Blood. phlegm. yellow bile. black bile. Long ago, the four humors lived together in harmony. Then, all of that changed when the blood nation attacked. For thousands of years of human history this was how people understood the human body. So long as the four humors are in balance, a person should be healthy. Any disease was the result of an imbalance of the humors. As humorism, this particular school of early medical thought, expanded, it was further theorized that the different humors were associated with different kinds of diseases and located in different parts of the body. Blood in the heart, yellow bile in the liver, black bile in the spleen and phlegm in the brain.
Over time the humors were further associated with astrological signs, seasons and even used as a way of explaining personality types. For example, black bile is associated with “melancholy” which itself is derived from the Greek word for black bile. Someone who is melancholic from an excess of black bile might be reserved, depressed or generally just kind of a bummer .
So how might you treat someone with an imbalance of humor? Well, typically bloodletting. If you’ve ever seen bloodletting mentioned in a period piece and wondered “Why on earth would someone do that?” Humorism is why. The amount of blood let and from where would depend on the diagnosis. Got too much yellow bile? We gotta bleed from around the liver to bring things back into balance. Obviously!
There is an enviable logic to humorism which helps explain how it persisted as the dominant medical model from potentially as early as ancient egypt all the way through to the 1850’s.
Small spoiler for anyone watching from the 17th century, humorism is no longer how we understand medicine. However, as anyone familiar with the all-timer Smashing Pumpkins album Mellon Collie and the Infinite Sadness could tell you, humorism hasn’t fully disappeared. You might have even heard someone toss around ACT words words like sanguine, choleric and phlegmatic if they were trying to impress you. Interestingly, the core idea of humorism: that there is some kind of biological substance in the human body that can influence a person’s overall health, thoughts and behaviors through its presence or absence, is a surprisingly prescient description of how hormones do work in the human body.
A large part of why humorism spread so far and lasted so long was that logic to the whole system. Without modern tools or concepts we take for granted today, like knowing about germs, doctors and patients had to work within that framework. The framework itself having been built on a foundation of anecdotal observations and shared stories going back thousands of years. Your uncle Harlod knew a guy who was sick and cut himself slicing an onion and then he got better…maybe JUST MAYBE there might be something to that. It’s the same logic as “mew under the truck in Pokemon red/blue” just for medicine.
As anyone watching this over the age of 30 knows, Mew isn’t under the truck even though the one kid who swore his uncle worked at Nintendo said so. Humorism doesn’t explain how diseases work. Drawing large amounts of blood from someone who is already sick almost certainly did more harm than good in most cases and yet doctors would still go on to believe despite being faced with evidence to the contrary. Sure Mew isn’t under the truck but that doesn’t mean there isn’t a way to get Pikablu if you talk to Professor Oak one hundred times, put a level 69 Raichu in the daycare and answer me my riddles three
But obviously that isn’t an issue today. Is what I would say if I wasn’t writing a script about the cultural history of testosterone. Testosterone is a fascinating topic to talk about. On one hand, it is a measurable thing. Like humors were imagined to be, it is a biological substance in the human body that can influence a person’s overall health, thoughts and behaviors through its presence or absence. Testosterone can be isolated, synthesized and studied. You can toss up the chemical formula for it in a youtube video like I did just now. You can even add or subtract it from a person’s body to a predictable effect. However, testosterone is not just testosterone the chemical. There’s also testosterone: the idea. Maybe more than any other chemical in the body, testosterone has a massive cultural footprint.
In case you’re doubting me, let’s play a game. Just for a second. I’m gonna say the name of a pasta and I want you to try to imagine it: testostero-ne. Did you imagine a noodle with huge biceps? If you thought of anything else I’d love to hear about it but I’d put money down that some of you thought about a most masculine noodle. You could even take another minute and jot down the first things that come to your mind when you think about testosterone. You might come up with words like aggressive, dominant, masculine, sports and sideburns. Even a quick google image search for testosterone is full of low-T/high-T contrast infographics, we’ll talk more about those later, and dudes with impossible eight packs, we’ll also be talking about those later. No other hormone comes close to the degree of consistent culture presence held by testosterone, not even estrogen, despite the two often being miscast as opposite sides of a coin. In her book, Cordelia Fine suitably dubs the cultural notion of testosterone as Testosterone Rex.
In essence, testosterone is simultaneously both a scientifically analyzable hormone and a carefully crafted story that has taken thousands of years to draft.
The shadow of Testosterone Rex is so big that it even overshadows testosterone, the hormone. When testosterone was identified in the 1930’s it was showing up late to its own party. At that point, the idea of testosterone had already existed for thousands of years. In fact, the story of testosterone starts at least 6,000 years ago in Asia Minor. No one knows what exact set of hopefully comical circumstances brought a neolithic farmer to discover that castrating animals made them easier to domesticate but across species of livestock, castration was followed by a set of changes in behavior. Castrated males were noticeably more docile, safer for humans to work with and finally (and importantly) much less prone to killing each other.
This observation gave birth to an idea, there is something stored in balls that is responsible for aggression, dominance and what we might now call machismo. It would be thousands of years before anyone would know what exactly it was but that didn’t stop people from speculating. So when testosterone finally entered the scene in the 1930’s, it was more than just late to the party. The party had already started and there were thousands of years of rumors, speculation and anecdotes about what it could and couldn’t do. Since then, like Kermit the Frog, or David Bryne of the Talking Heads covering Kermit, testosterone was, and perhaps still is, trying to fit into a suit that is much too big.
So for thousands of years, people had the idea of something like testosterone. They also knew that castration took whatever that thing might be away. However, the process was irreversible. Once lost, this “essence of masculinity” could not be restored at least until the 1800’s when advances in scientific understanding and surgical techniques made early experiments possible.
In 1849, Arnold Berthold, observed that castration resulted in a number of changes in behavior as well as the recession of the rooster's comb, the big frill looking dinosaur thing thing. Berthold had the idea to try to reimplant the testes somewhere else into the rooster’s body to see what would happen. Sure enough, returning the testes either prevented the decline of the rooster’s comb or might even restore it if it had been allowed to recede. Other scientists observed similar effects in other animals. Sure, it didn’t always work but it worked often enough to make the case for a major breakthrough. For the first time, the “essence of masculinity” could finally be restored once lost.
Which brings us to the curious case of Charles Edouard Brown-Sequard and his famous 1889 speech to the Socie`te de Biologie in Paris, France. Charles was a renowned scientist of his time but time marches on, and Charles was getting old. Berthold’s experiments showed that it was possible to restore lost masculine energy. Charles had done his own experiments trying to rejuvenate older animals which were mostly unsuccessful but science is like jazz. It’s about the experiments that don’t work out. Undeterred, Charles made the decision to jump from animal models to human experiments using himself as a test subject. At the ripe age of 72, Charles mixed together a combination of water and extractions from animal testes into what I will very scientifically refer to from here on as “dong water.” He injected himself with said “dong water” several times over a period of three weeks and kept detailed notes about his observations.
Within days of the first injection, Charles found his strength, stamina and intellectual abilities had been restored to the level of a man half his age. As you might expect from a scientist of his merit and as was the style at the time, he also kept detailed notes even down to how far he could urinate. The effects didn’t last but Charles was convinced that “dong water” may very well be a fountain of youth.
Even at the time, other scientists doubted Brown-Séquard’s findings but people love a good story and by the end of the year, more 12,000 physicians began prescribing “dong water” therapy to their patients. Sure, some of those physicians were uneducated in the inherent risks of animal injections which put their patients at risk for infection but medicine is like jazz. It’s about the patients you don’t infect.
About a century later, a group of scientists attempted to recreate “dong water” via Brown-Séquard’s own notes and found that there wasn’t enough testosterone in the substance to cause any biological reaction nevermind something as miraculous as Brown-Séquard described.
The curious case of Charles Edouard Brown-Sequard illustrates just how powerful a story can be. He was a serious scientist working decades before the isolation of testosterone. Everything he knew about the substance was based on hearsay, anecdotes and indirect experiments. Regardless, he was getting old and he wanted it to be true. His belief in the power of what would come to be known as testosterone was so strong that he was able to convince himself and tens of thousands of other people that “dong water” was the elixir of life in one of the most famous examples of the placebo effect.
So Brown-Sequard’s experiments didn’t amount to much in terms of their scientific contribution but that didn’t stop people from wanting the results to be true. Prestigious medical journals of time published a number of rejuvenation experiments. The testes of younger animals were transplanted onto older animals. Prisoners were injected with different flavors of “dong water” with or without their consent. Human transplantations were even conducted. Serge Vornoff, a russian surgeon and colleague of Brown-Sequard, even announced the establishment of a park in Africa to breed chimpanzees and make use of their bits to make rejuvenation accessible to everyone!
As much as I am making some jokes here because this story is kind of funny when looked at with 2025 vision, it really goes to show how much even a highly educated person’s expectations of testosterone can factor into their understanding of what it is and isn’t capable of as well as how those misconceptions can persist in the face of contrary evidence. Don’t worry though, that won’t become relevant again. Is what I would say, if I was a liar.
As all of this was going on, science continued to advance. In 1927, T.F. Gallaghrer and Fred C. Koch succeeded in extracting 20 mg of a substance from a colossal 40 pounds of bovine testes. Just to put things in perspective, this 10ml vial here contains 1,000 mg of testosterone. So using their methods you’d need roughly 2,000 pounds of bovine testes to distill the same amount of testosterone found in this one vial. Hey, progress is progress.
Not long after, Adolf Butenandt reported isolating 15 mg of the same substance from somewhere between 15,000 to 25,000 liters of urine. Butenandt dubbed the substance androsterone and presented his findings in 1931. In 1935, Butenandt and Hanisch were successful in synthesising the hormone now known as testosterone.
So there you have it. After thousands of years, some laughs, some tears and thousands upon thousands of liters of urine, we’re finally back to the beginning of the story. With the synthesis of testosterone it was now possible to conduct modern controlled experiments opening up an entire new world of scientific inquiry. However, Testosterone Rex, that looming cultural idea of what testosterone is, didn’t exactly go extinct. Instead, it has stuck around creating two different lines of thought. On one hand, you have the scientific understanding of testosterone backed by data and people with fancy degrees. On the other hand, you have thousands of years of anecdotes and expectations that succinctly boil down to “it’s literally magic.” Even today in the year of our lord and savior Luigi Mario 2025, testosterone can be used to explain basically anything if you try hard enough. It can even be used to support both sides of competing explanations. Depending on who you ask, T will turn someone into a successful businessman like Patrick Bateman in American Psycho. It might also turn someone into a violent sociopath like Patrick Bateman in American Psycho. And these images of T don’t exist in parallel, they’re inseparably linked and constantly feeding into each other.
What people want testosterone to be influences the kinds of questions that researchers ask, how they structure their experiments and how they analyze their data. It influences what kinds of papers journal editors are looking to publish and what standards of evidence reviewers are going to hold a new discovery to. That all happens before any research gets to the public where anyone is open to make their own interpretations.
In their book Testosterone: An Unauthorized Biography, Rebecca N, Jordan-Young and Katrina Karkazis drop a phrase that has haunted me since “we take science seriously, but not literally.” We take it seriously in the sense that we have a certain reverence for the effort and expertise that goes into the production of knowledge. However, the process of interpreting science is constructive. A person’s past experience, expectations and even whether or not they stubbed their toe that morning can factor into how a person views a piece of information. This is as true for scientists with fancy letters after their names, like me, as it is for anyone else. In essence, there is always a degree of vibes at play when interpreting information.
In talking with friends and family over the months I’ve taken to work on this video, I’ve found that everyone I’ve spoken to has internalized some misinformation about testosterone that “feels” correct; myself included. These are all people who I respect and still think are very intelligent. As the saying goes, we are not immune to propaganda.
What I’d like to try and do here is disentangle things to the best of my ability. Not just getting into what the science says about testosterone but also how the science sausage is made. This is going to be an information dense video so I’m going to break things down into sections. First, we’ll try to answer what the heck testosterone actually is and what it does. From there, we’ll look at the relationship between testosterone and different outcomes like aggression, risk-taking and athletic performance.
Back to the point of departure, after isolation and synthesis it was finally possible to answer the question that had been on people’s collective minds for thousands of years: what even is this stuff? So what actually is testosterone? Turns out that it’s complicated. Like a grade schooler struggling to start a daunting long five paragraph essay, I went to the dictionary to see what I could find. As you can see, we’ve already run into four mutually exclusive definitions of what testosterone is. The American definition describes T as “the sex hormone (C19 H28 O2) , secreted by the testes, that stimulates the development of male sexual organs, secondary sexual traits, and sperm. The British definition is similar but says that T is only mainly produced by the testes. The scientific definition says “A steroid hormone that is the most potent naturally occurring androgen and that regulates the development of the male reproductive system and male secondary sex characteristics.” Finally, the cultural definition succinctly describes testosterone as “A male hormone that governs secondary sex characteristics . It is produced in the testes .”
There’s a good bit of overlap between these four but they’re all either wholly incorrect or missing important additional information. The one thing they all have in common is the idea that testosterone is a “male hormone.” This might be the stickiest bit of misinformation surrounding testosterone and dates all the way back to that farmer who, hopefully for funny reasons, discovered the effects of castration on domestic animals. This set the stage for testosterone to be thought of as the “essence of masculinity.”
Remember those early experiments we talked about where researchers implanted tissue to try and “revitalize” a castrated animal? They were actually looking to prove a theory of sexual dualism wherein “sex hormones” were exclusive to males or females respectively and the presence of one reduced the presence of the other. There is a logic to it. If your standard is whether or not the rooster has a cool dinosaur-esque comb or not, then testosterone would appear to be the secret to maleness. If hens don’t have the same cool-looking comb, well then testosterone must be exclusive to males.
The thing is that researchers knew this wasn’t the case as early as the 1920’s, even before testosterone was isolated and named. By the 30’s, scientists had near definite proof that these “sex hormones” did way more in the body than just affect reproduction, having implications for bone development, heart health and mood regulation. Even further, they had evidence that testosterone and estrogen were not exclusive to the pink and blue version of life. Keeping with the bird examples, the vivid plumage of a peacock might be taken as a signal of whatever peacock’s call masculinity but it is actually independent of testosterone. Without T, a male peacock will still grow the same elaborate feathers. It’s actually estrogen that causes female peacocks to grow a different set of feathers.
I did look at my viewer demographics and know that most of you watching this are not birds, sorry if I’m wrong and I actually have a big avian audience, but the same is true for people. Well, not the part about feathers, the other stuff. At this point, the core ideas of testosterone as a “sex hormone” have been debunked for nearly 100 years and yet you can’t even look at the dictionary without seeing it because it fits the cultural narrative of testosterone too well. When information doesn’t mesh with what people want to believe about testosterone, it’s much easier to write off.
The idea of testosterone and estrogen as opposing parties serves to support a number of cultural narratives that don’t align with science. First, it frames testosterone as something that is unique to men. In fact, it has been theorized at points that exposure to testosterone might actually be dangerous for women. In reality, women’s bodies also make testosterone and require it for healthy functioning. This misconception has actually gotten in the way of making progress in the area of women’s health. Medical history records show doctors prescribing and successfully treating women with testosterone since the 1930’s however the use of testosterone therapy in women remains a hotly contested and often misrepresented aspect of women’s health.
Take the curious case of Dwyn Harben and Dr. Norbert Gleicher for example. Harben was an older woman trying to conceive a child via in vitro fertilization. After initially disappointing results, Harben came across a study that suggested DHEA, an androgen that can be converted to testosterone in the body, might improve her chances. To the shock of Dr. Gleicher, it worked. It worked incredibly well despite his training teaching that androgens were categorically bad for women’s fertility. Gleicher continued to look into DHEA and began applying DHEA therapy to other patients who also weren’t having success with typical IVF protocols. It didn’t work for everyone, but further investigation found that these women also had problems with converting DHEA into testosterone.
This finding flew in the face of conventional training which only taught that testosterone could hinder women’s reproduction. Here was repeated clinical evidence that there was actually a sweet spot where having some testosterone, but not too much, is actually important for women’s fertility. When Gleicher and colleagues tried to publish their findings, they ran into a set of roadblocks. The old saying goes that extraordinary claims require extraordinary evidence. What they were proposing upended thousands of years of how people had assumed testosterone works.
Framing estrogen and testosterone as opposing sex hormones also props up the misconception that testosterone is the essence of a unique form of masculine energy. Accepting that T is present in both men and women just in different amounts kinda takes away the mystique. You can’t keep up the charade that T is the source of all masculine energy if women have it too.
This artificial separation also allows for testosterone to serve as an explanation for literally any observed difference between men and women. Why are more women not working in higher-paying STEM careers? Testosterone. As an aside, this is the actual argument that former google employee and failed culture warrior James Damore aka “fired for truth” tried to make for why more women weren’t working in tech. Why do boys like dinosaurs? Ok, that was a gotcha. Literally everyone likes dinosaurs. Literally, any difference can be made into something biological through the magic of testosterone. The social becomes chemical which in turn makes it seem natural and therefore there’s nothing to be done about it. Actually, doing anything about it becomes the real problem because it’s disrupting some kind of “natural order.”
So we know that T isn’t just a sex hormone and isn’t just present in men but what if I told you we can add yet another level to it? Turns out testosterone as a concept is actually made up of several different forms of T in the body like a robot made up of other smaller robots. There’s prenatal testosterone or what we are exposed to before we are even born. Some portion of the T in your body is bound to a protein called SHBG, another portion is bound to albumin in the blood and another third portion is called “free testosterone” and is afraid of commitment therefore free to be used in the body. Generally, albumin-bound T and free T are collectively called “bioavailable T” because they represent the amount of T that is actually used in the body. All three combined; SHBG-bound, albumin-bound and free testosterone, make up total testosterone.
All three forms of T are present all over the body: in blood, muscles, urine, saliva, etc. So if you’re a researcher and you’re interested in looking at the relationship between T and the likelihood of liking, commenting and subscribing on this channel right here and right now, you’ve got a lot of decisions to make. Depending on what you’re interested in, one type of T and one type of measurement might actually be a better way of answering your question. Or you could just test as many as possible and only report the ones that work! No ambitious researcher would ever do that and cause major problems for decades to come! That would never happen. Is what I would say, if I was a liar.
There is also a notion floating around in the communal cultural mind palace that testosterone is fixed. A person is either low T or high T. Just do a quick search and you’ll find loads of infographics you’d swear were shitposts and some truly artisanal thumbnails. My god, he has cheek bones. Turns out this also isn’t true. Testosterone levels fluctuate within a person based on a number of different factors. Some of these are intuitive like how people’s amount of T generally declines with age. Some are less intuitive. Testosterone levels tend to be highest in the morning right as you wake up and decline rapidly as you stay awake. The difference between T in the same person measured on the same day between the morning and evening can be as much as 25%.
Typical reference range for men is 300 to 1,000 nanograms of testosterone per deciliter (ng/dL). However, because of natural variation and any number of other factors, up to 50% of men who test above that 300 nanogram threshold will actually test below it over the course of repeated testing.
We also know that testosterone levels tend to respond to social factors. Stress, especially chronic stress can result in lower levels of T. When we’re stressed, our bodies produce another hormone called cortisol. If you’re spending hours a day commuting back and forth to a job you hate but can’t afford to leave or you’re a federal employee writing this script during the early weeks of the second trump and not sure if you’ll even have a job tomorrow, that long-term increase in cortisol will suppress the body’s use of testosterone.
Drinking caffeine also increases production of cortisol so those hypothetical four to five cups of coffee keeping you functional during the hypothetical last leg of your hypothetical PhD can impact your body's ability to make and use testosterone. HaHaHaHaHaHa
Testosterone also increases in response to exercise or winning competitions. Interestingly, you don’t even have to be the one playing the game. Changes in testosterone have been documented among fans at sporting events when their team wins or loses.
It also decreases in men involved in raising children such as in response to a baby crying. Meaning men are hard wired to participate in child rearing. Once you start to look into it, it’s incredible just how responsive our bodies can be to even small changes in our social situation.
Now that you know all that, you can probably tell that the idea that a person is categorically either “low T” or “high T” is, scientifically speaking, bonk. It’s just not real. Testosterone is a powerful and multifaceted hormone but it’s not a fixed thing. There’s even debate over what the correct reference ranges for levels of testosterone should be. In a study by Dr. William Crowly and Frances Hayes, 15% of the healthy, ordinary and otherwise wholly unremarkable men they tested had testosterone levels more than 50% below the usual cutoff for low testosterone despite showing no ill-effects. One possible explanation for how this is possible is that some people are just really good at making use of T. Their bodies correspondingly don’t need to produce as much of it to get the same effects. Inversely, some people who tend to test on the high end of the reference range might just have bodies that are less efficient and need more T to stay healthy.
But that hasn’t stopped an entire cottage industry from propping up the idea of there being low-T and high-T people and there’s no shortage of influencers who want to sell you the solution to a problem they’re going to convince you that you have. You’ve probably seen these. You’ve got the low T man, crawling on his stomach, scorned by his creator and forced to play with the default fortnite skin and the ascendant high T man whose parents buy him all the vbucks. There is such a thing as clinically low testosterone but this ain’t it. Unfortunately, the internet lets the very worst people reach audiences in the millions and sell them newer and less interesting forms of snake oil.
This whole grift, and it is a grift, is nestled in that testosterone is not just a proxy for masculinity but for a person’s entire worth. It also assumes a linear relationship so “line go up” is always a good thing without exception. It does make for a good story. So what are you to do if you’re a man who suspects he might have low testosterone after letting youtube autoplay one too many times?
For some, the answer is steroids. If you’ve spent enough time around bodybuilding forums, you already know that testosterone is a commonly abused steroid. As much as there is real clinical evidence that supplementary testosterone is a steroid, remember “dong water.” Remember how a very accomplished scientist was able to convince himself of the powers of his elixir of life despite there being only miniscule amounts of testosterone in it. A lot of the benefits claimed by T grifters like improved focus, reduced fatigue, elevated mood, etc are probably partially or entirely just be a placebo effects.
Another thing you might come across while delving into the depths of body building sites is gynecomastia. As it turns out, adding large amounts of testosterone to your body might have some unexpected effects. Your body is going to try to maintain some kind of balance and will actually convert some of that excess testosterone into estradiol. The very same estradiol that trans women will take to feminize their bodies. So what might seem like a “puffy chest” is actually breast tissue development and once developed breast tissue doesn’t go away without surgical intervention. If you’ve been around hormone replacement discussion sites, you might have heard that your body will do the same thing turning estrogen into testosterone if your levels get too high but the T to E pipeline is a one-way street.
Being honest, it’s a bummer. Manosphere grifters have basically weaponized the cultural misconceptions around high and low testosterone against men and made bank doing it. All the thumbnails I pulled for this video also plugged an affiliate link as the first thing in their video. They’re preaching to an audience of mostly kids and teenagers and exploiting their insecurity over things they can’t control in order to sell them a product. It’s like the beauty industry but somehow more exploitative. That would be impressive if it wasn’t so sad.
I know this is a long video and I imagine that some people watching might have some overlap with the exact target audience for these kinds of testosterone influencers and have stayed for the dulcet tones of my voice, cutting insights and incredible charisma. If that’s you, thank you. If you have clinically low testosterone, there are treatments for that. There are people out there that are going to try to make you feel shitty about yourself so they can take advantage of you for clicks. If you’re healthy, you are enough.
So if you’re ever out and get a random encounter with someone who tries to impress you with their high testosterone level, the fact that they know their testosterone level and think that it says something about them personally says more about them than any test ever could.
So we can comfortably say that testosterone itself is complicated to say the least. What is often thought of as this singular stable thing actually varies quite a bit both between and within people. Even something as seemingly minor as how many cups of coffee you drink in the morning, what time of day it is or watching your favorite youtuber’s subscriber count go up might actually have an impact on your body's ability to produce and use testosterone. Gotta be real, that last one is a little freaky to me.
Of all the big cultural ideas about testosterone, the relationship between testosterone and aggression is one of the most widely accepted and most destructive for the lives of the people caught up in it. Like many other myths around our main character, this one also goes all the way back to the neolithic farmer who discovered castration was one way of reducing aggressive behaviors in domestic livestock. It made them safer not only to handle but also to the other animals around them. In the thousands of years between then and now, the link between testosterone and aggressive behavior became a given even before testosterone, the actual hormone, was distilled from tens of thousands of liters of urine. However, there are a number of differences between farm animals and people. Horses, for example can’t even answer emails but I guess we both might struggle to make a five minute phone call so perhaps we actually aren’t so different…
In the conversations I’ve had while writing this script, the idea that testosterone is directly and powerfully linked with aggression almost always comes up. It’s also one the areas where the supporting science is the most, shall we say, creative. Some of the strongest links in the chain connecting the two comes from research on violent crime and criminality. At a glance, this is a compelling story that aligns with popular ideas about how testosterone works. More testosterone means more aggression means a greater likelihood of committing a violent crime but if you take the time to look at the work a little more closely and have some understanding of research methods, the links stop looking so sturdy.
One of the earliest and most impactful links in the chain is Kreuz and Rose’s investigation into determinants of aggression in a young criminal population. In their work, inmates were split fighters and non-fighters based on whether they had been involved in two or more fights. They then had participants complete a number of psychological assessments, looked into their criminal histories and took multiple measures of testosterone. Especially for the time, this was a fairly robust methodology.
Data in-hand, Kreuz and Rose got to work looking for evidence that testosterone would be related with more aggression. In a sample of prisoners seen by the state as habitual offenders, this should be a slam dunk right? Right?
If you guessed it wouldn’t be so easy, you’ve been paying attention so far. Sure enough, they could not find a link between testosterone and aggression when looking at either the battery of psychological measures or whether or not a participant was involved in fights. So what is an aspiring researcher to do when the link you were so sure was going to be there just isn’t? Take chances, make mistakes, get messy! Unfortunately, making mistakes and getting messy doesn’t tend to result in good work but let’s just ignore that for now.
They did eventually find the link they were looking for when they dug through participants' past convictions for violent crimes but only when looking at crimes committed before the age of 19. So from a straightforward starting point of “testosterone should be related with more aggression” to “actually, testosterone is related with past, but not present aggressive behavior and only when you slice the data a certain way, rotate it 90 degrees and squint a little bit. It’s there though. It’s right under the truck!”
With 2025 vision, we can see that Kreuz and Rose had fallen for one of the classic blunders. You see, even the very best researchers have to make a decision when the question they set out with isn’t supported by their data; either the theory is wrong or the data is wrong. In this case, Kreuz and Rose were certain that there was a link to be found between T and aggression so when the data didn’t support their hypothesis, they kept digging until they found something that worked, took a deep breath and sighed in relief. They were right all along. This kind of thing happens often enough in research that we have a fun acronym for it: HARKING (hypothesizing after results are known). You slam your variables together like action figures until something clicks and then rationalize that what you found was actually what you were looking for all along. You don’t have to have ill-intentions to end up here, you just have to want it to be true. Motivated reasoning is a powerful force even for people with lots of degrees; maybe even more so.
That’s not to say that it’s always a bad thing to get inventive with your data especially when you’re working with a hard to access population. However, best practices would say that researchers should write down what they expect to find. Even scribbling on a bar napkin will do. Just make sure you have something to hold yourself accountable. Anything else should be taken with a grain of salt and replicated in another study to confirm that it’s not just noise. The catch is that replications aren’t sexy. You already got the finding once. Why would you do it again? Just churn out the manuscript to a journal and move on! Someone else will do it eventually!
In this case, someone actually did. In 1987, James Dabbs and his co-authors conducted a similar study where they measured saliva from 89 prison inmates and looked for relationships with aggressive behavior across each prisoner's entire history. They also made sure to recruit from a “weak” dorm, a “strong” dorm and the cellblock where the most difficult prisoners were housed. Sounds like a solid design but a look at the abstract for their paper should raise some alarms.
First, “The relationship was most striking at the extremes of the testosterone distribution, where 9 out of 11 inmates with the lowest testosterone concentrations had committed nonviolent crimes, and 10 out of 11 inmates with the highest testosterone concentrations had committed violent crimes.”
Let’s do a little crash course on statistics to unpack this. In stats, there are continuous variables that encompass an entire range of values like height, weight and how much you can deadlift. There are also categorical values where things fit into neat boxes like what color shirt you’re wearing, whether you’re still watching this video and whether you saw the gorilla that just popped up on the screen a second ago. Generally speaking, it’s a bad idea to take a continuous variable like height and divide it into boxes. Let’s say you decide anyone under 6’1 in your sample is a short king and everyone over 6’1 goes in another group. In doing so, you’ve said that someone who is 6’1 has more in common with someone who is 5 foot flat than someone who is 6’2. If that sounds suspect to you, it should.
So when you see that someone has split their data like this, it’s usually safe to assume they did it because the original idea didn’t work out so they bent the data it until it did.
Dabbs and co also made a huge number of comparisons in their study. You might have heard the term “statistically significant” before but what does that actually mean. In stats 101, you’re typically taught that it means that whatever trends you are observing in your data are different from what you would expect than by chance alone i.e. that there is a real effect there. Typically this is measured through a p-value with a cutoff of p < .05 which translates to “the likelihood we would observe this pattern by chance alone is less than 5% or one in twenty.. That’s well and good but even people with fancy degrees tend to forget that p-values are just a likelihood. Over time and poor statistical education, some researchers start to think that getting a p-value below .05 is shorthand for something being “real.”
Funny thing about likelihood, what do you think happens when you flip a fair coin five times? You’d expect to get heads at least once right? So what do you think happens when you run 50 different tests each with a 1/20 chance of the pattern you see being due to a signal and not noise. Just by random chance, you’d expect to get some false positives.
Back to the point of departure, the next line in the abstract reads “Among the inmates convicted of nonviolent crimes, those higher in testosterone received longer times to serve before parole and longer punishments for disciplinary infractions in prison.” That’s a pretty deep cut and not actually about violent crime at all despite the title of the paper. If that’s a finding important enough to make it into the abstract, you must not have found much else. Turns out, they didn’t. For all those tests, only four tests came back with “significant” results. Before you even ask, no they didn’t think to do a replication :sad trombone:.
None of that has stopped people from wanting to believe this connection not only exists but that it’s also very strong. The work of Dabbs et al as well as Kreuz and Rose helped lay the foundation for the scholarly connection between testosterone and aggression. As other researchers tried to build on that foundation though, they started to run into issues. The link between T and aggression in animals was robust but finding a definite link between T and aggression in email responding humans was proving harder than expected. Some researchers found results in the opposite direction where T actually predicted less aggression, some found no relationship at all and others found a weak relationship in the expected direction.
In these kinds of situations where there isn’t a clear conclusion even after decades of research, a researcher might reach for the ol’ reliable meta-analysis; a study of studies. Instead of looking at participants, you look at a number of different studies and weight the size of the effects they found, number of participants they measured, the average age of participants, you name it. These meta-analytic efforts have helped to give us a clearer picture of what the relationship looks like. While there is some disagreement in the finer details, several meta analyses conducted over the past 20 plus years have shown a weak, but still significant, relationship between testosterone and aggression.
A relatively recent analysis conducted by Geniole et al. and published in 2020 broke things down further by looking at baseline testosterone, changes in testosterone and manipulated testosterone separately. Both baseline and changes in testosterone were related with aggression but manipulated testosterone, a crucial finding needed to claim that changes in T actually cause changes in aggression, remains elusive.
One factor that has made these kinds of meta-analytic studies difficult is that every has such a gosh dang different version of aggression. Completely hypothetically, would you say that shooting at someone is an aggressive action? Also completely hypothetically and not referring to anything, what about working as a ceo at an insurance company and directing your employees to deny people’s claims for life saving care? Is that aggression? Back in high school, I was also taught that men and women do aggression differently. Men are direct and prone to resorting to fisticuffs while women do “relational aggression” aka aggression tied up with a pink bow, you know, spreading rumors. As an adult, I’ve since learned that no one loves drama more than straight men. Aggression is in the eye of the beholder which makes direct comparisons between different studies difficult.
Looking at the preponderance of evidence, it seems the link between testosterone and aggression is probably there but more complicated and weaker than you might expect. Recent work also points to potential moderators like elements of the social situation and the interaction of other hormones like cortisol.
So the story of T and aggression might not have as exciting of an ending as you were hoping for but it’s still just one chapter in the Great Big Book of T. Let me tell you, no one seems to love a good story like evolutionary psychologists. Ok, deep breath, here we go. Evolutionary psychology as a sub-field tries to work backwards to understand how our modern behavior might have roots deep in our evolutionary lizard brain. Most of the time, it boils down to sex. Modern mental frameworks must have given some group of people a reproductive advantage during an earlier phase of our evolution and so that’s why our brains work how they do thousands of years later.
Remember how one of the most compelling parts of the story of testosterone is how it can be used to take any observed difference between or within people and explain it as something biological. Doing so can sanitize basically any social difference by making it something inherent to the human condition. Example: Colonialism was just the natural biological order of things! The British simply had more testosterone, by their own account of course, that’s how they ended up with all those artifacts! It’s just testosterone! I’m not even making this up. This has been a real historical argument.
Evolutionary psychology and testosterone are a natural fit. You have a hormone that’s effectively magical in its ability to explain anything and a field that is always looking for an evolutionary explanation for generally unfalsifiable theories of human behavior. It’s peanut butter and jelly or movies and popcorn or my precious baby boy here and falling asleep with his mouth open.
One of the areas that this dynamic duo has set to work on is the psychology of risk-taking. Specifically, that having higher testosterone drives people, usually men, to take more risks and that doing so is adaptive. Let’s do the Wayne’s World doodley do transition to set the stage.
A long long time ago. Perhaps even before our favorite neolithic farmer discovered castrating livestock, there were two men; the paleolithic low T virgin and the paleolithic high T chad. No one ever told the paleolithic virgin that you miss 100% of the shots you don’t take so he never foraged far from the cave to look for food. Meanwhile, the paleolithic high T chad understood that when you aim for the moon, even if you miss you’ll always land amongst the stars so he would take the risk and venture out further than anyone else and find cool new berries that no one had ever seen before. Sure those berries were poisonous and brought about the untimely end of our neolithic chad but you can’t make an omelet without breaking a few eggs. Evolution is like jazz. It’s about the poisonous berries you don’t eat. Good news is that a different high T neolithic Chad brought back cool new berries that didn’t poison you. This allowed him to become the coolest guy in the cave and have lots of babies. The end.
So risk-taking is driven by testosterone and can help someone take advantage of opportunities that others might overlook which in turn raise someone’s status and makes them into a more appealing mate. That drive to engage in risky behavior should then carry over to modern life making high T men good at stuff like finance and stocks. Tl;dr A long long time ago, someone shot his shot and now that’s why more men are into cryptocurrency.
Research into who owns cryptocurrency and why has found that men who value masculinity but who see themselves as failing to meet their own expectations of masculinity are more likely to own crypto and meme stocks. Making these kinds of risky bets, even ones that are basically assured losses, makes them feel more masculine. Just stepping on financial rakes to performatively prove how much of a man you are.
Just think about these one-liners
“When the chips are down”
“I’m going all in”
“I’m calling your bluff”
“Never tell me the odds”
These are all lines a macho hero says before doing something cool at the climax of the story and they’re all gambling references. Again, it’s the power of the story. Manly men are bold, daring and willing to take risks. Why? Testosterone obviously. However, the reality seems more like some men engage in risky behavior not because of a base primal desire burning in their loins but because doing so helps them align themselves with the narrative they’ve been told about T, risk and manhood. It’s a behavior that’s not being driven from the bottom-up via hormones but rather from the top-down by insecurity.
So how does one measure risk-taking? In lab studies, it’s common to use economic games to try and determine if measured or manipulated testosterone levels might play a role in how people play. In 2008, Apicella et al presented participants with a choice. They all started with $250 fakebux and were given the choice of making an investment with a 50% chance of succeeding or failing. If it succeeded, they’d get back 2.5 times what they had invested. To make it spicy, one participant was drawn at the end of the study and paid out, turning their fake bucks into real bucks. Other studies looking at similar variables might change the rules a bit but the general idea stays the same.
Other studies stepping outside the lab have looked at things like the relationship between T and choosing a career in finance or starting a business which raises the tantalizing biological prospect of someone being labeled a small business owner at birth. Still others have looked at the success of actual professional day traders and the potential relationship between their baseline T, changes in T overtime and profitability.
You’re probably sensing a trend. In this literature, there is a strong interest in defining risk-taking as economic risk taking. Successfully managing risk then means making more money whether that is through gambling or starting a business. This raises some interesting conundrums. The evolutionary theory is based around early man, risk and mating behavior. Correct me if I’m wrong. I am a psychologist after all and haven’t taken an anthropology course since undergrad but I’m pretty sure neolithic farmers weren’t trading securities. This narrative is less about T the hormone and more about T the story. Finance is a man’s world ergo it must have some connection to testosterone and vice versa.
Maybe this is uncharitable of me but having a job managing other people’s money or playing stocks doesn’t seem all that risky at least not in how I think about risk. Driving a forklift is realistically way riskier in terms of proximate physical harm. In terms of reproduction, women carrying a child to term shoulder way more personal risk than men. Heck, just existing in public as a woman even if it’s just on the internet is a risk.
Unsurprisingly, the effects connecting T to risk-taking are mixed at best. Some studies find a positive link of wildly varying strength. Some find a negative trend where more T actually results in safer behavior. Some even find a curvilinear relationship where people at the high AND low ends of the spectrum both engage in riskier behavior relative to people in the middle. Just to make it more complicated, some only find a relationship in women or in men. Even more find no connection at all. Meta-analyses trying to cut through the noise find there’s not much to talk about. A recent meta-analysis found evidence of a small positive relationship between T and risk-taking. However, the quality of studies in this area overall leaves something to be desired.
There’s a cool concept called statistical power. Basically, as the size of the effect you’re interested in gets bigger and as you collect data from more people, your study becomes better able to detect an effect if it does exist. It’s like rolling a statistical katamari. Given that small effect size from the meta-analysis, it’s likely that many of the studies included in it didn’t actually have the power to detect the effect of T on risk-taking. One of the big weaknesses of meta-analysis is that garbage in becomes garbage out. Running a bunch of flawed studies through a meta-analysis doesn’t suddenly fix their issues. Instead, it makes the meta-analysis also unreliable. Based on the information we have, If there is an effect here, it’s probably small and depends on a number of other factors in the body but even that seems questionable at the moment.
As I was working through the literature for this video, I started coming across a measure I had never heard of before; digit ratio. The theory is that prenatal testosterone exposure is especially powerful in shaping a person’s future. Unfortunately, measuring prenatal levels of T and following someone to adulthood would be extremely complicated and expensive. Basically no one has the time or money to do a study like that with a respectable sample size. You also can’t ethically manipulate prenatal T by dosing a fetus with testosterone which throws another wrench in the works. Despite the difficulty of measuring prenatal T, it’s theorized to have an incredibly powerful effect. Maybe even a bigger effect than adult T levels.
The good news is that not only does that exposure irreversibly change the brain, it also has an effect on the relative length of a person’s index and ring fingers. Convenient! Having a longer ring finger relative to your index finger is taken as a sign of higher levels of prenatal testosterone exposure. If you just stopped and looked at your hand, it’s ok. I did too. So if you’re a researcher interested in prenatal T, you don’t even have to measure testosterone. You can just look at someone’s hands ezpz.
At first, I was suspicious of what sounded to me like at best astrology for hands and at worse phrenology for hands. Yet, the more I read the more I found studies that not only used digit ratio as a measure of testosterone, they would use it as their only measure of testosterone. So you have studies in the literature floating around preporting to measure something that they don’t. Digit ratio was used in studies ranging from criminality to career choice. In essence, claiming that some people are born with manager hands.
Prenatal T exposure has been proposed as an explanation for why lesbians are interested in other women so lesbian hands could be a thing in more ways than just the manicure! My personal favorites are the studies on aggression trying to determine if the left or right digit ratio is a better predictor of aggressive behavior.
I’ve tossed up some choice infographics here but it goes so much deeper. It’s genuinely unreal to me what people will claim is related to the length of two fingers.
Circling back to that idea that prenatal T exposure is responsible for the development of a masculine or feminine brain. Modern imaging studies into gender have tried to determine if there could be such thing as a prototypically gendered brain. While it is true that some traits are more or less likely to occur in the brains of men or women, there isn’t a uniformly “male or female” brain. If you were to show an MRI to someone, they might as well flip a coin because our brains are each a mosaic of different structures and traits.
So what does the actual science say about lesbian hands. Well, there is some evidence that digit ratio might be related to T levels in amniotic fluid. So there is that but what of the very strong claims made about digit ratio and adult behavior? At best, there’s a very small, weak and context dependent relationship if it exists at all.
I know you’re shocked. I am too. That’s three for three on finding out that the truth is actually not stranger than fiction. Even though anyone can go on google scholar right now and read many of these studies, even people who are very smart and maybe even experts in their fields will continue to believe the myth. You would think that once the definitive meta-analysis comes out, that should be the end of it. Right? We have this general idea even that science is supposed to be self-correcting but it turns out that isn’t often the case.
To really get into it, let’s talk about how the science sausage is made. In a perfect world, a team of researchers do their work, write their findings up into a manuscript and submit it to a scientific journal for publication. From there, an editor will give it a read and like Caesar give the work a quick thumbs up or thumbs down. Work that passes the desk rejection will be anonymized and sent out to be reviewed by a group of usually three or more experts in that specific area who will vet the work for accuracy, merit and whether it makes a contribution to the field. Basically no one ever gets through on the first pass but if you’re lucky you’ll get an opportunity to incorporate feedback from your reviewers, resubmit the paper and hopefully it will get accepted for publication. Boom! Now that work is part of the scientific record.
In practice, it’s much much messier. Peer review is a harrowing process. For starters, publishing is ultimately a business. While part of an editors job is to accept good work, they also have an incentive to accept work that is going to make for catchy headlines and attract attention to the journal. The more people cite the work, the more prestigious the journal becomes, the more subscriptions are sold and the more other researchers will want to submit their work there.
A paper that tells a good story tends to grab attention. If you had to pick between a paper that says digit ratios predict when you’re going to die and one that says it’s actually a very complicated topic and there is maybe no effect at all, you would probably pick the former. Null results that don’t find the relationship they set out to and replications of other existing work, especially replications that suggest that sexy finding might be too good to be true, are important for science, critically important even, but they just aren’t sexy so they’re less likely to see publication. Instead they get archived on a USB drive, published on a blog or tucked into a file drawer so the contrary evidence might not see the light of day.
And we haven’t even gotten to the peer part of peer review yet. I was once told that research is me-search. Lots of academics have this idea that they are impartial when it comes to their work but it would actually be kinda weird if you could invest your career into becoming an expert and not get a little in your feelings about it. In this wild world of influencers, a given academic might even become a celebrity on the back of their work combining professional, personal and financial interest. So what is that person to do when a paper comes across their desk for review that challenges the theory they built the last decade of their career on? Odds are they are going to be pretty harsh even if they don’t realize it.
We saw this with the fertility example. The researchers had evidence that testosterone plays an important role in women’s reproduction and they found it difficult to get those findings published. When you’re publishing something about T that challenges conventional wisdom, you’re going up against thousands of years of storytelling taken as given. Extraordinary claims require extraordinary evidence so the bar is so much higher for work that deviates from that established narrative.
Even if you clear all those hurdles and get your paper published, those past papers don’t just go away. If someone really wants to, they can dig them back up and keep building on lines of research that have been otherwise discredited. That’s why we call them zombie theories. They simply will not die. So something like digit ratios will always be around for some well meaning researcher who wants it to be true to include in a paper. There will also probably be an editor and three reviewers who also want it to be true badly enough that they’ll pass it through peer review and we’re back at it again at Krispy Kreme. Testosterone makes for a great story and not even the most educated among us are not immune to it.
Up until this point, we’ve mostly talked about the role of testosterone in influencing people’s behaviors and attitudes. However, the effect of testosterone, both the hormone and the idea, extends into people’s health, bodies and the policies that surround them. If and when you hear about testosterone in the news it’s usually in the context of sports. This video was inspired by the major media stories that ran during and after the 2024 Paris Olympic Games mostly, but not entirely, centered around Algerian boxer Imane Khelif. Khelif’s victory sparked, or maybe reignited, a longstanding controversy about fairness and about who gets to compete in women’s sports. Testosterone, being the latest in a century-long effort to determine who is and is not a woman, took center stage in that conversation.
There’s a concept in psychology called the curse of knowledge where you start to assume that other people know what you know so I wasn’t sure if any of this would even be helpful. As the controversy continued, I eventually realized that what I assumed was common knowledge was, in fact, not so common. Look, I am not a clever woman. I set to work on an earlier version of this video but T kept popping up in the news, this script kept getting longer and now I’m on page 17 of a script I didn’t intend to be this long and only just now actually writing about the thing I started off wanting to write about in the first place. Alas, what can we do?
Despite being on the frontlines of modern sporting controversy, testosterone is actually late to the game. Since the 1930’s there have been repeated attempts to use what was considered cutting-edge science at the time to define femaleness. As science has advanced, where to draw the line has become an exponentially more complicated question. It’s what design theorists Rittel and Webber describe as a “wicked problem.” Unlike the Popular problems one might find in math or engineering like Defying Gravity, wicked problems can never be actually solved but rather need to be re-solved over and over again. Sure enough, defining femaleness in sport has never actually been solved For Good.
Even before women were permitted to compete in the Olympic games, there had been a longstanding effort to either exclude or discourage women’s participation in sports. In Victorian England, women were medically understood as “incomplete men” and there was a very real concern from doctor’s that engaging not just in sport, but in any kind of physical activity, would be dangerous for women. Except during work hours in mines and factories, that was fine!
As cycling became a popular activity among Victorian women, publications ran stories about the dangers of “bicycle face;” a definitely very real and very serious distortion of the face brought on by concentrating too hard and riding into the wind. Despite this pressing health crisis, women continued to cycle and gasp even play sports. Despite attempts to ban women from formal competition, interest in women’s sports only continued to grow. In 1890, women were allowed to participate, without the consent of the International Olympic Committee (IOC), in a trial number of feminine events like tennis and golf during Olympics games. It wasn’t until 1928 that women were first allowed to officially compete. At the time, less than 10% of competitors were women.
The women’s 800m in particular became a spectacle with journalists insisting that the event was “profoundly unnatural” and competitors develop “whole masculine physiques and behavior traits.” Journalists also openly speculated what percentage male each of the runners might be. At the time, it was believed that sex could be measured by degrees and US Olympic Committee president Avery Brundage insisted that all competitors should be subjected to a physical examination to guarantee they were 100% female.
Anxiety around women’s participation in sports only continued to grow. First, in 1936, Helen Stephens was accused of being a man after her performance in the 100m. Later reports began to circulate of two runners who had transitioned and were living as men after competing in women’s track events. This was taken as evidence that these two had turned out to be men after all, which is actually surprisingly affirming in a very roundabout way. Following the resumption of the games after World War 2, women were now required to present a medical certificate certifying their womanhood. What that actually meant wasn’t specified. A doctor just needed to sign off saying that the competitor was a woman.
As the cold war heated up in the 1960’s and sports took on an important role in showing the respective strength of the east/west (see Rocky 4), both became increasingly suspicious that the other would try to have men compete in women’s events to underhandedly establish athletic supremacy. This fear led to the establishment of the first round of sex testing for female athletes. In this first incarnation, women were required to undergo a gynecological exam before competing. The experience was described by one woman as “the most crude and degrading experience I have ever known in my life.” Later that year, it got worse with the advent of the ‘nude parade’ where 200+ female athletes were asked to strip and parade themselves past three gynecologists.
Women who refused had their womanhood publicly questioned. World Athletics president, David Burghley, was quoted saying the effort had been “successful in frightening the doubtful ones away” as if the only reason someone wouldn’t want to be degraded was that they had something to hide. This wasn’t sustainable and the Olympic Committee needed something new. Something inarguable. Something science-y. And They found it sorta.
Back in the 1950’s, Murray Barr and a research student were studying the cells of cats when they noticed a consistently forming ball of chromosomal material in cells drawn from female cats. That ball of material was an inactive X chromosome. Turns out that when you have two, one of them just kinda hangs out. This was purrfect for the Olympic committee’s needs (get it. Purr because cats). The Barr Body test, as it would come to be called, could be done with a minimally invasive cheek swab and was set to debut at the 1967 European Cup in Kiev, Ukraine.
From that point on, every woman who wanted to compete at the Olympics had to submit to a chromosome test. Women who passed the test were given a “certificate of femininity” that they would need to show each and every time they competed. Based on public records, this whole endeavor uncovered a shocking zero men trying to sneak their way into the women’s games across the 30 years the policy was in place. Now, the cynical person might say that the knowledge that there would be chromosome testing kept those men away. In that case, I’ve got this rock that keeps bears away and I wanted to know if you might be interested.
Still, the IOC’s medical commission loved the test but scientific experts including Barr himself strongly objected at the misuse of the test. The barr body test could not be used to determine a person’s “true sex” Turns out that no longer after Barr published the initial paper, people started noticing that not everyone had an XY or XX chromosome pattern. Some people had XXY or XYY or just X. It was entirely possible that someone could be entirely “female” in all ways but one lacking the XX chromosome pattern. Entirely a woman with one exception that would never be known without chromosome testing. Of course, this became an issue.
In 1985, Maria Martinez-Patino failed the barr body test but decided to fight the ruling. With a team of medical experts, she successfully appealed her ban from competition on the grounds that she had Androgen Insensitivity Syndrome; her body lacked the ability to respond to androgens like testosterone. Her Y chromosome was calling but her body wasn’t answering so she matured entirely as a cis woman. Had she never been tested, she would likely have never known. Instead, she was told to fake an injury, go back home and months later received a letter that she had been classified as a man and banned from competition.
Martinez-Patino wasn’t the first or only woman to be banned via the Barr Body Test but was the last. As a result of her case, chromosome testing was dropped. I can’t imagine what it might be like to be banned over this test. Not only would a woman lose her career as an athlete but she would also face public humiliation and the denial of who she even is as a person. This misuse of the Barr Body Test even after the creator of the test advised against it comes back to that whole deal about people engaging with science seriously but not literally. Officials took the text seriously. They thought it really meant something, they just didn’t quite care to understand it past what they wanted to hear. Sex testing is like jazz. It’s about the women you don’t humiliate.
The end of chromosome testing also meant the end of compulsory testing as a whole. Rather, if there was sufficient suspicion or if an athlete's sex was challenged, that athlete may be asked to undergo sex testing. This revised testing paradigm also incorporated testosterone as a new “scientific” measure to identify any men who would try to compete in women’s events. That may seem at first to be an improvement. Instead of all women facing the potential humiliation of sex testing, only a small number of women would be singled out and inspected based on subjective assessments.
What does that assessment look like? World Athletics, to their credit, has made some of these historical criteria available. In their 2011 documentation, the examination starts with what seems like a standard questionnaire of family and personal medical history followed by a visual inspection of the athletes, chest, upper back, abdomen, etc. Most of these visual criteria focus on the presence or absence of body hair. Finally, an endocrine panel may be needed to complete the test. Especially the visual elements of the assessment seem to be more about whether or not a woman conforms to certain beauty standards like the size and shape of her breasts or removal of body hair.
Apart from aesthetics there’s also the issue that targeted testing cannot provide counterfactual evidence to the claim that testosterone is definitively and causally linked to elevated athletic performance. If an athlete performs so well that it arouses suspicion and they submit to an endocrine panel, it’s going to come back with one of three results: low testosterone, “normal” levels of testosterone or high levels of testosterone. If her testosterone comes back above the cutoff, she has an advantage. In the other two cases, she’s just working hard.
The lived experience of being tested has been recounted by Indian athlete Santhi Soundarajan. She was asked to undergo medical testing without being told what the point of the tests were. She laid naked on an examination table while four strangers examined and probed her body. None of the doctors spoke her language or made any attempt to communicate why any of this was happening or for what . At the 2006 Asian Games, officials disclosed that Santhi “did not possess the sexual characteristics of a woman” and stripped her of her silver medal in addition to banning her from future competition. Humiliated, Santhi returned to her village, lapsed into severe depression and eventually attempted to take her own life.
Almost 100 years ago, sex testing was introduced explicitly to ensure fairness in sport and implicitly to draw a line between men and women. In all that history, there has not been a single case of a man trying to enter women’s sports to gain an unfair advantage. The handful of historical instances where accusations were made under further examination reveal themselves as cases of ambiguous sex characteristics or what we’d now understand as being intersex. So either this has happened and the man was so wholly unremarkable that no one even cared to notice or it hasn’t happened.
If you think I’m just ideologically motivated, even friend of the…nah I’m not even going to make that joke. Anyway, winner of the college debate club’s “when will they graduate” award Ben Shapiro could not find a single example of this happening. When making the movie Lady Ballers, they wanted to make it as a documentary about men pretending to be women to dominate women’s sports but turns out that doesn’t and has never happened.
There’s a possibility that awareness of testing kept people from trying but it seems doubtful that a moustache twirling villain would shave his moustache to try and win in women’s sports…for some reason I guess. Totally unrelated, again I have to mention this rock that keeps bears away. I’ll cut you a deal.
There is a real and documented human cost to actual women in order to out this hypothetical man. Santhi Soundarajan story does have an upturn and she’s been successful as a coach but she also isn’t the only woman to be impacted by these regulations. I’m not going to be exhaustive here but I strongly suggest giving the NPR podcast series “Tested” a listen if you find this interesting. It’s an infuriating (positive) listen that covers the history of sex testing and the impact it has had on its subjects lives in their own words.
For women who were suspected and identified as producing “excessive androgenic hormones” there were two ways to proceed: abandon sport or take steps to reduce their testosterone. Try to imagine being told that something you had no control over has disqualified you and cast your entire career under suspicion. You can fight the ruling but you only have so many years at your physical peak. An appeal might take years. Years spent being unable to compete and very importantly unable to earn money from doing so.
Understandably, some women opted to reduce their testosterone either via medicinal or surgical intervention. This was however not always an informed choice. Due to a lack of guidance from the same organizations that asked them to reduce their testosterone to begin with, some of these women didn’t understand the full extent of what they were being asked to do and the potential side effects up to and including including infertility. All this in the name of fairness in sport.
If a woman does all this and then returns to competition and doesn’t excel, well, that just confirms what the officials suspected right? It couldn’t be the massive stress, medical side effects and having taken time away from competition. Keep in mind all of this is medically unnecessary, these women were not just healthy they were elite athletes. Interventions, especially surgical interventions, also carried the very real possibility of health complications in the future and a lifelong dependency on supplementary hormones.
I also want to circle back to way earlier in this video and one theory for how totally healthy and normally functioning men might have what would be diagnosed as clinically low levels of testosterone. Some people are just more or less efficient at using the hormone. These interventions are taking someone who might produce more testosterone to compensate for a lack of receptors and asking them to crater their bodies levels of a hormone with broad implications for their health.
There was, however, a third option. In 2015, Dutee Chand sued citing the Olympic anti-discrimination charter. She and her legal team further argued that there was no evidence of a definitive link between higher levels of endogenous testosterone (i.e. what a person’s body naturally produces) and enhanced performance. Surprisingly, the Court of Arbitration for Sport agreed and gave Olympic organizers two years to find support for the policy or void it. Sure enough, they came forward with exactly that just as the clock was about to strike midnight.
A team of researchers affiliated with the Olympic organizing body had come up with a sponsored study that supported a connection between testosterone and performance. Using 2,127 observations from across the 2011 and 2013 International Association of Athletics Federations World Championship, researchers found a relationship between testosterone and performance in five events; the women’s 400m, 400m hurdle, 800m, hammer throw and pole vault with margins of advantage ranging from around 2% to 5%. None of these same associations were found when looking at men.
When I was earning my PhD one of my mentors told me that one of the perks of working in psychology is that nobody dies when we get it wrong, usually. This is an entirely different beast. that had an immediate impact on people’s lives and careers. I talked in earlier sections about how even researchers with the best intentions can be apt to make errors in their statistics by doing things like running too many tests, using small samples and conflating correlation and causation. This paper not only checks every box, it draws some new boxes we haven’t talked about yet.I think I know a thing or two about research methods so let’s unpack a few concerns.
The first thing that jumps at me is the sheer number of tests that the researchers conducted by looking at 21 women’s events and 22 men’s events. So you are already committing to over 40 tests and at no point did the researchers look at apply any kind of correction for the number of comparisons by adopting a stricter criteria than the conventional p < .05 which again informally means “we’re 95% sure the observed difference is due to an actual effect and not just chance.” 43 tests with a 1/20 chance that whatever difference you observed is noise.
Dig a little further into their methods and you’ll find that they did these comparisons by splitting athletes into three groups and comparing the lowest and highest tertiles average performance in each event. Generally speaking, taking something that is continuous like serum androgen levels and trying to split it into neat categories is almost always a bad idea. Not everyone that is packed into each of those groups has exactly the same testosterone level but that variation is lost. Essentially, they’re taking everyone in the bottom third and saying the person with the lowest level is exactly the same as the person who just barely missed the cutoff for the next highest group.
There’s also the matter of theory. Performance is a fuzzy word. Presumably the same mechanism that contributes to success in one event should also contribute to success in another similar event. I’m not a track person but discus, javelin, hammer throw and shot put seem pretty similar to me. Correct me if I’m wrong, but I would assume that whatever makes you good at throwing one thing should carry over to throwing other things. The fact that they only found a difference in one of these events is puzzling to me. The observed effects are also fairly small overall.
Nevermind that they didn’t find an effect of testosterone concentrations in any of the 22 tests they ran for men’s events. We know that testosterone levels vary among men at the level of elite athletes. A 2014 investigation looking at 693 endocrine profiles from elite athletes found that 16% of the men had low levels of testosterone and 14% of the women had high levels. So shouldn’t you expect to see some kind of effect there as well? Why would this only be present for women and only in a handful of events but not other similar events.
Dr. Bermon, the first author of that initial paper has also admitted that there were errors in their dataset and walked back the importance of the original study framing it as exploratory. However, the Court of Arbitration for Sport had already accepted their findings and made them the bedrock for the justification for future androgen testings. In response to a later appeal, the Court found that the restrictions were indeed discriminatory but were necessary discrimination in order to maintain fairness in sport.
Let’s take a moment and assume that is correct. According to the Olympic governing body, you might expect men to outperform women by anywhere from 10-12% depending on the event. However, women with higher levels of endogenous testosterone don’t even come close to that level of performance. Their advantage, if there is one, is a fraction of that. Depending on the event it can be as little as 1-2%. Even if there is a driving causal link wherein higher levels of T cause higher levels of performance in some events, is it really that big of a deal?
When you’re aiming to be the singular best person in the world at a particular sport, the reality is that you’re going to need to have advantages to get there. Height is a classic example. Being tall is an enormous advantage across a large number of sports but it’s largely out of a person’s control. I fence and it’s agonizing trying to compete with someone when they have even just a few extra inches of reach on you. At some levels of play, you can outwork your competition but that isn’t always going to be true at the highest levels of sport.
Eero Mantyranta won two gold medals in cross-country skiing in the 1964 winter games. Due to a mutation, his red blood cells ability to carry oxygen was anywhere from 25-50% above his competition. This mutation is extremely rare but offered a clear advantage in endurance sports. However, no one was suggesting that he needed to bloodlet before competing to even the odds.
In a more current example, let’s look at Michael Phelps. If you tried to build a human in a lab to be good at swimming, you’d make Michael Phelps. If you can name an advantage that could give someone an edge in swimming, he’s got it. Disproportionately long arms? Check. Big hands? Check. Large lungs? Check. From Baltimore? Also Check. No one is trying to tell him he can’t put Old Bay on literally everything for the sake of fairness.
That’s not even to get into other forms of advantage like having the wealth to afford to travel to train, afford better coaches and equipment, etc.
The world anti-doping agency describes the spirit of sport, the essence of Olympism, as “‘the pursuit of human excellence through the dedicated perfection of each person’s natural talent.’” So how is having larger than average hands or being born under the auspicious sign of the National Bohemian any more or less natural than being born with a body that produces a higher than average level of testosterone? At this point in the video, you probably already know the answer. The story around testosterone is just too big, too weighty and too dramatic. It has been made into something it could never be, the singular load bearing beam for the all important question of what actually makes someone a man or woman.
So what does science say about the connection between testosterone and athletic performance? Did you guess that it’s complicated? You’ve been paying attention. Good job. Testosterone really is a fascinating thing to look into. Exogenous testosterone, i.e. adding the hormone to the body, will generally result in an increase in performance. Taking medications that suppress endogenous testosterone, will generally result in a decline in performance. However, whether having higher levels of naturally occurring endogenous testosterone will result in greater athletic performance isn’t well supported by the literature.
In one study, researchers were interested in whether testosterone and cortisol were related with skeletal muscle markers like thickness and strength. They tracked testosterone, cortisol and performance across a track and field macrocycle. They found that testosterone levels increased over the course of the cycle, those increases did not predict corresponding increases in muscle strength or moderate the link between muscle strength and performance. These findings suggest that testosterone and performance both increase in response to training but in parallel where testosterone is indicative of the body’s response to training and not connected with performance.
Testosterone not only influences how we respond to situations but is also influenced by how situations react to us. This makes it very hard to say with certainty that higher levels of naturally occurring testosterone cause athletes to be harder, better, faster and/or stronger or if there might be a third variable at play causing both T and performance to increase.
Studies using populations of pre and post menopausal women consistently find that testosterone is not associated with lean muscle mass or muscle strength. Meta-analytic studies looking at the relationship between testosterone and muscle mass tend to conclude that there either is no relationship there or that it depends on a number of over factors in the body such as cortisol, estrogen or the ratio between testosterone and these other hormones.
However, that hasn’t stopped the story of testosterone from taking center stage. In researching this section I came across so many papers that stated as a given that testosterone is related to performance or that testosterone explains all or the majority of differences in performance between men and women. As you now know, that just ain’t it but that doesn’t stop authors from continuing to build arguments on top of a shaky foundation. Then subsequent work cites them and reiterates the link between T and performance. Good thing science is self-correcting, right?
The last subject I want to touch on here is one of the hardest to tackle; trans inclusion in sports. In the case of women with higher than average T, we were still talking about naturally occurring endogenous testosterone. Now, we’re talking about suppressing testosterone in trans women and trans men taking supplementary exogenous testosterone.
As an aside, it’s shocking the sheer number of people who purport to be experts on the topic but will use “the transgenders” or “transgender” to refer only to trans women as if trans men are in the same category as dragons and moderate republicans. I also played a little game where I’d check if the author was British every time I saw the phrase “biological male” and had like a 90% hit rate.
Depending on who you cite, trans people make up approximately 1% of the adult population but the topic of the inclusion of trans people in sport at all levels has become a firestorm of controversy well in excess of the representation of trans athletes. Like the topic of sex testing, this has shown itself to be a “wicked” problem with no definite solution that must be constantly re-solved.
When you make testosterone the sole criteria through which a person’s eligibility is determined, how do you determine where to draw that line? As of writing, no singular athletics body has stepped forward to provide universal guidance; instead the International Olympic Committee has decided to defer to sub-organizations that govern individual sports. Historically, that line has been drawn and redrawn across time and sports whether it’s at 10 nmol/L, 5 nmol/L or 2.5 nmol/L.
In more recent developments, some sports organizations have updated their guidance to only allow participation by athletes “who have completed their transition before the age of 12 to avoid unfair advantages. The logic is that any degree of masculinizing puberty would provide a trans women with a potential advantage over cis competition which cannot be mitigated by medical or surgical means later in life. At a time where access to puberty blockers has become increasingly politicized and restricted, policies like this are near-total bans on trans participation in sport. Want to compete when you’re 24? Should have start hormones at 12? Want to start hormones at 12? Should have been 19 when you were 12.
Much like with the issue of endogenous testosterone in women’s sports, getting a firm scientific answer on this issue is extremely complicated. Joanna Harper who describes herself as a scientist first, athlete second and a transgender person third was called to testify at that initial hearing to support testosterone testing. Harper published the first study looking at the effect of gender transition of athletic performance following her own performance and the performance of seven other women over time. Her findings showed that, controlling for testosterone, trans women did not have a competitive advantage over cis women peers.
Some studies conducted in the past few years have moved away from testosterone as a major focus to instead look at other factors like muscle mass, strength and lean body mass that might be impacted by hormone therapy. So far those studies suggest that even after 36 months of suppression, strength levels remained above those observed in cisgender women. How much that actually matters for athletic performance depends heavily on the sport and how much the athlete exercises to maintain muscle mass. For example, a 2021 study of air force personnel found that trans women lost their advantage over ciswomen in number of push-ups and sit-ups they could do in 1 minute but retained an advantage in 1.5 mile run times.
There are issues with trying to make expansive claims from this data. The reality is that there simply aren’t enough trans athletes in any given sport to actually do a scientifically rigorous survey of their performance nevermind when looking at the elite levels of any given sport. Some researchers have looked at non-athlete trans women and others have opted to compare cis women and cis men and extrapolate from there. Almost all of these studies use non-athletes or cis athletes which may further limit generalizability to a trans athlete population.
So do trans women have any kind of advantage, maybe several large question marks and it heavily depends on the sport as well as a range of other factors. But the need for more robust data hasn’t stopped the exclusion of trans athletes from competition. Seemingly, it’s more about vibes than anything based on science. The reality is that the vast majority of people don’t know a single trans person. That lack of knowledge is like dry tinder for conspiracism. Not even banning trans women from competition has managed to stop competitors and spectators from accusing women that perform a little too well or don't present feminine enough of secretly being men.
This was fully on display during the 2024 Olympic games but it’s a trend in women’s athletics generally. To be dominant on the court you also have to be feminine off it or risk having your womanhood and competitive eligibility questioned. Depending on the sport, just participation in it can be enough to detract from a woman’s femininity. If you need an example, there is a very long, very public and very gross media history around Superbowl half-time show MVP Serena Willaims calling her womanhood into question. t is tragically common for women who win to be derided as less a woman for it. It’s a precarious balancing act that cuts back to old misconceptions of estrogen and testosterone as opposing forces and complementary ones like we know now.
That paranoia has given rise to renewed calls to reinstitute genital inspections even in youth sports. Like with bathroom bills, Just by law of numbers, efforts to exclude trans women end up having a much bigger impact on the lives of ciswomen who just happen to be tall, as if trying to find cute heels in size 12 wasn’t suffering enough.
You’ve probably noticed that I haven’t gone into the participation of trans men in sports. WADA regulations stipulate that trans men should be allowed to use exogenous testosterone without controversy. There just doesn’t seem to be the same degree of cultural anxiety about a woman pretending to be a man and entering men’s athletics. The lack of reactivity to the inclusion of trans men in competition further solidifies that these restrictions are less about fairness and testosterone and more about enshrined ideas about gender, competition and a need to protect women. The policing of who gets to be a woman in sport is less a logical decision and more an emotional knee jerk.
In all my life, I’ve never known anyone to be more emotional, petty and cruel than the parents of youth athletes. Over the past several years, an enormous amount of media attention and legislative energy has gone into banning the participation of trans kids from sports wholesale at any level high school, middle school and even younger. As of writing this in early 2025, the U.S. house of representatives passed the "Protection of Women and Girls in Sports Act" which proposes abdication of federal funding for schools that allow "a person whose sex is male to participate in an athletic program or activity that is designated for women or girls." While there have been prior state level efforts to bar participation by trans athletes at the high school level, this would prohibit inclusion at any level at all.
Curious how once again trans boys and men don’t seem to factor into the equation at all. Trans man, Mack Beggs was required by texas law to wrestle girl’s in high school and went on to two undefeated seasons. He is the single best example of a trans kid dominating a girls sport, but it doesn’t fit the narrative. Trans guys don’t elicit the same kind of reaction which in turn doesn’t drive our ad-driven nightmare media machine forward.
Back to the point of departure! As much as I may disagree with the conclusion, I can empathize that people have concerns at the professional level where there is a lot of money involved and people’s livelihoods are on the line. I have a much harder time empathizing as you move down from there. As you move younger and younger, eventually you’re talking about kids that haven’t even started going through puberty yet so any concerns about advantages from a masculinizing puberty or testosterone are just off the table. It gives up the game, not that they were really trying to hide it with bill titles like “Protection of Women and Girls in Sports Act.” It’s about policing the bodies of girls who do not conform to conventional femininity and excluding trans kids from public life.
In a 2021 report after more than 20 states had put forward bills to ban trans girls from participation in high school sports, the Associated Press reached out to 24 lawmakers sponsoring these bills. At the time of reporting, the issue of trans girls in sports had only been raised a few times amongst the hundreds of thousands of American high schoolers playing sports. Rep. Ashley Trantham of South Carolina could not name a single trans athlete in her state despite seeking to ban their inclusion. Tennessee rep Cameron Sexton acknowledged that there may not be a single trans student participating in high school or middle school sports in his state. Other lawmakers turned away from their own states, deflecting to the case of two trans runners in Connecticut; Terry Miller and Andraya Yearwood.
There is an excellent episode of the since wrapped WNYC podcast Nancy titled “when they win” covering Terry and Andraya that I highly recommend for anyone interested in the topic. I’ve linked it in the video description below and you should see a card popping up now for the episode. Since listening to it years ago, one passage from the episode has stuck with me.
“When transgender athletes lose, it doesn't fit the narrative that they are dominant and that they are stealing opportunities from cisgender girls. If an athlete who is trans is just like every other athlete that wins and loses sometimes, then how can you say that they are so dominant? And so when it doesn't fit the narrative, there isn't the coverage. There isn't the outrage, because there's nothing to be outraged about. But it creates this double-edged sword for these athletes where…if they do win, it's not because they worked hard or because they’re talented. It is because they are — have an “unfair advantage.” And when they lose, there's no acknowledgment that they're just like everybody else”
Especially at the high school level where college admissions and athletics scholarships are in play, there is rampant conspiracism that trans girls are taking over sports. When her daughter didn’t qualify for a regional track meet, one parent authored a venomous op-ed in USA Today attacking Terry and Andraya and sued on behalf of her daughter along with three other runners and their parents. I followed up on this and found that the case was dismissed with the court citing that while Terry and Andraya did win some of their races, they are also still lost to the plaintiffs at others.
What I find particularly egregious about this case is the plaintiffs seeking to strike Terry and Andraya’s times from the record, claim their daughters were denied the chance to be champions and further claim that not winning more races damaged their daughter’s employment prospects. It’s one thing to sue over the regulations that allowed Terry and Andraya to compete but to go so far as to try and erase their accomplishments while also claiming that doing so would hurt their future employment prospects. Like I said, parents of youth athletes. We really got shut this whole little league down until we can get to the bottom of this.
Terry and Andraya come up often when you’re looking into this issue because they aren’t just two of the only examples of trans girls winning in high school athletics, they were the only two at the time. Most people don’t know a trans person nevermind a trans kid who competes in sport so there’s ample room for brain worms to set in making it seem like there are far more trans athletes than there are performing far better than they actually do.
Splicing this in here because it just occurred to me during editing that it's not just that people are bad at base rates. These kids aren’t dumb. They know they're going to attract vitriol just by stepping up to compete. So not only are there very few trans kids generally, the kids that do stick with sports despite all the forces against them must be incredibly committed to what they’re doing; as much, if not more, than any of their cis peers.
The truth is, that there are hardly any trans athletes at the high school and college level. In December 2024, NCAA President Charlie Baker stated there were “fewer than 10” transgender athletes competing in college sports. He didn’t further specify how that breaks down but I’d wager than not all of those ten are even trans women. All athletics across over 1,000 colleges and universities and you can count the number of trans women competing in women’s sports without even using your toes.
The story doesn’t change much as you move to the high school level. In response to the state-level ban on the inclusion of trans girls in high school athletics, Governor Cox of Utah vetoed the effort citing that out of 75,000 students participating in high school sports only 4 identified as transgender and only one was a trans girl. This entire sweeping legislative effort for one single person. One kid who wanted to play sports with her friends.The state legislature went on to override his veto.
Governor Cox went on to also cite two other statistics. 86% of trans youth report suicidality and 56% report having attempted suicide. The physical and mental health benefits of participating in youth sports are well documented. Having a place they belong can help buffer trans kids against the discrimination they face in other areas of life. Further, the exclusion of trans kids from sports has an actively detrimental effect on their mental health as if things weren’t hard enough already.
For the people who put forward these kinds of measures designed to deliberately isolate, derogate and dehumanize a single child in an entire state, you have lost the mandate of heaven. As the sadly departed, David Lynch once said “fix their hearts or die.”
So now I’m sitting here thinking of how to write the ending to this. I just checked my phone and saw a new executive order come down the pipe banning participation of trans women from sports at all levels from basketball and swimming all the way through disc golf and chess. Personally, I do historical fencing or HEMA which tends to, like most geek-adjacent hobbies, break one of two ways; gay or fascists. Thankfully, people in my region tend to be the former including running events for “underrepresented genders” which is rough but appreciably better than women and women-lite.
In writing and researching this video I’ve also had to face the fact that I am also not immune to propaganda. I have internalized shame around my participation and anxiety that other competitors see me as a man or assume that I have some kind of advantage. It impressively manages to suck the fun out of wrestling with swords which is, honestly, pretty hard to do. Sure, there is some degree of everyone looking pretty similar underneath that much padding regardless of gender, but it’s been bothering me and more lately. It’s hard to always believe that these spaces are somewhere that I’m welcome, nevermind somewhere I belong. I don’t like that I feel that way and I’m gonna do some work on myself to change that.
The story of testosterone is a love story. For thousands of years people have been in love with the idea of testosterone so much so that the story continues to overshadow the reality of the hormone it is based on. It’s a love so powerful that it can convince a serious academic that injecting dong water was the secret to eternal youth. A love that continues to drive misconceptions in health, sport and academic research. But only by putting down the story can we really understand how beautiful and complex the reality of our bodies can be. That’s what I’ve got for this time. Until next video, be nice to yourself.