Serious question: If you’re right–if these labs represent a slam-dunk, child’s-play case for starting TRT–why didn’t the urologist start it? You surmised that the doctor is literally impaired, which is certainly possible. So in that regard: @KCChuck, did your doctor strike you as impaired in some way–demented, intoxicated, incapacitated with depression, etc? Because if he did, @systemlord and others are right–you shouldn’t see him again.
Let’s assume the answer to the above is ‘no.’ (Because OP surely would have mentioned it before now.) How then to explain his passing up on the slam dunk? A possibility: Docs dread suggesting a course of action they know a pt is averse to, because it risks losing the pt as a ‘customer.’ But that can’t be the reason here, because OP wants to be on TRT. (If anything, the doc’s decision may cost him OP as a pt, so he [the doc] was acting against his own financial interests by doing this.)
Other possibilities…Maybe the doc is afraid of the Feds coming after him for inappropriate prescribing? Obviously that can’t be it–not if this is a “child’s play” case of hypogonadism, as you maintain.
It seems to me we’re left with only one possibility, which is that OP’s is not a slam-dunk/child’s-play case of hypogonadism. That there is something going on–something in OP’s other labs, or his medical history, or his physical exam–that makes this anything but a straightforward case of needing TRT. But you guys–brimming with unearned confidence–can’t see this from your base camp on the slopes of Dunning-Kreuger Mountain.
Most of the frequent posters on this subforum know something about hypogonadism. Trouble is, none of you know enough to be able to appreciate how much you don’t know about it.