New research from Griffith University suggests that some men are turning to underground sources of testosterone replacement therapy (TRT) due to significant challenges in accessing treatment through formal healthcare systems.
The study, led by PhD candidate Ben Bonenti from Griffith University’s School of Applied Psychology, examined the experiences of Australian men using TRT. It focused on the barriers they face in accessing treatment, their perceived health outcomes, and the ways they manage and regulate testosterone use in everyday practice.
According to Bonenti, the findings present “a complex picture.” Participants reported multiple obstacles when trying to obtain TRT through legitimate medical channels, including long administrative processes, high costs, and stigma associated with treatment.
Despite these difficulties, many of the men involved in the study described TRT as highly beneficial, reporting noticeable improvements in both physical health and mental wellbeing.
The research involved in-depth interviews with nine men aged 18 and over who were currently using TRT. These interviews were conducted via videoconferencing and explored their lived experiences with treatment access and use.
A key theme that emerged was self-management. Several participants reported adjusting their own dosages, and in some cases combining prescribed testosterone with products sourced outside the regulated medical system in order to maintain consistent access.
Rather than simply following medical instructions, these practices reflected a more active, self-directed approach to treatment.
While TRT is intended to be a clinically managed therapy, the study suggests that real-world use is shaped heavily by financial, social, and regulatory constraints.
The findings also point to a potential mismatch between existing TRT healthcare models and how patients actually engage with testosterone use in practice.
The researchers argue for more flexible, harm-reduction-oriented approaches that take these realities into account. They suggest that improving access to legitimate treatment and reducing stigma could help decrease reliance on informal and unregulated sources.
The study, titled “Much easier to just buy underground from a guy at the gym: The politics of accessing testosterone among men who use prescribed testosterone in Australia,” was published in the Journal of Drug Issues.
