Or, as it is in my case, it is a disease that is caused by the body simply not producing enough T for a normal person my age (and, FWIW, much, much less than the normal amount).
I put off treatment for about 15 years because of the mindset you described above. Too many people do. At the end of the day, it has left me in my early 30s feeling like a very old man that has a lot of catching up to do. Perhaps people commenting on the validity of the use of a medical treatment to a medical problem should instead focus on targeting the abusers of the medication for personal gain (i.e., athletes that use it for an advantage).
As for "getting more sleep and hitting the gym," you have no idea what it is like to have low T. People see you as being lazy, but you're not lazy, you literally have zero energy to do what you need to do, let alone the additional energy needed to work out. People give pregnant women the benefit during their first trimester because they have absolutely no energy, but refuse to give the same benefit to men suffering from a very similar lethargy.
Whatever, it was the best decision I ever made. Increasing the chance of prostate cancer or heart attack later in life is worth being able to live life now. Had I had to go another 50 years feeling like I had the last 15, I'd probably not be a very happy old person.
FWIW - when I say much, much less:
Testosterone, Serum: Actual Amount: 222 ng/dL, Normal Amount: 348-1197
Free Testosterone: Actual Amount: 6.2 pg/mL, Normal Amount: 8.7-25.1