Carole Hooven is a human evolutionary biologist whose research centers on testosterone, sex differences, & behavior. In this episode, she explores how prenatal testosterone orchestrates male development in the body & brain, how early hormonal surges shape lifelong behavioral tendencies, & what rare natural experiments—such as 5-alpha-reductase deficiency—reveal about the biology of sex differentiation. She discusses distinct male & female aggression styles through an evolutionary lens, how modern environments interact with ancient competitive drives, & the implications of attempting to suppress them. The conversation also covers testosterone across the lifespan, the role of hormone therapy in both men & women, & Carole’s own experience after surgical menopause, culminating in a broader discussion of masculinity, cultural narratives, & the consequences of denying biological sex differences. View show notes here: https://bit.ly/3Kh6UBi Become a member to receive exclusive content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ 0:00:00-Intro 0:00:11-How Carole became interested in exploring the biological & evolutionary roots of sex differences & the role of testosterone 0:08:25-How testosterone & other hormones influence sex differences in aggression & behavior across species 0:11:09-How chromosomes, the SRY gene, & early hormones direct embryonic sexual differentiation 0:20:04-A stark contrast of male social bonding compared to females 0:23:43-How hormones like DHT shape sexual differentiation, & how 5⍺-reductase deficiency reveals the distinct roles of these hormones 0:34:20-How sex chromosomes & prenatal testosterone shape early brain development & explain sex differences in childhood behavior 0:47:13-How gamete differences shape reproductive strategies, energetic costs, & sex-specific behavior 0:55:04-How evolutionary biology shapes sex differences in play, aggression, & conflict resolution 1:09:10-Why males commit disproportionately more violent crime 1:13:12-Why females evolved different behavioral strategies 1:15:59-Whether male aggression is still necessary in modern society & why the underlying biological drives persist 1:24:45-How testosterone levels naturally shift to support fatherhood & caregiving 1:30:38-How testosterone shapes male mating strategies, & why long-term pair-bonding persists even when reproduction is no longer at stake 1:38:42-The distinct roles of estrogen in male development, mood, libido, & muscle 1:49:50-How evolution, health, lifestyle, & androgen receptor biology shape modern testosterone replacement therapy (TRT) 2:02:44-Carole’s experience with hormone replacement therapy (HRT), & the risks associated with TRT in younger men 2:10:32-How Carole rebuilt after controversy: leaving academia & recommitting to scientific honesty 2:17:40-Carole’s next book: examining masculinity, cultural narratives, & the cost of denying biological sex differences -------- About: The Peter Attia Drive is a deep-dive podcast focusing on maximizing longevity, & all that goes into that from physical to cognitive to emotional health. With over 90 million episodes downloaded, it features topics including exercise, nutritional biochemistry, cardiovascular disease, Alzheimer’s disease, cancer, mental health, & much more. Peter Attia is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan & simultaneously improving their healthspan. Learn more: https://peterattiamd.com Connect with Peter on: Facebook: http://bit.ly/PeterAttiaMDFB Twitter: http://bit.ly/PeterAttiaMDTW Instagram: http://bit.ly/PeterAttiaMDIG Subscribe to The Drive: Apple Podcast: http://bit.ly/TheDriveApplePodcasts Overcast: http://bit.ly/TheDriveOvercast Spotify: http://bit.ly/TheDriveSpotify Google Podcasts: http://bit.ly/TheDriveGoogle Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice. No doctor-patient relationship is formed. The use of this information and the materials linked to this podcast is at the user's own risk. The content on this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they have, and they should seek the assistance of their healthcare professionals for any such conditions. I take conflicts of interest very seriously. For all of my disclosures and the companies I invest in or advise, please visit my website where I keep an up-to-date and active list of such companies. For a full list of our registered and unregistered trademarks, trade names, and service marks, please review our Terms of Use: https://peterattiamd.com/terms-of-use/