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Bigger than sport: the enhanced games and the commodification of telehealth, testosterone, and dependency

Luke Cox Orcid Logo, Imran Khan

Harm Reduction Journal, Volume: 22, Issue: 1

Swansea University Author: Luke Cox Orcid Logo

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DOI (Published version): 10.1186/s12954-025-01321-w

Abstract

Background: Much of the existing discourse surrounding the Enhanced Games has focused on its potential to undermine traditional sporting values by permitting and promoting the use of performance-enhancing drugs (PEDs), thereby challenging established anti-doping frameworks. However, as the Enhanced...

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Published in: Harm Reduction Journal
ISSN: 1477-7517
Published: Springer Science and Business Media LLC 2025
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URI: https://cronfa.swan.ac.uk/Record/cronfa71533
first_indexed 2026-03-04T12:33:00Z
last_indexed 2026-04-24T04:16:13Z
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spelling 2026-04-22T16:49:34.2715184 v2 71533 2026-03-04 Bigger than sport: the enhanced games and the commodification of telehealth, testosterone, and dependency 9811ac84cad867903c385bf7086dfd2d 0000-0001-7625-4603 Luke Cox Luke Cox true false 2026-03-04 EAAS Background: Much of the existing discourse surrounding the Enhanced Games has focused on its potential to undermine traditional sporting values by permitting and promoting the use of performance-enhancing drugs (PEDs), thereby challenging established anti-doping frameworks. However, as the Enhanced Games continues to expand its brand, a broader agenda has emerged, specifically, the incorporation of telehealth services into its platform. Aim: This study aims to critically examine the Enhanced Games’ role in facilitating access to testosterone replacement therapy (TRT) through its emerging telehealth services. Method: A qualitative content analysis was conducted of the Enhanced Games’ official website, with a specific focus on its telehealth offerings. Drawing on Cooper and Waldby’s (2014) concept of the bioeconomy, in which human bodies become sites for pharmaceutical accumulation and capital generation, we examine how the Enhanced Game’s seek to exploit this notion. Results: Findings indicate that the Enhanced Games leverages sport as a vehicle to market TRT. This underscores its ambitions to extend beyond the sporting arena, positioning the organisation as a commercial actor within the broader biomedical, wellness, and longevity sector. Their telehealth advertisments explicitly promote testosterone products, signalling a shift and bluring boundaries between sport (performance enhancement) and society (longevity, wellness, optimisation). Discussion: In light of the over-prescription of testosterone through telehealth services, the Enhanced Games may serve as a powerful force towards expanding that market. These developments raise important concerns, particularly regarding the risk of physiological dependency resulting from prolonged use of exogenous testosterone. The commodification of TRT under the guise of sport and health optimisation calls for critical reflection on the ethical, medical, and regulatory implications of such practices. Journal Article Harm Reduction Journal 22 1 Springer Science and Business Media LLC 1477-7517 Anabolic androgenic steroids; Testosterone replacement therapy; Telehealth; Autonomy; Dependency 10 11 2025 2025-11-10 10.1186/s12954-025-01321-w COLLEGE NANME Engineering and Applied Sciences School COLLEGE CODE EAAS Swansea University SU College/Department paid the OA fee 2026-04-22T16:49:34.2715184 2026-03-04T12:28:11.3856973 Faculty of Science and Engineering School of Engineering and Applied Sciences - Sport and Exercise Sciences Luke Cox 0000-0001-7625-4603 1 Imran Khan 2 71533__36561__3b9c0e64e7d3461f9a407cbbcc296f09.pdf 71533.VoR.pdf 2026-04-22T16:47:35.5094920 Output 2099698 application/pdf Version of Record true © The Author(s) 2025. This article is licensed under a Creative Commons Attribution NonCommercial-NoDerivatives 4.0 International License. true eng http://creativecommons.org/licenses/by-nc-nd/4.0/
title Bigger than sport: the enhanced games and the commodification of telehealth, testosterone, and dependency
spellingShingle Bigger than sport: the enhanced games and the commodification of telehealth, testosterone, and dependency
Luke Cox
title_short Bigger than sport: the enhanced games and the commodification of telehealth, testosterone, and dependency
title_full Bigger than sport: the enhanced games and the commodification of telehealth, testosterone, and dependency
title_fullStr Bigger than sport: the enhanced games and the commodification of telehealth, testosterone, and dependency
title_full_unstemmed Bigger than sport: the enhanced games and the commodification of telehealth, testosterone, and dependency
title_sort Bigger than sport: the enhanced games and the commodification of telehealth, testosterone, and dependency
author_id_str_mv 9811ac84cad867903c385bf7086dfd2d
author_id_fullname_str_mv 9811ac84cad867903c385bf7086dfd2d_***_Luke Cox
author Luke Cox
author2 Luke Cox
Imran Khan
format Journal article
container_title Harm Reduction Journal
container_volume 22
container_issue 1
publishDate 2025
institution Swansea University
issn 1477-7517
doi_str_mv 10.1186/s12954-025-01321-w
publisher Springer Science and Business Media LLC
college_str Faculty of Science and Engineering
hierarchytype
hierarchy_top_id facultyofscienceandengineering
hierarchy_top_title Faculty of Science and Engineering
hierarchy_parent_id facultyofscienceandengineering
hierarchy_parent_title Faculty of Science and Engineering
department_str School of Engineering and Applied Sciences - Sport and Exercise Sciences{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Engineering and Applied Sciences - Sport and Exercise Sciences
document_store_str 1
active_str 0
description Background: Much of the existing discourse surrounding the Enhanced Games has focused on its potential to undermine traditional sporting values by permitting and promoting the use of performance-enhancing drugs (PEDs), thereby challenging established anti-doping frameworks. However, as the Enhanced Games continues to expand its brand, a broader agenda has emerged, specifically, the incorporation of telehealth services into its platform. Aim: This study aims to critically examine the Enhanced Games’ role in facilitating access to testosterone replacement therapy (TRT) through its emerging telehealth services. Method: A qualitative content analysis was conducted of the Enhanced Games’ official website, with a specific focus on its telehealth offerings. Drawing on Cooper and Waldby’s (2014) concept of the bioeconomy, in which human bodies become sites for pharmaceutical accumulation and capital generation, we examine how the Enhanced Game’s seek to exploit this notion. Results: Findings indicate that the Enhanced Games leverages sport as a vehicle to market TRT. This underscores its ambitions to extend beyond the sporting arena, positioning the organisation as a commercial actor within the broader biomedical, wellness, and longevity sector. Their telehealth advertisments explicitly promote testosterone products, signalling a shift and bluring boundaries between sport (performance enhancement) and society (longevity, wellness, optimisation). Discussion: In light of the over-prescription of testosterone through telehealth services, the Enhanced Games may serve as a powerful force towards expanding that market. These developments raise important concerns, particularly regarding the risk of physiological dependency resulting from prolonged use of exogenous testosterone. The commodification of TRT under the guise of sport and health optimisation calls for critical reflection on the ethical, medical, and regulatory implications of such practices.
published_date 2025-11-10T06:24:29Z
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