Enthusiasm for testosterone cuts across political lines. Several of the women I interviewed belong to religious communities that strongly oppose gender-affirming care, and yet were taking testosterone in amounts comparable to those taken by some trans men. Marcella Hill, one of the most popular testosterone influencers on Instagram, was a member of the Church of Jesus Christ of Latter-day Saints when she first started experimenting with high-dose testosterone and proselytizing about its powers. Although she has since left the church, in part because of the way she says it shames women about their sexual desire, she has many friends still there who take high doses of the hormone. “I’d never really sat with myself and thought about what I think about gender-affirming care,” Hill said. “But I think everyone should get to decide how they want to live in their body.”
President Trump’s commissioner of the F.D.A., Martin Makary, has signaled his enthusiasm for hormone therapies for middle-aged women, and the company Marius Pharmaceuticals is in conversations with the agency about clinical trials it intends to start on a standard-dose testosterone pill for women. The conversations so far suggest that “it won’t be easy by any means, but I think the new F.D.A. will be reasonable,” said Marius’s chief executive, Shalin Shah, “which represents a step in the right direction.” In the past, he said, the agency’s response to hormones for postmenopausal women has generally been “like running into a brick wall.” (The F.D.A. declined to comment on its past decisions regarding testosterone, citing the government shutdown.)