Are online TRT clinics really going away? Here's what's actually happening

What did @cbronsonmd actually say?

The creator claims that a new federal rule, citing the Federal Register, will require all patients to have an in-person visit with a physician before receiving a testosterone prescription. He argues this will effectively end online-only TRT clinics that "just add to cart your testosterone" without any face-to-face evaluation. Follow-up visits via telemedicine would still be allowed, but the initial prescribing relationship must happen in person.

This is a specific, regulatory claim, not a vague health opinion. It deserves a specific, regulatory answer. So let's get into what the rule actually says, what it actually does, and where the doctor's framing holds up or falls apart.

Does the science back this up?

This is less a science question than a policy question, and the underlying facts are mostly correct. The DEA did propose rules in 2023 requiring in-person evaluations before prescribing controlled substances via telemedicine, following the expiration of COVID-era flexibilities. Testosterone, as a Schedule III controlled substance under the Controlled Substances Act, falls squarely within that scope.

The DEA's proposed rules, published in the Federal Register in February 2023, would have required a prior in-person medical evaluation before any controlled substance could be prescribed via telemedicine. The agency received over 38,000 public comments, an unusually large response, and subsequently issued temporary extensions to the COVID-era telemedicine flexibilities while it worked through revisions. As of late 2024, a final rule has not been fully implemented, meaning the regulatory picture is still actively evolving and not as settled as this video implies.

What did they get wrong (or right)?

The creator gets the broad strokes right. Testosterone is a Schedule III controlled substance. The DEA did propose rules that would require in-person visits before prescribing it via telemedicine. Online clinics operating on a purely virtual, no-exam model would face serious legal exposure under such a rule.

Where the video oversimplifies: the creator speaks as if the rule is finalized and enforcement is imminent. It is not. The DEA extended the COVID-era telemedicine flexibilities multiple times through 2024, and the final telemedicine prescribing rules for controlled substances had not been fully codified at the time this type of content was circulating. Saying these clinics "are likely going to be shut down" is a reasonable prediction, but framing it as a done deal, based on a Federal Register link, is misleading. The Federal Register contains proposals, interim rules, and final rules, and conflating them matters when you're talking about a business model that serves tens of thousands of patients.

Also worth noting: some compliant telehealth platforms already require in-person or hybrid evaluations. The rule doesn't necessarily end telehealth TRT. It ends the fully asynchronous, no-exam, add-to-cart model.

What should you actually know?

If you're currently getting testosterone through a fully online clinic with no in-person evaluation, your situation is genuinely uncertain. Here is what the regulatory record actually supports:

• The DEA proposed in-person evaluation requirements for Schedule III controlled substances in early 2023, covering testosterone cypionate, enanthate, and similar compounds.
• The agency has repeatedly extended COVID-era telemedicine flexibilities, most recently through 2024, while finalizing its approach.
• A final rule requiring in-person evaluations is expected, but enforcement timelines matter. Patients should not assume their current prescriptions are immediately at risk, but they should plan ahead.
• Telehealth follow-up visits after an in-person initial evaluation are explicitly preserved in the proposed framework, consistent with what the creator says.
• Clinics that already incorporate in-person or hybrid components may be largely unaffected. The target is the fully virtual, no-exam model.

The practical takeaway is this: if your clinic has never required you to see anyone in person, start asking questions now about their compliance plan, not after a rule kicks in and your prescription lapses.