Peter Attia, M.D.

Hey, everyone.

Welcome to The Drive Podcast.

I'm your host, Peter Attia.

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My guest this week is Carol Hoeven.

Carol is a human evolutionary biologist, a former Harvard lecturer, and non-resident senior fellow at the American Enterprise Institute.

Her research focuses on testosterone, sex differences, and behavior.

She holds a PhD in biological anthropology, now human evolutionary biology, from Harvard University, and is the author of T, The Story of Testosterone, The Hormone That Dominates and Divides Us.

In this episode, we discuss how prenatal testosterone shapes the male body and brain, turning genetic signals into thousands of developmental changes that underlie later sex differences, critical hormone surges and why they matter for lifelong behavior.

DHT, androgen receptors, and rare natural experiments, for example 5-alpha reductase deficiency, that reveal how external genitalia and the prostate masculinize, distinct male and female aggression styles, direct physical confrontation versus indirect or relational tactics, and the evolutionary logic behind each, why modern life changes but doesn't erase ancient drives like male competitiveness and the trade-offs of trying to suppress them.

testosterone, aging, and hormone therapy for both sexes, including Carol's personal experience after surgical menopause, and the cultural debate over masculinity and the cost of denying biological sex differences, a theme of Carol's forthcoming book.

So without further delay, please enjoy my conversation with Carol Hoeven.

Carol, thank you so much for coming out to Austin.

Great to meet you in person.