The TRT clinics are ignoring levels or even not testing at all. They’ll find an excuse to prescribe to someone even who has clinically high levels because they want the monthly recurring revenue from keeping that customer for life.
I'm not going to say TRT clinics are the best actors here, but to an actual endocrinologist, diagnosing hormone issues isn't so simple as looking at single point-in-time measurement of total testosterone.
Testosterone levels naturally vary even for a given individual - two readings at the same time of day on different days even a short period apart can be dramatically different - and that's not even taking into consideration the fact that total testosterone levels aren't the sole (or even primary) mechanism for diagnosing androgenic endocrine issues.
Now I am worried about the long term effects, but it's been so long that if I am on it for the rest of my life and it does help me, that's good enough.
I don't disagree that there are some bad actors out there - the bar to getting it under 40 or 50 should be very high. But honestly, I think everyone's levels should be checked before being put on an SSRI for depression.
HRT is also a life-long treatment, no?