Testosterone Replacement Therapy (TRT) has been the subject of endless discussion and debate ever since the much publicized suspension of Chael Sonnen by the California State Athletic Commission for failing to properly disclose his use of TRT prior to his middleweight championship bout against Anderson Silva.
Many arguments have been made for and against TRT use in the cage. Some say it is medically necessary, such as Nate Marquardt. Some say it's a potential danger to both the fighters using it and their opponents. Others say, well, it's just not that big of a deal.
Though testosterone levels can be checked by athletic commissions prior to or after bouts, testing is expensive, inconsistent, and not always effective. Mike Chiappetta of MMAFighting.com recently wrote a very thorough and detailed article about this very issue.
I don't think anyone will argue that TRT does have its medical uses for people who have an actual need for it; it is intended to combat the effects of declining testosterone levels seen in men typically due to aging, hypogonadism, or a pituitary gland dysfunction. Such effects can include reduced sex drive, decreased energy, depression, reduction of muscle mass, increase in body fat, etc.
However, as far as I'm concerned, TRT use as a sports performance enhancer should not be allowable for any reason. Therapeutic use exemptions be damned.
I think it's fairly obvious that providing a therapeutic exemption for a treatment or substance, that is otherwise banned, provides fighters with the opportunity to exploit a loophole in a State Athletic Commission's rules.
Should therapeutic use exemptions for TRT be allowed in MMA?
Is it possible that a fighter, for one reason or another, truly has low testosterone and needs TRT? Yes, of course. Is it just as possible that, in a sport so grueling on the body, a fighter might fake the need for TRT—or hide it's use altogether—to gain an advantage? Of course.
And therein lies the problem.
TRT is too exploitable and can easily be used as a performance enhancer in order to aid recovery or gain strength and endurance.
Some might say that it's unfair to ban TRT, thereby putting a fighter with a medical condition on an uneven playing field, but since when do sports have to be played on a level playing field, especially at the professional level?
Combat sports embody the most basic form of competition. As they say, "Two men enter, one man leaves." Fighters should be stepping into the ring/cage to put their skills and natural abilities to the test. Like it or not, your body is what it is. Not the fastest guy in the world? Maybe you shouldn't try to be an Olympic sprinter. Not the smartest? Chess probably isn't your game.
If you're a fighter and your testosterone levels decrease to the point where you can't cut it anymore, then it might just be time for a new career, as tough as that is to face.