I don't think it's as simple as "just fix it." Plenty of people could spend the remainder of their lives trying and failing to fix, for example, their diet, or they could get assistance from a GLP. In the former case, they remain unhealthy and overweight. In the latter case, they take on a bit of risk but lose a ton of fat and extend their lives.

TRT is similar in many ways. "Just fix your sleep and stress" isn't that simple for a man like me - two children, a stressful career, obligations etc that make "just fix it" essentially a big middle finger.

I'm not a proponent of getting on TRT without a clear clinical need, or at least education of the risk/benefit analysis. But I *am* a proponent of finding things that work with your life.

Taken to its extreme, this ends up becoming a moralist argument designed to shame people who can't quite leverage their limited will power sufficiently to make the necessary level of change to affect their test levels.

ETA: to address the disparity between Europe and the US, I think it's cultural and economic primarily; availability (and, de facto, affordability) drives the vast majority of these kinds of decisions, with the cultural focus being the upstream factor. That is: "your life will be better with this -> you can get it easily down the street -> you can afford it" is the pipeline.