By Neil Howe
According to a recent report from JAMA, testosterone therapy among American men is on the rise. From 2010 to 2013, prescriptions more than doubled, which researchers partially attribute to ubiquitous drug marketing campaigns urging older men to boost “low T” levels. The swell of interest reflects a genuine physiological shift: Across the population, men today have less testosterone compared to men of the same age a generation ago. Asking why requires untangling a complex web of social, environmental, and behavioral factors that are dismantling age-old ideas about masculinity and triggering real anxiety over changing gender roles.
Studies show that men’s testosterone levels have been declining for decades. The most prominent, a 2007 study in the Journal of Clinical Endocrinology and Metabolism, revealed a “substantial” drop in U.S. men’s testosterone levels since the 1980s, with average levels declining by about 1% per year. This means, for example, that a 60-year-old man in 2004 had testosterone levels 17% lower than those of a 60-year-old in 1987. Another study of Danish men produced similar findings, with double-digit declines among men born in the 1960s compared to those born in the 1920s.
The challenges to men’s health don’t end there. Rates of certain reproductive disorders (like testicular cancer) have risen over time, while multiple European studies have found that sperm counts are sinking. These trends coincide with a decline in musculoskeletal strength among young men: In a 2016 study, the average 20- to 34-year-old man could apply 98 pounds of force with a right-handed grip, down from 117 pounds by a man of the same age in 1985. Though grip strength isn’t necessarily a proxy for overall fitness, it’s a strong predictor of future mortality.
What’s behind all the downward trends? The answer is complicated. The decline in testosterone levels is almost certainly linked to higher rates of obesity (which suppresses testosterone) and may be linked to lower rates of smoking in men (since nicotine is a potent aromatase inhibitor). In the 2007 study, however, the age-matched declines persisted after controlling for these variables. Many observers put more weight on increased exposure to environmental toxins, such as pesticides, parabens, and chemicals common in household products like phthalates and bisphenol A.
Also playing a role are long-term shifts in the ways we work and live. Young men are far less likely to hold jobs in manual labor, so they don’t have to be as physically strong as previous generations. Meanwhile, certain forms of close relationships—such as marriage, fatherhood, and increased time spent with children—are causally linked to lower testosterone levels. Yet here again the evidence is muddled: On the one hand, Gen-X and Millennial men are marrying later and having fewer kids. On the other hand, young men today are more likely to live with other people—which may promote prosocial hormones like oxytocin that are natural antagonists to testosterone. And those who are fathers are spending more time with their children.
One reason why it’s so hard to pinpoint what’s driving the declines is the sheer number of factors that could be in play. To account for low testosterone, researchers have cited other lifestyle trends as wide-ranging as increased temperatures in homes and offices, lack of exercise, and even tight underwear. It’s also difficult to establish the direction of causality. Has testosterone declined in response to a changed world, or has the world changed to accommodate less virile men? Or is it both? Take declines in strength, for example: While we know supplementing with extra testosterone by itself increases muscle mass, we also know that strenuous exercise by itself promotes natural testosterone production.
What’s happening to men physically dovetails with a broader story of social transformation. The economy is shifting away from jobs that favor men, like manufacturing, and toward sectors dominated by women. Young men have fallen behind women in educational attainment. They’re increasingly dropping out of the workforce and expressing less work centrality. The anxiety over the state of men mirrors a bigger debate over America’s national identity. Americans have traditionally seen themselves as a “pro-testosterone” nation: restless, striving, and rowdy. Yet in his new book The Complacent Class, Tyler Cowen argues that America is losing the dynamism, mobility, and enterprise that made it special. This anxiety may have even led the old-fashioned, overtly macho President Trump to victory.
The confusion over what masculinity means today is reflected in the conflicted feelings of males now coming of age. Most American Millennial men report feeling pressured to project a traditional image of manhood characterized by traits like toughness, self-reliance, and hypersexuality—but when asked if they wish to emulate these characteristics themselves, the majority don’t. A separate survey asked men to rate themselves on a scale of “completely masculine” to “completely feminine.” Only 30% of 18- to 29-year-olds chose “completely masculine.” That’s compared to 65% of men over 65.
All these social and cultural changes have also left Millennial women in uncharted waters. More face a dating pool where partners of equal education and status are harder to come by, leaving them waiting for men catch up or deciding to go it alone. “They aren’t men,” one young woman told Philadelphia Magazine flatly. “They’re boys.” It’s a sign of a long-term generational reversal: When Boomer women were coming of age, they wanted kinder, gentler men in touch with their feelings. Now Millennial women yearn for guys who can “man up” and take care of business.
Ultimately, it’s impossible to pigeonhole what’s happening to masculinity as wholly positive or negative. The strongest objections come from critics who believe men and women are naturally built for traditional roles—or from those who argue that toxic chemicals are wreaking havoc on men’s health. Those who believe traditional gender roles are dysfunctional, however, welcome moving past them. A less testosterone-laden world might be less aggressive and more emotionally expressive. If there’s one thing on which observers agree, it’s the need for solutions to support the men the 21st-century economy is leaving behind.