Going on T: what TikTok gets right and wrong about testosterone

What did @vadavada_.com actually say?

Honestly? Not much, medically speaking. The transcript is song lyrics, specifically what appears to be a remix or snippet of Madonna's "Vogue," overlaid on a video captioned as advice for people considering testosterone therapy. There are no spoken medical claims, no dosage recommendations, no physiological assertions. The creator's message is entirely in the framing, not the words.

The video's intent is clear from the caption: "Posting this for the folks who may be considering going on T." The hashtags confirm this is directed at trans masculine individuals exploring gender-affirming testosterone therapy. But the audio content itself is pure performance, not information. That makes this less of a fact-check problem and more of a context problem. What assumptions does this video carry without ever stating them?

Does the science back this up?

There are no explicit scientific claims here to evaluate, but the implicit message, that starting testosterone is worth considering and perhaps even liberating, does have a body of evidence behind it. The question is whether that framing is responsible without caveats.

Gender-affirming hormone therapy (GAHT) with testosterone has been associated with meaningful improvements in psychological well-being. A 2020 prospective study by van der Miesen et al. in Psychoneuroendocrinology found significant reductions in gender dysphoria and improved quality of life in trans masculine adolescents and adults following testosterone initiation. A broader 2021 systematic review by Lehmann et al. in EClinicalMedicine covering over 3,000 participants similarly found improvements in depression, anxiety, and life satisfaction. So the general emotional tenor of the video, encouragement toward a potentially beneficial medical intervention, is not wrong.

What is missing is any acknowledgment that testosterone therapy involves real physiological changes, requires medical supervision, and carries risks that vary by individual health status.

What did they get wrong (or right)?

The creator did not get anything factually wrong because they did not make factual claims. That is both the defense and the critique. Encouragement videos can be valuable in communities where stigma and gatekeeping are real barriers to care. Research by Gridley et al. (2016, Transgender Health) found that peer community support significantly influenced trans individuals' decisions to seek medical care, often in positive ways.

But here is the problem: a video with 285,000 views that positions itself as guidance for people "considering going on T" carries implicit authority. Viewers may walk away with the impression that starting testosterone is simple, uniformly positive, or low-stakes. It is none of those things. Testosterone therapy for trans masculine individuals affects fertility, cardiovascular risk, hematocrit levels, and liver function, among other things. The Endocrine Society's 2017 clinical practice guidelines explicitly call for baseline labs and ongoing monitoring.

Inspiration without information can send people toward care unprepared, or toward unmonitored self-administration, which is genuinely dangerous.

What should you actually know?

If you are considering testosterone therapy, the evidence supports that it can be beneficial, particularly for gender dysphoria and psychological well-being. But "beneficial" is not the same as "uncomplicated." Here is what the research actually says you need to know before starting.

• Testosterone increases red blood cell production, which can raise hematocrit to unsafe levels without monitoring. The Endocrine Society recommends hematocrit checks every three months in the first year.
• Fertility is affected quickly. A 2019 study by Adeleye et al. in Fertility and Sterility found that testosterone suppresses ovarian function, sometimes irreversibly. If biological children are a consideration, discuss fertility preservation before starting.
• Cardiovascular risk data in trans masculine individuals is still developing. A 2018 cohort study by Getahun et al. in Annals of Internal Medicine found modestly elevated cardiovascular event rates, particularly in older patients.
• Access matters. Working with a provider who follows informed consent models or established WPATH guidelines is important for both safety and legal protections.

Encouragement from community members is real and valuable. It should not replace a conversation with a clinician who can review your individual labs and health history.