JoejitsuMD - What people don't realize is that there aren't really any studies into the long term effects of normal dose TRT. What I mean is, I think there is a very strong likelihood that the human body simply is not meant to have testosterone at the 13-30 year old levels for such an extended period of time.
People talk about "normal dose" testosterone, but what if what they consider to be normal dose is actually a very high dose because the body ramps up testosterone production greatly during the teenage and 20s. Perhaps normal testosterone is actually what an average man in his 40s and 50s has, not the high levels we see when a man's nature is about scoring a mate. I'm betting when all is said and done 10-15 years from now TRT will begin to fade as we see a dramatic rise in incidence of heart disease, death by blood clots, and cancer. Most testosterone fans will argue otherwise but truth is they simply don't know because medicine hasn't had time to study this, and are spouting very wishful thinking. Even if those studies do come out, there will be a segment of people that will ignore the data and claim otherwise. Any time people are dealing with a substance that makes them feel good they will look to rationalize its use even in the face of scrutiny. 
Fair point. But . . . it's worth noting that this view is mere speculation as well.
At one time, there weren't long term studies on the effect of a daily multivitamin (and I understand that it's still a fairly disputed area). I'm sure that when the contact lens debuted, there weren't long term studies about their daily wear. Are there long term studies about the daily consumption of one cup of coffee? Three cups? Ten? What about long term studies confirming the safety of taking an aspirin every day for 35 years? Etc.
I don't read medical journals of course and assume that some of those were ultimately backed up by multi-decade studies, but the fact is that at some point a lot of folks just decided to go with their anecdotal experience and (perhaps) the prevailing medical view at the time, and to just proceed at their own risk. You can speculate that the long term outcomes will be bad, or you can speculate that they'll be good or at least neutral. Either way, you're just speculating.
That said, I have no doubt that just about anything in sufficient quantities can be bad for you. Someone who gulps down an entire bottle of multivitamins every morning is likely to have a different long term outcome than someone who just has one. Ten daily cups of coffee is different than three.
So with that in mind, let me ask you this . . . . You believe that in 10-15 years, we'll see all sorts of bad outcomes with TRT. And based on your comments about "normal doses" and the "strong likelihood" that men aren't meant to have the testosterone levels of 13-30 year olds for their whole lives, I assume you're not just referring to the guys who are getting huge doses prescribed at "anti-aging" clinics, but that you're also including in your dire prediction the guys who are using comparatively modest doses prescribed by mainstream endos.
With regard to the guys using comparatively modest doses, why do you believe we'll see so many bad outcomes?
You've observed we don't have long term studies, so that can't be the basis of your conclusion. So what is? The rationale surely can't be merely that just because we're altering our own body chemistry we must therefore be at higher risk. After all, much of medical science is based on the premise that alterations to what is naturally occuring can be theraputic--every prescription, every cancer surgery, and myriad other medical treatments alter what's naturally occuring, and we have no problem with that concept.
Nature only cares that we reproduce and live long enough to raise our young. Beyond that, nature is not terribly interested in maximizing the quality (or even duration) of your life. Once you have babies and raise them, nature could care less whether you just shrivel up and die. Why assume that taking steps against that--whether it be multivitamins, exercise, TRT, arthritis medication, or blood pressure medication--has a "strong likelihood" of leading to disaster? Nearly our entire medical system is devoted to doing just that, and it has been very successful. The average life expectancy in the Roman empire was 20-30, now it's nearly 70. For all we know, future "long term studies" may show that men who got on modest TRT doses in their 40s and 50s far outlive those who never got on it. Perhaps they'll stay healthier, for longer, and thus live longer on average. We just don't know, right?
