@augustshapiro's three years on testosterone, fact-checked

What did @augustshapiro actually say?

Not much, technically. The entire script is four sentences: "Hi, my name is August and this is my voice" repeated at one month, one year, two years, and three years on testosterone. The content is the voice itself, not any verbal claims about how testosterone works. That's worth noting before we fact-check anything, because the implicit claim is that testosterone caused the audible changes between recordings.

That implicit claim is actually well-supported. Testosterone therapy in transmasculine individuals produces laryngeal changes that lower fundamental vocal frequency, and this video appears to demonstrate exactly that progression. The creator isn't overstating anything or making mechanistic claims. They're showing a timeline. That's a meaningful distinction from the typical TikTok health claim.

Does the science back this up?

Yes, and pretty robustly. Testosterone-induced voice masculinization is one of the better-documented effects of gender-affirming hormone therapy. The changes are real, measurable, and largely irreversible once they occur.

Ziegler et al. (2018, Journal of Voice) found that transmasculine individuals on testosterone showed significant decreases in fundamental frequency, often within the first three to six months, with continued changes through the first two years. Azul et al. (2017, International Journal of Language and Communication Disorders) documented that voice changes are among the earliest and most consistent effects of testosterone therapy. A 2020 study by Deuster et al. in the Journal of Voice confirmed that most vocal frequency change occurs in the first year, with more subtle shifts continuing into years two and three. This timeline matches exactly what @augustshapiro's video appears to show.

What did they get wrong (or right)?

They got the timeline right. The changes shown across one month, one year, two years, and three years align with what the clinical literature actually describes. Month one typically shows early roughness or instability. Year one shows substantial drop in pitch. Years two and three show continued refinement. That's consistent with the Ziegler 2018 data.

What the video can't show, and doesn't try to, is individual variability. Some transmasculine people see minimal voice change on testosterone. Factors like age at start, genetics, and dosing all influence outcomes. The video also can't convey that voice changes aren't guaranteed or uniform. For a viral video with 7.6 million views, the absence of that context is a gap, though it would be unreasonable to expect a four-sentence TikTok to include it. The creator isn't claiming their experience is universal. They're documenting their own.

What should you actually know?

Testosterone causes voice changes through laryngeal growth, the same basic mechanism as puberty in adolescent males. This is not reversible once the larynx has remodeled. That's worth understanding before starting testosterone therapy, because unlike some other effects of testosterone, voice changes persist even if hormone therapy is stopped.

The changes are dose-influenced but not purely dose-dependent. Research by Azul et al. and others suggests that the threshold for voice masculinization can occur at relatively low testosterone levels, meaning higher doses don't necessarily produce faster or more dramatic vocal changes. Some individuals choose voice training alongside hormone therapy to optimize outcomes. Others find hormone-induced changes sufficient on their own.

If you're considering testosterone therapy for any reason, voice change should be part of the informed consent conversation. For transmasculine individuals, it's often a desired outcome. For people using testosterone for hypogonadism or other indications, unintended vocal changes are worth flagging with a prescribing clinician before starting.

Is this video actually a problem?

No. This is one of the cleaner examples of personal health documentation on TikTok. @augustshapiro makes no mechanistic claims, recommends no dosing, and doesn't present their individual experience as a universal outcome. The video is essentially a before-and-after audio log, and the implicit claims it makes are backed by peer-reviewed evidence.

The larger issue is what viewers might infer: that testosterone will produce this specific type and degree of change for them. That inference is not guaranteed. Individual variation in testosterone response is real and documented. But the video itself doesn't make that promise, which is more than can be said for a lot of TikTok health content with this kind of reach.