I HAVE NEVER BEEN ABLE to jab the needle suddenly, as my doctor told me to. Instead I push it in slowly until all three inches are submerged in my hip muscle. Then I squeeze in 200 milligrams of a slightly golden-hued, oily liquid. Within a day I feel a deep surge of energy. It is less edgy than a double espresso, but it’s just as powerful.
The chemical? Synthetic testosterone:
a substance that has become a metaphor for manhood.
T WENTY YEARS AGO, as it surged through my pubescent body, it deepened my voice, grew hair on my face and chest, strengthened my limbs, made me a man. So what, I wonder, is it doing to me now?
There are few things more challenging to the question of what really is the differ-ence between men and women than to see the difference injected into your hip. Men and women differ biologically mainly because men produce some ten times as much testosterone as most women do, and because this chemical profoundly affects physique, behavior and mood.
As more people use testosterone medically, as more use testosterone-based steroids in sports and recreation, and as more research explores the behavioral effects of this chemical, the more we see the power of that biology. It touches on every aspect of our society, from divorce and male violence to the exploding cult of body-building. It may even help us explain, perhaps ...... life.
The lure of testosterone may be. even greater now that AndroGel—an easy-to-apply prescription treatment for the four to five million men who suffer from low testost-erone levels—hit the market last summer. (1999). My own manhood supplement came about for a simple medical reason. I am HIV-positive, and two years ago, after a period of extreme fatigue and weight loss, I had my testosterone levels checked. My body, producing far less testosterone than it should have been at my age, needed regular injections of the chemical. At that point I weighed around 165 pounds. I now weigh 185 pounds. (April 2, 2001). My collar size went from a 15 to a 17 in just a few months; my chest went from 40 to 44. My appetite expanded beyond measure. Going from napping two hours a day, I now rarely sleep in the daytime and have enough energy for a hefty work schedule . I can squat more than 400 pounds. I feel better able to recover from life’s curve-balls, more alive. (Men with normal testosterone levels will not experience these effects.)
In the Beginning
Testosterone, oddly enough, is a chemical closely related to cholesterol. First isolated in 1935 by a scientist based in the Netherlands, it was successfully synthesized by a German and a Swiss biochemist. Although testosterone is often thought of as the definition of maleness, both men and women produce it—men in their testicles, women in their ovaries, and both men and women in their adrenal glands. Men, however, produce much, much more of it. An average woman has 40 to 60 nanograms of testosterone in a deciliter of blood plasma. An average man has 300 to 1000, and a teenage boy can range up to 1300 or so. (There’s no contest here.)
Testosterone’s effects start early—really early. You need testosterone to turn a fetus with a Y chromosome into a real boy, to masculinize his brain and body. Men experience a flood of testosterone three times: in the womb several weeks after conception, during the first few months after birth, and at puberty. The first fetal burst primes the brain and the body, endowing male fetuses with the instinctual knowledge of how to respond to later testosterone surges. The third, more familiar adolescent rush—squeaky voices, facial hair and all completes the process. Without testosterone, humans would essentially revert to the default sex, which is female. The Book of Genesis is therefore wrong. It isn’t women who are made out of men. Men are made out of women. Testosterone, to stretch the metaphor, is Eve’s rib.
The effect of testosterone is systemic; it engenders both the brain and the body. Apart from the obvious genital distinction, differences include body hair, upper-body strength, the ratio of muscle to fat and so on. But it leads to other changes as well. Since it is unethical to experiment with human embryos by altering hormonal balances, much of the evidence for this idea is based on animal studies. When researchers, for example, injected newborn female rats with testosterone, the rats went on to develop typically male mounting behavior. Newborn male rats that had their testosterone blocked did not develop normal penises, and they presented themselves to untreated male rats in a way typical of female sexual behavior.
Other scientists, theorizing that testosterone enabled male zebra finches to sing, exposed mute female finches as newborns to masculinizing hormones, then as adults to testosterone. Sure enough, the females sang. Certain “male” behavior, in other words, could be induced by testosterone exposure, even in chromosomal females.
Does this apply to humans? Pregnant women given progestins (chemically similar to testosterone) in the 1950s to avoid miscarriage had daughters who were reported to have tomboyish childhoods. Ditto girls born with a disorder that causes their adrenal glands to produce too much male hormone. In his book As Nature Made Him, John Colapinto chronicles the moving story of David Reimer, who as an infant was surgically altered (after a botched circumcision) to become a girl. Despite a concerted attempt to socialize David as a girl and to give him hormonal treatment to develop as one, his behavioral and psychological makeup was still ineradicably male. Eventually, with the help of more testosterone, he fully resumed his male identity.
In the complex human engine, testosterone is gasoline. For deficient males, the Big T revs up the body—with energy, strength and sexual drive. Unlike Popeye’s spinach, however, testosterone is also a relatively subtle agent. It is not some kind of on-off switch with men constantly turned on and women off. For one thing, we all start out with different base-line levels. For another, testosterone is suscep-tible to environment. T levels can rise and fall depending on external circumstan-ces. Short term, testosterone appears to be elevated by certain competitive challenges—a sports match or an exchange of insults, for example.
Similarly, testosterone levels may respond to long-term stimuli, as well as influencing them. One study shows that men in long-term marriages see their testosterone levels progressively fall. A 1993 study found that a man with a high level of testosterone is less likely to marry and is more likely to have experienced divorce. One of the most remarkable statistics is the sex differential in crime. For decades, arrest rates have shown that an overwhelmingly disproportionate number of arrestees are male. Although the sex differential has narrowed since the chivalrous 1930s, when the male-female arrest ratio reached 12 to one, it remains almost four to one.
In violent crime, men make up an even bigger proportion. Eighty-nine percent of the people arrested for murder in the United States in 1998, for example, were men. This, then, is what it comes down to: testosterone correlates with risk—physical, criminal, personal. Without the influence of testosterone, the cost of these risks might seem to far outweigh the benefits. But with testosterone charging through the brain, it may be that caution is thrown to the wind. The influence of testosterone may not always lead to raw physical confrontation. In men with many options, it may influence the decision to invest money in a dubious enterprise, jump into an ill-advised sexual affair or tell a big whopper. At the time, these decisions may make some sort of testosteroned sense. The White House, anyone?
In our ancient evolutionary past, it’s been surmised, men in general hunted and women in general gathered. Women would have needed some testosterone— for self-defense, occasional risk-taking, strength—but not as much as men. But highly testosteroned men may not always be attractive to women. Although their features can turn women on (strong jaws and pronounced cheekbones are believed to correlate with high testos terone), they can also be perceived as precisely the unstable, highly sexed creatures that childbearing, stability-seeking women avoid.
One way, researchers hazard, that women may have successfully squared this particular circle would have been to marry the sweet class nerd and then to have an affair with the college quarterback. Many feminists have made tenacious argument about the lack of substantive physical or mental differences between men and women. But to rest the equality of women on the physical and psychological equivalence of the sexes is to rest it on sand. In the end testosterone bites. Last year, for example, Toys “R” Us announced that based on its market research, it was planning to redesign its stores to group products according to “logical adjacencies.” When one store posted a directory referring to the new sections as “Boy s World” and “Girl’s World,” a public outcry ensued. Though Toys “R” Us said that the labels had been a mistake and denied that their redesign had led to gender separation, a protest campaign was launched.
Meanwhile, Fox Family Channels has introduced two separate channels for boys and girls, boyzChannel and girlzChannel, to attract advertisers and consumers more efficiently. Fox executives told The Wall Street Journal that this move reflects what Nielsen research tells them about viewing habits: “In general terms, girls are more interested in entertainment that is more relationship-oriented,” while boys are “more action-oriented.” T anyone? After more than two decades of argument over sexual difference between boys and girls, the market has shown that little has changed.
Author Matt RidIcy points out in The Red Queen that there is also physiological evidence of early mental differences between the sexes, much of it to the advantage of girls. Two to three times as many boys are hyperactive than girls. In general, boys are better at spatial tasks, girls at verbal tasks. These are generalizations, of course. But the influence of womb-given testosterone on those generalities seems likely. In adult men, a high level of testosterone doesn’t necessarily correlate with economic power. Blue-collar workers have more testosterone than white-collar workers, according to a study of more than 4000 former military personnel.
For reasons no one seems to understand, testosterone may also play a role in immune suppression. Testosterone levels correlate not only with baldness but have been tentatively linked with heart disease and susceptibility to infection. Higher testosterone levels found in certain groups of black American men, some researchers believe, may be related to black men’s higher rates of prostate cancer. The aggression testosterone may foster, and the risks it seems to encourage, can lead men into situations that often wound or kill them. In these male trade-offs, it is as if quantity of life is sacrificed for intensity of experience.
A Man’s World
As our economy becomes less physical and more cerebral, as women slowly supplant men in many industries, as income inequalities grow and more highly testosteroned blue-collar men find themselves shunted to one side, we will have to find new ways of channeling what nature has bequeathed us. A world without the unruly, vulnerable, pioneering force of testosterone would be a fairer and calmer, but far grayer and duller, place. It is certainly somewhere I would never want to live. For my part, I’ll keep injecting the Big T. Apart from how great it makes me feel, it seems no disrespect to womanhood to say that I am perfectly happy to be a man, to experience the world in a way no woman ever has. And, as the demand for testosterone becomes more widespread, let’s use our increasing knowledge of the “He” hormone to understand what it is to be a man, for better and for worse. Let’s accept how men and women aren’t created equal—and move on.
NEW YORK TIMES Magazine
Copyright @ April 2, 2000, 229 W. 43rd St., New York, N.Y. 10036
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