more than a threefold increase. And data from 41 nations shows that yearly testosterone sales have increased from $150 million in 2000 to $1.8 billion in 2011. Meanwhile, chains of “low T clinics” focusing on testosterone therapy have opened dozens of locations across the country.

So what’s behind this growth? Let’s take a look at one commercial for prescription testosterone gel:

“I have low testosterone. There, I said it. See, I knew testosterone could affect sex drive, but not energy or even my mood. That’s when I talked with my doctor. He gave me some blood tests – showed it was low T. That’s it. It was a number.”

Companies selling these medications increased their spending on testosterone ads from $14 million in 2011 to $107 million in 2012, using a snappy new name like “low T” and the promise of a quick and easy pick-me-up for older men. If your T is low, you feel bad; if your T is higher, you feel good – right? This is the approach that’s fueled an explosion in testosterone usage. The problem is, it’s not just a number. In reality, “low T” levels are uncertain, the symptoms are vague, and the relationship between levels and symptoms really isn’t so direct. Continue reading “Low T: A Tale of Two Hormones (Gender Analysis 01)”

Low T: A Tale of Two Hormones (Gender Analysis 01)

How Depression Is Like Back Pain

As a person with depression, I’m always thinking of new ways to describe it. Partially so that people who don’t experience it can understand what it’s like, and in the hope that these perspectives will help me treat it like a legitimate problem instead of beating myself up over feeling bad “for no reason.” It’s becoming common to relate it to physical illnesses like cancer and strep throat. Here’s a good one: chronic back pain.

(I don’t experience any severe chronic pain, so if I’m completely off the mark with any of this, feel free to correct me.)

Someone with intense back pain might have difficulty getting out of bed. They probably could get out of bed, even if in pain, but most people wouldn’t expect someone to push through that kind of agony unless there were pressing matters to attend to.

Some people with intense pain can’t even bring themselves to go to work every day (or at all, in some cases).

If they do go to work, they might be tired and/or sore enough to be unable to do dishes, laundry, or other house work when they get home.

Chronic pain comes and goes, and sometimes it’s more debilitating than others. One day might be bearable and the next day, even going to sit at the computer is a task of unimaginable difficulty.

It seems as though, by and large, these things are accepted and the person experiencing the pain is not shamed for not being up to the tasks before them. Unfortunately, some people do experience invalidation from others, especially if the pain is not the direct result of an injury. Then, it’s “just in their head.” Which is pretty much the attitude toward depression and other forms of mental illness.

The thing about depression is that it is painful at times. Emotional agony is just as real as physical pain. At the end of the day, it’s all just brain signals, and most people have a pretty firm knowledge of what feels good and what feels bad, whether skin sensations or states of mind.

Depression, like chronic pain, can go for periods of time in “remission,” can pop up for a couple days at a time or months on end, and can be triggered by other things. Someone with back pain might twinge something while lifting a heavy object and be stuck in bed for several days. Meanwhile, someone with depression might have a particularly stressful day at work or a heated argument with a friend or partner, thus cascading them toward depression even if they were feeling okay beforehand.

They’re both unpredictable. They’re both painful. And they’re both real. Invisible illnesses deserve as much respect as cancer or Ebola. (Though you can leave the panic at home.) Nobody should face stigma just because they’re sick.

How Depression Is Like Back Pain