特朗普在两年前果断赢得了美国男性的选票,但民调显示,男性选民对这届发动战争、肥己肥人的政府日益幻灭。
Two years after Donald Trump decisively won the vote of the American man, polls say male voters are increasingly disillusioned with an administration that has waged wars and enriched itself.
在中期选举前夕,特朗普的策略似乎是想方设法重新赢回那份男性的敌意,让男性选民不凭理智、不凭真心,而是凭“下半身”投票。至少,这是理解为何今夏特朗普的卫生部长和国防部长宣布了一些计划的一种方式——这些计划可能会提高平民和军人体内的睾酮水平,或简称为“T”。
Ahead of the midterms, Trumps strategy seems to be to find a way to get that masculine animus back, so the male populace will vote not with their heads or their hearts, but with their hogs. At least, thats one way of understanding why, this summer, Trump`s secretaries of health and defense announced plans that could increase levels of testosterone, or simply “T”, in the civilian and military population.
6月,卫生部长小罗伯特·F·肯尼迪宣布,FDA将取消对睾酮替代疗法(TRT)的一项限制,该限制声明其安全性和有效性“尚未确立”。这是一系列FDA变革的一部分,这些变革可能让男性更容易获得睾酮处方,从而可能加速接受TRT的男性数量激增;2025年已开出近1200万张处方,而2000年不足100万张。
In June, the health secretary, Robert F Kennedy Jr, announced the FDA was removing a limitation on testosterone replacement therapy (TRT) which stated that its safety and effectiveness “have not been established”. This was part of a suite of FDA changes that could make it much easier for men to be prescribed testosterone, potentially accelerating a boom in the number of men on TRT; already nearly 12m prescriptions were dispensed in 2025, from fewer than 1m in 2000.
几周后,国防部长皮特·赫格塞斯宣布,将强制要求30岁以上现役军人进行睾酮筛查,并为所有现役人员提供自愿筛查——这是打造他所谓的“高睾酮战争部”的一部分努力。被认定为睾酮水平低的现役人员将获得国家资助的替代疗法。
A few weeks later the defense secretary, Pete Hegseth, announced he was making testosterone screening compulsory for military service members over the age of 30, and offering voluntary screening for all members – part of an effort to forge what he calls a “High-T department of war”. Service members who are deemed to have low T will be offered state-sponsored replacement therapy.
特朗普的追随者不仅想给男性补充更多睾酮,还热衷于谴责那些在他们眼中睾酮不足的人。正在竞选得克萨斯州参议员席位(该席位可能决定华盛顿权力平衡)的肯·帕克森,投放广告将其民主党挑战者詹姆斯·塔拉里科描绘为“睾酮太低,不配得州”。特朗普最忠诚的顾问斯蒂芬·米勒称这位顺性别异性恋男性塔拉里科为“首位跨性别参议员候选人”。
Trump acolytes dont only want to give men more testosterone, they are keen to castigate those who they think dont have enough of it. Ken Paxton, campaigning for a Texas Senate seat that may decide the balance of power in Washington, has run ads casting his Democratic challenger, James Talarico, as “too low-T for Texas”. Trump`s most loyal adviser, Stephen Miller, called Talarico, a cisgendered heterosexual man, the “first transgender Senate candidate”.
睾酮是一种存在于男性和女性身体各处的激素——血液、唾液、器官、大脑。它在从排卵到骨密度的方方面面都发挥着重要作用,但通常只需极低量的激素即可维持正常功能。它只是人体内分泌系统中流动的众多激素之一。然而在2026年,它的角色似乎被无限放大。
Testosterone is a hormone that is found everywhere in the bodies of men and women – blood, saliva, organs, the brain. It plays an important role in everything from ovulation to bone density, but often a low amount of the hormone is all that is needed for normal function. It is just one of many hormones churning through the human endocrine system. Yet in 2026, its role feels outsized.
全美各地的共和党人正试图将为跨性别青少年提供睾酮定性为犯罪,称其为“残害”,与此同时,女性们却争相通过非品牌睾酮来重振性生活——而肯尼迪领导的FDA希望让这变得更容易。共和党众议员安娜·保利娜·卢纳在表示“任何‘产生睾酮’的人都会喜欢白宫草坪上的UFC格斗赛”时,推崇高睾酮水平。然而在华盛顿州,共和党人却在推动一项投票提案,要求对每一名参加体育运动的学龄女童进行检测,以确认她们的睾酮水平不算太高。
Republicans across the country are trying to criminalize providing testosterone for trans youth, describing it as “mutilation”, at the same time women are clamoring to revitalize their sex lives with off-brand testosterone – something Kennedys FDA wants to make easier. The Republican congresswoman Anna Paulina Luna celebrated high T levels when she said anyone who “produces testosterone” would love the UFC fight on the White House lawn. Yet in Washington state, Republicans are pushing a ballot measure to test every school-age girl who plays sports to check their testosterone levels arent too high.
与此同时,廉价的家用血液和唾液检测套件的出现,给男性感知到的男子气概打上了数字标签,让他们产生了一种新的相对匮乏感。围绕“T”(睾酮)的文化叙事为何变得如此混乱?
Meanwhile, the advent of cheap home blood and saliva testing kits has put a number on men`s perceived masculinity, giving them a new sense of comparative deficiency. How has the cultural story around T become so confused?
确实,睾酮能显著改变服用者的外貌和性欲。临床睾酮缺乏的男性在睾酮水平恢复后,在肌肉增长和性功能方面会获得真实获益。但“让美国再次伟大”(MAGA)阵营的高睾酮政治赋予了睾酮更多含义——将其视为一种男子气概的灵药,能赋予侵略性、运动能力、精力旺盛和冒险精神。这一观念建立在一个世纪的有缺陷的科学之上。
Its true that testosterone meaningfully changes the appearance and libido of the people who take it. Men with clinical testosterone deficiencies experience real benefits in muscle growth and sexual function when testosterone levels are restored. But Maga worlds high-T politics ascribes more to testosterone – for it to be an elixir of masculinity that bestows aggression, athleticism, virility and risk-taking. This idea rests on a century of flawed science.
“我看到大量‘科学洗白’倒退观念的现象,”在麦吉尔大学科学与社会办公室工作的科学传播者、屡获殊荣的医学播客《The Body of Evidence》联合主持人乔纳森·贾里说道。“在美国,一切都已政治化。疫苗是自由派的,睾酮替代疗法是‘让美国再次伟大’派的。针头本身无政治立场,但注射器里的内容却取决于你投给谁。”没有人比皮特·赫格塞斯更热衷于将选举竞争力、军事能力和睾酮混为一谈。
“I am seeing a lot of ‘sciencewashingof regressive beliefs,” said Jonathan Jarry, a science communicator working at McGill Universitys office for science and society who co-hosts the award-winning medical podcast The Body of Evidence. “Everything has been politicized in the United States. Vaccines are liberal and TRT is Maga. The needle is apolitical but the content of the syringe is decided by who you vote for.”No one is more excited to conflate electability, military capability and T than Pete Hegseth.
睾酮暗语 随着伊朗战争威胁到共和党在中期选举中的前景,赫格塞斯似乎被赋予了重新包装战略失败的任务,将其包装成阳刚之气和无情嗜血的展示。作为更名后的“然而,若要让军队成为纯粹暴力的工具,赫格塞斯认为,它不仅要打击敌人的士气,还要打击女性军人的士气。自担任部长以来,赫格塞斯领导的五角大楼见证了高阶女性军官晋升的急剧下降,此类任命已降至20年低点。赫格塞斯在其2024年著作《战士之战》中总结了他对军队性别问题的看法:“父亲推动我们冒险,母亲给我们的自行车装上辅助轮。我们需要母亲。但不在军队里,尤其是不在作战部队里。”
The testosterone dogwhistle As the war in Iran threatens to derail Republicansmidterms chances, it seems Hegseth has been tasked with rebranding the strategic failure as a show of machismo and relentless bloodlust. As head of the renamed “Department of War” (a name change that Hegseth has said reflects a shift in the mission from “defense” to “lethality, lethality, lethality”), he has promised to “untie the hands of our warfighters to intimidate, demoralize, hunt and kill”. Yet, for the military to be a vehicle of pure violence, Hegseth believes it must demoralize not just enemies but also female service members. Since becoming secretary, Hegseths Pentagon has overseen a sharp decline in the promotion of high-ranking women, with such appointments at a 20-year low.
近日在奥斯汀的一次竞选集会上,他将性别议题与暴力议题融为一谈,称:“我们在提醒战士们,他们的唯一目标是成为地球上最致命的战斗力量。到此为止。我们不是来搞社会工程、社会正义、性别扭曲、DEI(多元化、公平与包容),也不是来搞‘男扮女装’的。”
Hegseth summed up his own views on gender in the military in his 2024 book, The War on Warriors: “Dads push us to take risks, moms put the training wheels on our bikes. We need moms. But not in the military, especially in combat units.”On a recent campaign stop in Austin, he melded his messages on gender and violence, saying: “Were reminding our warriors that their sole purpose is to be the most lethal fighting force on the planet. Full stop. Were not here to do social engineering, or social justice, or gender-bending, or DEI, or dudes and dresses.”
赫格塞斯渴望打造一支以男性为先的暴力军队,这或许迎合了其“让美国再次伟大”基本盘中的某部分人,但却疏远了许多退伍军人和现役军人,包括女性和LGBTQ+群体成员。在他的宣传视频中,他将强制性睾酮筛查政策包装为一项健康措施,旨在“恢复并优化你的天然能力,保护你的长寿,并确保你拥有维持战斗所需的生物学基础”。
Hegseth`s desire for a violent male-first military might appeal to his segment of the Maga base, but it alienates many veterans and active-duty personnel, including women and LGBTQ+ members. In his announcement video, he framed the mandatory testosterone screening policy as a health measure aimed at “restoring and optimizing your natural capabilities, protecting your longevity, and ensuring you have the biological foundation required to sustain the fight”.
但在美国收视率最高的有线新闻节目《五人行》中,主持人杰西·沃特斯听出了其中的“暗号”,并得意地预测当精英士兵开始注射睾酮“兴奋剂”时会发生什么:“基地里的女性,你们最好小心点,”他咧嘴一笑,“靠港时的亚洲女性,你们最好小心点。因为这些家伙会变成野兽,你们最好当心。”
But on the US`s most popular cable news show, The Five, host Jesse Watters heard the dogwhistle and gleefully predicted what would happen when elite soldiers started juicing with T: “Women on base, you better be careful,” he grinned. “Port calls, women in Asia, you better be careful. Because these guys are going to be wild animals and you better watch out.”
睾酮在赫格塞斯手中被挥舞为武器,为原本植根于性别歧视的言论披上了一层“科学感”的外衣。这正是科学人类学家丽贝卡·乔丹-杨和卡特里娜·卡尔卡齐斯在其2019年著作《睾酮:未授权传记》中所称的“T话语”。
Testosterone, wielded as Hegseth does, brings a sense of the sciencey to a rhetoric otherwise rooted in sexism. This is what the anthropologists of science Rebecca Jordan-Young and Katrina Karkazis refer to as “T-talk” in their 2019 book, Testosterone: An Unauthorised Biography.
所谓的“睾酮论调”,正如人们所说,“将民间传说编织进科学之中,因为关于睾酮的科学主张似乎验证了文化上关于男性气质结构以及女性与男性‘天然’关系的信仰”。
T-talk, they say, “weaves folklore into science, as scientific claims about T seemingly validate cultural beliefs about the structure of masculinity and the ‘natural` relationship between women and men”.
这在右翼圈子里是常见做法。查理·柯克曾在其播客节目中辩称,睾酮水平较低的男性天生顺从,并讽刺道:“你的睾酮水平越低,就越有可能被控制,变成‘好的,我要打第九针[新冠]加强针。请更用力地给我打加强针,爸爸政府’。” 埃隆·马斯克曾在X平台上转发一张4chan的图片,声称女性和“低睾酮男性”缺乏独立思考能力,只有“高睾酮阿尔法”男性才能自由处理信息。这些说法与睾酮的实际作用机制几乎毫无关系。
This is common practice on the right. Charlie Kirk used to argue on his podcast that men with lower T levels are inherently subservient, quipping: “The lower your testosterone is, the more likely you are to be controlled to be [like] yes, I`ll take the ninth [Covid] booster shot. Please boost me harder, daddy government.”Elon Musk once reposted a 4chan image on X claiming that women and “low-T men” lack the capacity for independent thought, leaving only “high-T alpha” males to process information freely. None of this has much to do with how testosterone actually works.
讽刺的是,赫格塞斯曾将几乎相同的睾酮水平干预描述为“与现役不兼容”,但这仅限于跨性别现役军人。军方已暂停为所有军事人员提供性别肯定护理,包括睾酮替代疗法(TRT)。上个月,赫格塞斯在竞选途中用一个针对跨性别者的侮辱性词汇总结了这一政策:“在战争部,我们搞训练——不搞‘人妖’”。
There`s irony too that Hegseth has described near-identical interventions in testosterone levels as “incompatible with active duty”, but only when they are for trans service members. The military has paused all gender-affirming care for military personnel, including TRT, a policy which last month Hegseth summed up on the campaign route using a transphobic slur: “at the Department of War, we do training – not trannies”.
正在审理针对特朗普禁止跨性别者服役禁令诉讼的美国地区法官安娜·雷耶斯指出了这种“睾酮论调”的虚伪性,要求特朗普政府说明向跨性别与顺性别现役军人提供睾酮替代疗法“在医疗和后勤方面的异同”。
US district judge Ana Reyes, who is adjudicating a lawsuit against Trump`s ban on transgender troops, has highlighted the T-talk hypocrisy, calling on the Trump administration to address “the similarities and differences in administering TRT, both medically and logistically” to trans versus cis servicemen.
还有进一步的虚伪之处。虽然赫格塞斯最初宣布睾酮检测将适用于所有现役军人,但新的五角大楼指导方针现在规定只对男性进行检测,目前并未宣布针对女性现役军人的平行激素替代疗法项目——尽管退伍军人事务部的研究显示,患有创伤后应激障碍(PTSD)的军队女性比平民女性面临早发性更年期的风险高出一倍。
There are further hypocrisies. While Hegseth initially announced that his testosterone testing would apply to all service members, new Pentagon guidance now says only men will be tested, with no parallel program of hormone replacement therapy for female service members currently announced – despite VA studies showing that military women with PTSD have double the risk of early menopause than the civilian population.
在他们的著作中,杨和卡卡齐斯描述了仅仅提及睾酮就如何为毫无事实依据的论点增添了“真实感”。这种误解并非现代发明,而是将社会等级与身体化学物质挂钩的百年执念。它始于将睾酮和雌激素严格二元分类为“男性”和“女性”性激素,这种僵化的划分可以追溯到19世纪末,由法裔美籍生理学家查尔斯·爱德华·布朗-塞卡尔发现该激素之时。
In their book, Young and Karkazis describe how even the mention of testosterone “truthiness” to arguments that have no factual basis. This misunderstanding isnt a modern invention but a century-old obsession with tying social hierarchy to bodily chemistry. It begins with the binary classification of testosterone and estrogen as strictly “male” and “female” sex hormones, a rigid division that dates back to the hormones discovery in the late 19th century by the French American physiologist Charles Édouard Brown-Sequard.
为了让自己不再感到虚弱和衰老,布朗-塞卡尔进行了一系列疯狂的实验,将狗和豚鼠的睾丸提取物注射到自己体内。他自认为实验大获成功——他的前臂变强壮了,“尿流”也变强了。
Brown-Sequard, in an attempt to feel less weak and old, conducted a series of wild experiments where he injected himself with testicular extracts from dogs and guinea pigs. He considered the experiments a huge success – his forearm was stronger, as was his “jet of urine”.
尽管这一想法很快被揭穿为非科学且不可重复,但移植睾丸的想法——从年轻男性到年长男性,从野猪和公羊身上——却风靡一时。一些同时代的科学家认为,此类实验可以对抗衰老或“治愈”同性恋。这种早期关于睾酮的思考中也包含着强烈的优生学色彩。1921年,哥伦比亚大学医生路易斯·伯曼声称:“我们有理由将白人在地球上的统治地位归因于其血液中全能激素浓度更高、更全面。”
Despite being quickly debunked as non-scientific and unrepeatable, the idea of implanting testes – from younger men to older men, from boars and rams – took off. Some contemporaneous scientists posited such tests could counter senility or “cure” homosexuality. There was a potent eugenic strain in this early thinking about testosterone, too. In 1921 Louis Berman, a physician at Columbia University, claimed that “we are justified in putting down the white man`s predominance on the planet to a greater all-around concentration in his blood of the omnipotent hormones”.
到了20世纪30年代,科学家已能测量睾酮水平并将其用于治疗缺乏症患者。然而在随后的几十年里,杨和卡卡齐斯认为,围绕睾酮的科学研究几乎未变得更加严谨。许多研究人员依然固守于一种激素能成为所有男性气质根源这一观念。他们对睾酮在男女生育能力和心脏功能中,以及女性排卵中所起的基本作用兴趣较小,反而专注于其在求偶、支配欲、攻击性和性欲中的作用,且仅限于男性。
By the 1930s, scientists were able to measure T levels and administer it to patients who had deficiencies. Yet in the decades that followed, science around testosterone barely became more rigorous, argue Young and Karkazis. Many researchers remained fixed on the idea that one hormone could be the source of all masculinity. They tended to be less interested in the essential role that testosterone plays in fertility and heart function in men and women, and ovulation in women. Instead they focused on its role in courtship, dominance, aggression and sex drive, exclusively in men.
这种现象在需要为男性暴力行为寻找解释的时刻尤为明显。当越战时期的美军士兵被指控犯下骇人听闻的谋杀、强奸和残害罪行时,军队精神科医生开始假设,男性性激素水平过高可能导致无法控制的攻击性(这或许预示着赫格塞斯后来要求在军队中补充睾酮,以使士兵更具“杀伤力”)。这种论调在2013年众议院军事委员会关于军队强奸和性侵犯的听证会上再次出现,共和党参议员萨克斯比·钱布利斯感叹道:“天哪,大自然产生的激素水平为这类事情的发生埋下了伏笔。”
This was particularly noticeable in moments when explanation was demanded for the violent behavior of men. When American soldiers in the Vietnam war were accused of horrific murders, rapes and mutilation, army psychiatrists began positing that high levels of male sex hormones could lead to uncontrollable aggression (foreshadowing, perhaps, Hegseth`s demands for T in the army so that soldiers will be more “lethal”). This thinking was repeated in a 2013 House armed services committee hearing on rape and sexual assault in the military, where the Republican senator Saxby Chambliss remarked: “Gee whiz, the hormone level created by nature sets in place the possibility for these types of things to occur.”
杨和卡卡齐斯在考察过去一个世纪中一些最具影响力的睾酮研究后意识到,这种激素并非以这种方式发挥作用——在男性耳边低语,诱使他们做出原本不会做的行为。事实上,他们发现睾酮与所谓的普遍攻击性、冒险精神或运动天赋之间,鲜有显著关联——无论是因为科学家测量睾酮的方式不一致(通过唾液、血浆或血液),还是因为研究聚焦于睾酮水平本身,而非睾酮与体内其他分子复杂的相互作用机制。
As Young and Karkazis examined some of the most prominent studies into testosterone over the past century, they realized that the hormone does not function in this way, whispering in the ear of men to act in ways they otherwise wouldn`t. In fact they found little meaningful association between testosterone and claims of widespread aggression, risk-taking or athletic prowess – whether because scientists measured testosterone inconsistently (via saliva, plasma or blood) or because the research focused on T levels rather than the complex way T interacts with other molecules in the body.
关于睾酮与暴力关联的科学认知——这正是赫格塞斯最感兴趣的关联——很大程度上源于20世纪70年代初由莱奥·克罗伊茨少校和罗伯特·罗斯博士进行的一系列狱中实验,实验显示,更具攻击性的囚犯(以打架、威胁、毁坏财物为衡量标准)睾酮水平更高。
Much of the scientific belief in the association between testosterone and violence – the link Hegseth is most interested in – comes from a series of prison experiments done by Maj Leo Kreuz and Dr Robert Rose in the early 1970s which showed that more aggressive prisoners (measured by prison fights, threats made, property destroyed) had higher testosterone levels.
然而,扬和卡卡齐斯发现,该研究最初根本未显示出任何效果——睾酮无法预测囚犯的暴力倾向。克鲁兹和罗斯不愿让实验以失败告终,便加入了囚犯过往犯罪暴力程度等其他数据,结果仍未发现关联。只有当他们单独增设一类囚犯罪行,并将“越狱未遂”归类为“暴力行为”时,才找到了他们想要的关联。
Yet Young and Karkazis found the study originally showed no effect at all – testosterone was a useless predictor of how violent a prisoner was. Kreuz and Rose, not wanting their experiments to be a failure, added in other data such as how violent a prisoners past offenses were, and still found no connection. It was only when they added a separate category for a prisoners offenses, and included attempted escape from prison as a “violent” act, that they found the connection they were looking for.
这是糟糕的科学,数据被多次操纵,直到能证明假设为止。但当《华盛顿邮报》1994年的一篇文章引用该研究时,标题却是“美国式谋杀”,文中称“年轻男性体内涌动着睾酮,比长辈暴力得多”。
This was poor science, data manipulated multiple times until it could prove a hypothesis. But when it was cited in a Washington Post piece from 1994, the headline read “The American Way of Murder”, and said “young men, their bodies surging with testosterone, are far more violent than their elders”.
一些军医认为,睾酮替代疗法(TRT)有助于深受创伤性脑损伤和创伤后应激障碍(PTSD)困扰的退伍军人和现役军人。特种作战专家瑞安·齐格勒医生告诉《卫报》,他认为赫格塞斯的授令是“一个很好的第一步”,旨在收集睾酮水平与各类军事医疗问题之间关联的数据。
Some military doctors believe TRT can help veterans and active service members who are struggling with traumatic brain injuries and PTSD. Dr Ryan Ziegler, a special operatives specialist, told the Guardian he thought Hegseth`s mandate was “a great first step” in gathering data about the association between testosterone levels and a variety of military medical issues.
但赫格塞斯认为睾酮将让军队“处于致命性的前沿”,这是一个文化叙事,而非科学事实。“我们离科学太远了,这很可怕,”麦吉尔大学的科学传播者贾里说道。
But Hegseths idea that testosterone will put the military “on the leading edge of lethality” is a cultural story, not a scientific fact. “We are so far from the science, its scary,” said Jarry, the science communicator from McGill.
共和党人喜欢讲述的一个关于睾酮的故事也是如此,该故事基于一名博士生2011年的一项研究,发现摇摆不定的民主党倾向选民在服用睾酮后,对共和党候选人产生好感的可能性比服用安慰剂的对照组高出45%,出现了“红色偏移”。
This is also true of a favored story Republicans like to tell about T, based on a piece of research done by a PhD student in 2011 that found a “red shift” among loosely Democratic swing voters, who were 45% more likely to have warm feelings for Republican candidates after they took testosterone than a control group who took a placebo.
右翼播客反复炒作这一说法,声称共和党男性的睾酮水平高于民主党男性。但事实上,这项针对136名大学生男性的研究发现,强烈认同民主党和共和党的男性睾酮水平几乎完全相同。弱认同民主党男性出现的轻微“红移”(即睾酮水平上升),仅发生在单次注射睾酮后的一天。该实验从未在更大样本、更长周期中成功复现,也从未被证明能真正改变投票行为。但这个故事听起来很符合“睾酮叙事”,所以依然广为流传。
This account has been repeated ad nauseum on rightwing podcasts to say that Republicans have higher T than Democrats. But in fact the research, which looked at 136 college-age men, found that strongly identified Democrat and Republican men showed near-identical testosterone levels. The small red shift in weakly affiliated Democrats came one day after a single dose of testosterone. The experiment has never been successfully repeated with larger groups over a longer period of time, nor has it ever been shown to actually change voting behavior. But it still sounds good in the story of T.
TRT(睾酮替代疗法)的“真实风险” 或许正是“睾酮话语”在本次大选中大获全胜的标志,民主党人开始蹭“男性气概”概念的热度。虽然没点名睾酮,但密歇根州参议员候选人阿卜杜勒·埃尔-赛义德指责共和党对手迈克·罗杰斯散发“Beta男气质”,双方还为此比拼高中橄榄球资历。35岁的左翼主播哈桑·皮克尔告诉《滚石》杂志,他健身是因为担心到了“睾酮水平开始下降”的年纪。
The ‘real risksof TRT Perhaps its a sign of how successful T-talk has been in this election that Democrats are starting to glom on to ideas about masculinity. Though he didnt specifically mention testosterone, the Michigan Senate candidate Abdul El-Sayed accused Republican rival Mike Rogers of “beta energy” as they argued over their high school football credentials. Hasan Piker, the 35-year-old leftwing streamer, told Rolling Stone he works out because hes worried about being at the age when “testosterone levels start declining”.
加州州长加文·纽森沉浸在“有毒男性气概”的语言游戏中,发帖骂对手是“法西斯绿帽男”,还拿自己的长相跟《美国精神病人》里的帕特里克·贝特曼比。8月,纽森签署法案,规定加州对睾酮的分类将自动跟随联邦未来放宽该药物管制的任何举措。与此同时,作为跨性别者权利倡导者表现不一的纽森,否决了一项本应要求保险公司为跨性别患者覆盖12个月激素治疗(如TRT)的法案。
Californias governor, Gavin Newsom, has reveled in the language of toxic masculinity, posting about his rivals being “fascists cucks” and comparing his looks to American Psychos Patrick Bateman. In August, Newsom signed a bill that would automatically bring California`s classification of testosterone into line with any future federal move to loosen restrictions on the drug. This comes at the same time as Newsom, an inconsistent advocate for trans rights, vetoed a bill that would have required insurers to cover 12 months of hormone therapy, such as TRT, to transgender patients.
并非一切都是“T谈”(睾酮谈论)。科学依据支持美国食品药品监督管理局(FDA)拟对睾酮替代疗法(TRT)警示进行的部分修改。关于该疗法最严重的两大担忧——可能增加前列腺癌风险或心血管风险——根据一项由拜登政府下的FDA委托、领先的Traverse研究显示,发生率似乎比先前报道的更低。该研究发现,与安慰剂组相比,患有性腺功能减退症的老年男性并未出现风险增加。
Not everything is T-talk. There is science that supports some of the FDA`s proposed changes to warnings about TRT. Two of the most serious fears about the treatment – that it might increase prostate cancer or have increased cardiovascular risk – seem to be rarer than previously reported according to a leading Traverse study commissioned by the FDA under Joe Biden, which found no increased risk compared with a placebo group among older men suffering from hypogonadism.
哈佛医学院的Shalender Bhasin医生是美国TRT领域的权威从业者之一。他共同撰写了内分泌学会关于睾酮的临床实践指南,建议仅向有严重症状且两次血液检测确认睾酮水平低下的男性提供TRT。研究人员发现,2026年获得处方的男性中,仅有12%符合该标准。而2022年发表在《JAMA Internal Medicine》上的一项研究发现,七分之六的远程医疗提供者向“神秘顾客”患者提供了TRT,即使他们的睾酮水平显示处于健康范围内。
Dr Shalender Bhasin from Harvard medical school is one of the USs leading practitioners of TRT. He co-authored the Endocrine Societys clinical practice guidelines on testosterone, which recommend only offering TRT to men with serious symptoms and two blood test results confirming low T levels. Researchers found that just 12% of men getting a prescription in 2026 met that criteria. And in 2022 a study published in Jama Internal Medicine found that six out of seven telehealth providers offered TRT to a secret-shopper patient, even when their testosterone levels were shown to be in a healthy range.
Bhasin表示,睾酮水平健康的人接受TRT存在一些“真实风险”。“这会抑制他们自身的睾酮生成,抑制睾丸功能并导致不育,”他说。“而且停药并不容易:可能需要几个月,当人们停止补充睾酮时,他们的水平会骤降。”他渴望将这群人与真正的性腺功能减退症(低睾酮)患者区分开来,“后者是一种真实存在的、可诊断和治疗的疾病”。
Bhasin said there were some “real risks” for people with healthy levels of testosterone to go on TRT. “It`ll suppress their bodily testosterone production, suppress their testicular function and induce infertility,” he said. “And getting off is not that easy: it can take months and when people stop testosterone, their levels plummet.”He is keen to distinguish this group from real hypogonadism (low-T) sufferers, “which is a bona fide condition that can be diagnosed and treated”.
但即使在这些情况下,治疗也并非肯尼迪等人所描绘的那样是万能药。美国国立卫生研究院(NIH)最近的一项大型研究给近800名老年男性补充了该激素,发现它改善了勃起功能障碍和性欲,但对情绪影响极小,且在记忆力、疲劳或整体幸福感等指标上均无改善。
But even in those contexts, the treatment isnt quite the fix-all thats portrayed by Kennedy and others. A recent large NIH study that gave nearly 800 older men the hormone found it improved erectile dysfunction and libido, but had minimal effect on mood and no improvement on measures like memory, fatigue or overall wellbeing.
尽管存在这一切,睾酮行业已准备好利用肯尼迪的政策。远程医疗药房 Hims & Hers 的股价因预期它们将能从今年开始提供睾酮替代疗法(TRT)而飙升。
Despite all of this, the testosterone industry gets ready to take advantage of Kennedys policies. Telemedicine pharmacies Hims & Hers saw their stock price soar on the expectation that theyll be able to offer TRT starting this year.
“这个政权已脱离循证决策,”Jarry 说。“这些宣布与科学无关,完全关乎关于男性气质的倒退观念:强壮、魁梧和专横。” Bhasin 建议,一个真正关注男性健康的政府或许应从别处着手,关注过去二十年来恶化的年轻男性死亡率那些不讨喜的统计数据。
“This regime has divorced itself from evidence-based decision making,” said Jarry. “These announcements have nothing to do with science and everything to do with regressive ideas of what masculinity is: virile, brawny and domineering.”An administration genuinely invested in men`s health might start by looking elsewhere, suggests Bhasin, at the unglamorous statistics of young male mortality that have worsened over the last two decades.
但那将意味着这一切关乎健康,而非睾酮可能为特朗普低迷的民调数字带来什么。
But that would imply this was all about health, rather than what testosterone might be able to do for Trump`s flaccid poll numbers.