As a wellness writer with a lens on men’s health, my social media is bombarded by body transformations, superhero workout plans and dubious fitness advice. But about six months ago, amongst the cottage cheese protein recipes and kettlebell routines, I started to notice a new trend.

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Bodybuilders, coaches and influencers were openly talking about the steroids and other performance-enhancing drugs used to achieve their physiques. Rather than highlighting specific workout programs and calorie deficits, the emphasis was on the “stacks” of chemicals most impactful for a lean and muscular frame.

On some level, I admire the honesty. Over the past two decades, superhero movies have changed the perception of what being in shape even means. Just look at the difference between Hugh Jackman in the first X-Men movie compared with his recent stint in Deadpool and Wolverine. While many speculate those kinds of changes are fuelled by performance enhancers, very few actors are willing to talk about drug use. Instead they attribute the changes strictly to hard work, clean eating and some good genetics.

Debates about whether or not someone’s physique is achieved naturally have even spawned their own series of content, where creators speculate on whether someone is “natty or not.” In translation, are you achieving results without performance-enhancing drugs, or are you using steroids?

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By being forthcoming about steroids, influencers offer a realistic take on what achieving a perfect body actually entails beyond diet and exercise. It’s a phenomenon equivalent to celebrities admitting to the use of Ozempic and other weight-loss drugs while shedding pounds.

But the constant bombardment of content featuring open drug use and chiselled bodies can take the societal pressures around body image and make it feel like they’re on … well, steroids. It seems like drugs are everywhere.

“[Social media] is one of the things that is obviously boosting more people to use steroids and consider performance enhancers, not only for performance, but for the aesthetic aspect of it,” said Kyle Ganson, a registered social worker and an assistant professor at University of Toronto’s Factor-Inwentash Faculty of Social Work.

His research focuses on eating disorders, muscle dysmorphia and muscle-building behaviours among adolescents and young adults. “The stigma is still there but in the social-media realm it’s becoming a bit more open.”

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It’s a perspective that’s backed by data. Because steroids are illegal in Canada and the United States, stats on their overall use are hard to come by. But an article from the American Psychological Association showed a correlation between social-media use, greater body-image concerns and appearance-altering behaviours.

A study from the Center for Countering Digital Hate – a platform dedicated to counteracting discrimination and disinformation online – also noted that videos with hashtags promoting “steroid-like drugs” were viewed by American users up to 587 million times in the past three years, with up to 420 million views from users under 24. TikTok criticized the report, noting the group didn’t differentiate between potentially harmful videos and videos talking about steroid addiction or side effects.

The constant comparison to idealized bodies on the internet – many of whom are on performance enhancers and doing fitness as a full-time job – might make it seem like something a viewer needs to do if they want to get in shape.

“It’s where media literacy becomes really important, especially for young men seeing that on their feed. They need to really understand there’s context to why those guys look that way,” said Ganson.

On Reddit and other forums, it’s easy to find suggestions on where to buy steroids and how to best use the drugs. But without proper research or medical supervision, many steroid users overlook major long-term side effects such as infertility and suppression of their body’s natural testosterone production – not to mention more minor outcomes including hair loss, acne and testicular atrophy – in favour of listening to strangers on the internet.

Another factor in the normalization of hormones and performance enhancers has to do with health companies and startups advertising testosterone replacement therapy. With TRT, testosterone is prescribed by a doctor to men who medically qualify. In Canada, this would mean testing repeatedly with a total testosterone level below 8.0 nanomoles per litre for men under the age of 50. According to Mount Sinai, normal levels fall between 10 to 35 nmol/litre. The drugs are said to help with depression, sexual functions, energy and physique.

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It’s debated whether TRT counts as steroid use. The focus of TRT is to achieve higher levels of testosterone still within the body’s natural range, all overseen by a doctor. Anabolic steroid use often pushes people’s levels way beyond what even the most genetically gifted could achieve. They’re often mixed with other substances such as human growth hormone and obtained through unregulated sources. Regardless, some doctors feel like TRT is being over prescribed.

“Testosterone replacement has almost been glamourized, especially for men under the age of 40,” said George Mankaryous, chief medical officer of Rocky Health, an online medical clinic focused on men’s health. “But low testosterone level doesn’t necessarily mean that there’s actually something physically wrong with your body’s natural production of testosterone.”

Rocky Health offers prescriptions for hair loss and weight-management drugs, but the brand opts not to offer TRT, believing online clinics are ill-equipped to diagnose low testosterone.

Testosterone levels naturally decrease as we get older, while lifestyle and physical factors such as obesity, stress and excessive alcohol use also play a role.

Still, TRT is a rapidly growing industry, with the market expected to grow more than US$400-million globally by 2026. Consumers can expect to pay anywhere between $100 to $500 a month, according to Canadian provider Jack Health.

While social media can make the use of steroids seem normalized, many folks who’ve experimented with the drugs are also warning viewers about the dark side of their use, the tradeoffs for the muscle gain and the impact it had on their longevity and health.

But among all the cautionary videos, one thing stood out. A lot of men – people who looked in pique physical shape – complained about how awful they felt in their bodies. They’d started using performance enhancers with the hope of achieving their physical best, but even after reaching those heights, they didn’t feel better about their bodies on a mental level. As more and more videos pop up on my feed, it’s something I remind myself of.

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