Assistant HHS Secretary Admiral Brian Christine on the Crisis in Men’s Health

25:46They do have their place. And, you know, I think they certainly can help in a variety of, you know, healthcare conditions, everything from cancer to sexual dysfunction to mental health concerns. They have their role, but certainly we prescribe too much in general in the United States. I believe that's true. We don't emphasize things like good health, meaning diet, exercise, mental health, keeping your relationships able. It's easy. It's easy to write the prescription. Uh, because, and then it's tougher sometimes to do the harder work of really talking to someone, talking to a patient, helping them, him or her to understand what's going on, really getting to the root of what's going on with them and then offering things that may take more effort.

26:32Like let's face it. It is, it is harder to get up in the morning and go exercise and then eat a healthy breakfast. And I'm not always good at that. I mean, I trust me, I fall off the wagon continuously, but it's harder to do that than it is maybe to take a pill or take something to try to lose weight. I mean, so it's easy to prescribe. It's always not the right answer for things, whether it be men or women. Yeah. Yeah. We need a playbook, Admiral. We need a guy's playbook. And when we hit 18, we need to say, okay, well, I'm confronted with this situation. I didn't wake up this morning in the direction.

27:04What do I do? What are my reps? What What are my, you know, what are my, what's my A route? What's my B route? What's my C route? You know, and, and I think that's the key is that I, you know, the, the excitement is finding some nutritional based guidelines that are not biased and finding what do we teach a guy about, about how to eat right, you know, when he's out. And I think some of the work that, that you're doing, really looking at changing the way that we engage our nutrition, foods, food sourcing, food desert. So, yeah, tell me a little bit about that, because for me, it's, you know, it's that's where a lot of this starts is that the nutritional knowledge that I have based on just being in the field, but also doing some graduate work in that.

27:48You know, it's easy for me on a one patient to patient scale to really unpack it. But but tell me nationally, you know, how do we get a cohesive message about what guys should be eating? Because again, you had a protein-packed breakfast because you went to the gym and you earned it. How do we, and this is a question, boy, it's going to probably take a while, but I'm trying to figure out how you move that needle to get the nutritional guidelines into the hands of guys so that it makes sense to them. And they can eat something that is evidence-based and has some degree of stewardship about how that food got to their plate in the first place.

28:27Well, I'm glad you brought up diet because we released our new dietary guidelines from the Department of Health and Human Services. It's mandated by law that on a minimum, every five years, you have to produce new dietary guidelines, the country does. And that's always a joint effort between the Department of Health and Human Services and USDA. And then on every other cycle, one of those two departments will take the lead. So this year, the Department of Health and Human Services kind of took the lead, but in conjunction with USDA. And the dietary guidelines are always a joint effort. It's a team effort, but they come from the Office of the Assistant Secretary for Health primarily.

29:09Our dietary guidelines are incredibly important. They are a seismic shift from probably what, Jesse, you and I were used to. let's face it when we were kids and even still certainly what do people talk about as a breakfast it's going to be some kind of a sugary highly refined highly processed cereal or sweet bun or something like that our dietary guidelines we said we like to say we flip the pyramid and the point is what we have what we recognize what science shows and our guidelines are backed up by gold standard science is that the foundation of our diet really should be nutrient dense real food.

29:47We say eat real food. We really emphasize protein, protein obtained by fish, meat, poultry, beef, legumes. Protein is the foundation of our diet. And then you mix in, you bring in certainly healthy fats because fats are not bad, right? Healthy fats like you might get in a nicely marbled steak or a piece of salmon or whole fat milk. Fats are important. You bring in then, carbohydrate in the form of fresh fruits and vegetables, eat real food. So our dietary guidelines are really a seismic shift. We've produced the guidelines. One of the main things Secretary Kennedy wanted to get done, and he has gotten done working with Secretary Rollins at USDA, our new dietary guidelines.

30:32And now we're in the implementation phase. In other words, we're evangelizing about that. To your point about how do we let people know about healthy food, getting on shows like this. Secretary Kennedy and all of us are always talking about the dietary guidelines and how important they are, really telling people how to eat real food, get out, be active, eat real food. All those things are important. When you look at men, because we referenced back a bit ago that for all the chronic diseases, unfortunately, men take the lead looking at obesity. Yeah, we have to help men understand, how should you be eating?

31:08and our guidelines point the way to that. And they're not rigid rules, they're guidelines, but they point the way to say, listen, eating real food, nutrient-dense food, and of course, combining that with a healthy lifestyle of exercise and things like not smoking, not drinking to excess, all of those things can help men be healthier. So shows like this, every opportunity we have to talk about it, we do, meaning those of us here at HHS, every opportunity we have, we talk about that when we're interviewed or doing podcasts. we have to help men understand and women that how you eat is incredibly important to your overall health and how you eat is absolutely affects the chronic disease or can impact the chronic disease epidemic in the country yeah yeah so you know in my limited office time in a surgical practice seem tell me if i'm out of line if i tell guys this but i i say if if you can shoot it or grow it, you can eat it.

32:03That's about what I say. No, I think that's, listen, you're right. You don't find anything that one may hunt and any creature that you're going to bring down with a gun or the fishing pole or something like that is not highly refined and highly processed carbohydrate. That's for darn sure. So yeah. I mean, I think that's not a bad way to look at things, Jesse. Again, we like to say eat real food. We like to talk about get active, get out there and do things, be out there in the sun, be outside in the fresh air, exercise, use your body, fuel your body with that nutrient-dense real food. Simple recommendations, but we need to continue to talk about those things and evangelize those things.

32:45So our dietary guidelines, our dietary guidance are really important for both men and women. But again, with obesity rates being higher than men, with cardiovascular disease being higher in men, perhaps particularly important for men to embrace the guidelines and changing the way we eat.

33:20Yeah, and we get cardiovascular disease 10 years earlier. And I'm going to go back to testosterone again, because we think, you know, for women, estrogen tends to be a little bit more cardioprotective, which is probably why they're not seeing heart disease until they're in their postmenopausal area, especially if they're not getting HRT or hormone replacement therapy. One of the things I'm super excited about in your administration is what I always say is, you know, there's that old curl. I don't know if it was, I think it aired everywhere, but there was a great commercial probably in the nineties.

33:50It was by the California Egg Commission where there There was an egg sitting in a jail cell and looking despondent. And it was just an egg, right? An animated egg. And then all of a sudden the warden comes in, opens the door and the egg walks out a free egg because he said, look, you're finally out of jail. Eggs are not bad for you. Because as you were saying, when we were younger, we were told anything with fat is bad. No eggs, no butter, all nonfat milk. And then finally evidence turned around and said, no, eggs are actually good for you. Get out of jail, live your life. I feel the same thing about testosterone.

34:22Right. So without being an evangelical for testosterone, because I think, you know, there's certainly there's certainly an argument about overprescription. But I think we're still actually in a statistically in a phase of underprescribing testosterone for something that. Right. If a guy comes in with depression, if he comes with erectile dysfunction, if he comes in with cardiovascular issues, high LDL or bad cholesterol, low HDL, those are all signs that he may have hypogonadism and he may not get screened for it. And it may get started on a statin or it may get started on an antidepressant or it may get started on a PDE5 inhibitor for his erectile dysfunction without ever getting testosterone screening.

34:58So I guess I'm saying, wow, I'm super excited with what's happening in Washington. It was only 10 years ago that I was on an FDA advisory panel in Washington with Mocare and Shailene and all the guys, right, that are the legends in the field. And we tried to write a little bit of a rebuttal to the seminal papers that put testosterone in jail. And we said, no, actually adult onset hypogonademy is probably real. It probably is something that does need therapy because at the time the FDA statement is you cannot treat a guy for symptoms of low testosterone only if the blood work shows he's low and you cannot look at testosterone as aging as anything pathologic.

35:41And in other words, if a guy has testosterone just because he's 60 and he's not 40, then maybe we don't treat testosterone. So we missed a generation of guys. I always bring my reading glasses prop out as a microsurgeon. You know, I started using reading glasses because I was getting older in my 40s. I don't want to stop wearing glasses as a sign of aging, right? But it's a normal part of aging. And so that's kind of where testosterone is. So unpack how you got the ball so far forward with that, that we're able to look at testosterone and isolated low libido as disease states. Because that is already something that no administration has been able to do in the history of us looking at TRT.

36:24No, I appreciate you bringing that up because that's one of the things that I'm most excited about that we're working on and been able to accomplish up here. Have a great relationship and really have to shout out Commissioner of the FDA, Marty McCary. Marty, as you know, Hopkins, an incredible pancreatic and gastric surgeon or GI surgeon, really an amazing author. Author, blank spots. Yeah, exactly. Oh, yeah. Healthcare reform and looking at our healthcare system. Marty's incredibly talented. He's great. He's a great communicator. Marty is a dear friend of mine, but I have tremendous respect for him professionally.

37:00And so one of the things I approached Marty and said, listen, we need to have an expert panel on testosterone replacement in men. And we were able to do that through the FDA. We did that back in the fall, had great attendance from names like you mentioned, Mo Cara or Larry Lipschulz or Abe Morgenthaler. Dave Morgenthaler, yeah. Docs who are really, you know, great. And Helen Burney was part of this. And so, you know, just a great panel. And really what we did in that panel was said, let's talk about testosterone. Let's try to remember it shouldn't be in jail like you, like, you know, like the egg.

37:34That it shouldn't be demonized because testosterone therapy has a role. Listen, we have an issue in this country, too, as you know, Jesse, you know, particularly with testicular failure, testicular disease in this country, meaning falling testosterone levels over time in men, falling fertility rates in men. Fertility rates are testosterone production rates in men are the lowest they've ever been, as far as I can tell, in recorded history in the United States. And so we wanted to really look at testosterone because anytime that you or I would prescribe testosterone for a man who has just falling levels as he gets older and is symptomatic, we'd be prescribing testosterone off-label, right?

38:17I mean, there's no indication for simply what we call idiopathic hypogonadism, because you can have hypogonadism, which in this case means low testosterone, because of, for instance, disease in the brain, the pituitary gland, pituitary disease can lead to low testosterone. Well, if a man has that and you give him testosterone, that's indicated. That's an indicated use for it. That's on-label, we say. But for the vast majority of men who get testosterone, it's because we're getting older, our levels fall, and we can be symptomatic from that. Low sexual desire, low libido, low energy. Depression.

38:54Depression. But that's not an indicated label used for testosterone. So we're trying to address that. and we are looking at changing the indications for testosterone to where it'll accept. I mean, it'll be legitimate to say if a man simply has low testosterone because he's getting older and is symptomatic, it will be unlabeled to use testosterone. We're looking at that. We're working toward that. There are some warnings, as you know, Jesse, in the labeling for testosterone products that says if a man has an enlarged prostate, you shouldn't give testosterone. Or if a man has had or may have prostate cancer, you shouldn't give testosterone.

39:31And we know the data doesn't support that. There is none. Yeah. But we're looking at exactly looking at labeling changes, the warning changes in the labeling. So these are things that are incredibly important. I predict they will happen. Right. We're working on those things. Again, Commissioner McCary has been, Marty has been incredibly supportive of this because he's looked at it with the eye of a scientist and says, you know, we haven't done right. We got to change this. And so that's going to be a seismic shift in testosterone use, legitimate testosterone use in men. So I'm very excited about it.

40:02Yeah, no, that's, I mean, I can tell you I've served as expert witness on many cases of physicians being sued because of testosterone prescription with complications had nothing to do with the testosterone, but just because it was an off-label drug, that was enough for these well-intentioned clinicians to prescribe a therapy that has great data, but they had a complication. And then all of a sudden you got a 1-800-BAD-DRUG billboard looking at you in the face. And so, I mean, that's huge that we can, yeah. No, I agree, Jesse. And listen, again, I'm a passionate advocate for men's health, but as the assistant secretary for health, one of my sub offices is the office of women's health, which we take very seriously.

40:41We do incredibly good things there. We had the first ever national conference on women's health was held back at the first part of the year. the director of our office of women's health dr dorothy fink really put that together drove it forward incredibly well attended including by the by the second lady usha vance came and made an appearance talked about amazingly important things uh so i strongly support women's health and i think as a demonstration of that i think it's high time that we look at an indication for testosterone use in women well very legitimate we need to get that on label right and that's something we're looking at as well.

41:19So, you know, again, when it comes to testosterone, it's been demonized. It has its place. It has its role in men, but also in women, as we've learned over time, incredibly important that we move that ball forward. And we are. I think that's huge that you brought that up. And I'm glad you did. Cause yeah, we, you know, the tagline is this is a, this is the mail room, but it's, it's a show for, for men and those that love those men. And so I think it's great that you're talking because it is something that, that we definitely need a dedicated episode to is TRT and women. And the fact that you have an office of women's health, you already have a blueprint, you know, and the other statistic I always love to show for any marketers out there listening is that 70 to 75 % of healthcare decisions in a traditional heterosexual couple are made by the women.

42:05And so you already have an office that is doing great work on the female side. So it doesn't seem it's going to be as heavy a lift to build something that that walks in those amazing maternal footsteps. So that's kind of exciting. Yeah, no, I think so. We have, you know, we have a coin right now. I like to say this, we have a coin. And on one side of that coin, we have the Office of Women's Health. Absolutely important that we have it. It is well-funded as it should be, does incredible things as it should, things from maternal health, things from, you know, advocating for breastfeeding. I mean, there are so many good things that come out of our Office of Women's Health.

42:45That's one side of the coin. But the other side of the coin, we need to have that side of the coin have an Office of Men's Health. We don't have an Office of Men's Health. I strongly believe we need an Office of Men's Health at the Department of Health and Human Services. I think it's high time we have that. I think we will have that. That's one of the things that I'm very passionate about in this role as the Assistant Secretary for Health for making that happen. We have so many good things that we're doing at HHS. We talked about the dietary guidelines. There's things that we're doing for affordability.

43:19And one of the privileges of this job is getting to work with people like Marty McCary at FDA, getting to form an incredibly good relationship and working with Mehmet Oz at CMS. And Dr. Oz, Mehmet has been so instrumental in increasing affordability and working with the president on getting what we call most favored nation pricing for a lot of prescription drugs. And for the audience, basically what's happened in the past is that U.S. citizens have effectively been subsidizing lower prescription drug costs in other countries while we pay higher prescription drug costs. Well, President Trump and Secretary Oz have worked, I mean, not Secretary Oz, but Dr.

44:02Oz, have worked with some of the major drug companies to get what we call most favored nation pricing, where we're paying prices, low prices, commensurate with the low prices being paid in other nations like the United States, peer nations. We are paying the lowest prices for these prescription drugs that we ever have in this country, most favored nation pricing. And you link that up with something like TrumpRx.gov, which links up patients with the lowest prices for prescription drugs and the number of prescription drugs being covered is increasing all the time. And we're doing incredibly important things with affordability in this administration.

44:40So we're doing great things with food. We're doing great things looking at chronic disease. We are bringing down health care costs and prescription drug costs. We also need to do something really important for men's health. And that's where I think an office of men's health would be incredibly important. And I think it's high time, Jesse, that we have. Yeah, no, I mean, I think that and that's a legacy. You know, that's something that'll that'll last for administrations to come. So that's that's amazing. I applaud you for it. So I want to have you put on your doctor, your white coat here. You know, we always do a segment called You're Probably Going to Be Okay.

45:11And Jordan, this one is going to be good. I want to see how Dr. Christine, not Admiral Christine, is going to handle this guy. But there's a 55-year-old guy, a very well-spoken, very handsome urologist with a robust surgical. Wait, wait, no. That sounds a little bit maybe too close to home. Let me change that a little bit. I'm going to protect the innocent. Let's say he's 58. Still very good looking. He's a very stressed, highly accomplished CEO of a tech company. Now I can completely get rid of any plausible deniability. And he admits, he's like, Dr. Christine, I need to eat better. I need to exercise more.

45:49I'm so stressed. Kids are keeping me up at night. He's definitely not able to perform as well as he should and get through the task. He has a little bit of brain fog and his wife is telling him, Hey, look, you know what? I don't think we've, um, you know, I don't know. We've made sweet love in the last six months since you took on this new project. And so he, uh, he basically is, is kind of suffering from what you would say was, um, poor libido, poor energy, mental fog. And, and he's really coming to you because his wife was like, dude, you know, every time it's spoon time, you've reversed spoon on me.

46:26And then we all fall asleep and you get off and go to work at six in the morning. So the wife says, makes the appointment. I'm sure you had many of these as a clinician where, you know, you'll say in your little notes, you know, wife made appointment, low testosterone, or wife made an appointment, erectile dysfunction. Because again, 75 % of healthcare decisions are made by the women and as families, right? And so, you know, you're thinking, well, this guy's a train wreck, right? He's a head of a CEO. He's making good money. Kids are going to college. Everything is good. And so you get the labs.

46:59His labs comes back. I'll do a little prostate cancer plug that we screened him for prostate cancer, even though no correlation between testosterone and prostate cancer necessarily. And his PSA is 0.8. His testosterone is 276. Is this guy going to be, is he going to be okay? Is this guy, what are we going to do for this guy? And are you going to get him through this rough patch in his life. Yeah. I mean, so, you know, the thing that catches, the thing that catches my mind first or catches my eye first is the fact that number one, I'm glad this guy came in. I'm glad his wife got him in, which brings up an interesting point as a little side note, and I'll get back to your patient.

47:34When you survey individuals, if you send out a survey, do we need men and women? Do we need a focus on men's health, a national focus on men's health a men's health initiative, you know, it's like 70, 75 % of the guys surveyed say, yeah, I think that's a great idea. It's like 95 % of the women. Hell yes, we do. It's really important. So they understand that they play this pivotal role in men's health. They want to see us focus on men's health. They want to see us push men toward being seen and taking care of themselves because a lot of times we don't do it ourselves. So the fact that this hypothetical patient was really prodded to coming in for a much-needed appointment by his wife, it really does fit the pattern.

48:20You know, his testosterone levels are low. When you have something like this, you always want to talk about diet. You always want to talk about exercise. You want to talk about smoking. You talk about excessive drinking. You want to talk about those things that lead to healthy lifestyle. But for this individual with a low testosterone or certainly borderline testosterone level and incredibly symptomatic, this is a guy I think would benefit from a trial from testosterone, at least a trial of testosterone, right? I think, you know, you want to do all your lab work, you know, rule out other conditions that could be leading to his low testosterone pituitary disease.

48:53But saying this is just idiopathic hypogonad as when he's gotten older, you know, I'd want to work on his diet, want to work on his exercise, want to work on his sleep. but I think giving him a trial of testosterone makes sense. And so I would start him on testosterone. There's different ways to get testosterone. You know, there's injectables, there's topicals, you know, there's, there's subcutaneous implants, pellets. I mean, I would put them on a trial of testosterone, try them on that and give them a several month trial and see how he's doing, monitor his levels, see how he's doing. But I think it makes, it makes a lot of sense in this man.

49:23You have to always link that up with saying, okay, diet, exercise, healthy lifestyle. Sleep is incredibly important. Good sleep patterns. You have to take that, you know, integrate all those things together. But yeah, I'm an advocate for testosterone use. And this sounds like a good, a good, a good reason or a good patient to give a trial of testosterone. I don't know. What do you think?

50:04yeah no you walked right into my trap it was so perfect i think that this is exactly why if we had a message of incentivization for guys to come to the doctor it is exactly that because what did you do you did you followed the guidelines you know you said look for reversible causes diet exercise, sleep, but we have an incredibly safe therapy that we can reverse a lot of the things that brought that guy into your office in the first place. And now you've established a relationship with a medical professional so that if he comes back to you and he says, you know, in three months, he said, oh, Dr.

50:42Christine, I mean, you changed everything. My libido is better. My wife's happy, but you know, I'm still stressed at work or I'm still having some mental health issues, you've just created a relationship, just like our women have with their primary care physicians, just why they're going in, because they have incentives, screenings, just checkups that we don't normally get. You've just incentivized a guy to come in, and you've taken care of the whole patient. I mean, you're a specialized, incredibly world-renowned surgeon who just practiced good old-fashioned country doctoring. And that's what makes me so happy to be in this conversation with you, but also in the men's health field is that that's exactly right, is that we have therapies for these guys.

51:24We've just got to get them in the door. And we've got to get into that level of stewardship where they understand how important lifestyle modification is to making them healthier. And then maybe, you know, maybe they don't need most favored nation drug pricing because they don't have the drugs anymore. even better no i mean and again all these things that i'm glad you brought that up uh because all of these things again and i'm incredibly proud of the great things we're doing here at hhs uh we talked about god dietary guidelines we talked about you know the the drug pricing that we're trying to lower lower health care costs but all of these are related together chronic disease because you're right you know if we can whip and beat chronic disease and we can get men and women healthier, eating better food, nutritious, dense, nutrient-dense food, get them exercising, living a healthier lifestyle for those that smoke, getting away from smoking, getting away from excessive alcohol intake, getting out, moving, getting active, then these incredibly wonderful things that we're doing with affordability with the president and Mehmet Oz, we don't need, I mean, we have that great low drug pricing, but hopefully the people will be off the medications and not have to pay any.

52:30They won't need the prescription medicines, But so, no, it all relates together. It's certainly all interconnected. And about this patient you mentioned, again, you and I would treat this man with testosterone. We'd be treating him off-label. Oh, yeah. That's right. Right now. We need to treat them off-label, which is why I'm so excited that I've been able to partner up with Marty, with FDA Commissioner McCary, and we're moving the testosterone in men. We're moving that ball forward. And understand, we are doing it with gold standard and gold level science backing us up. This isn't done willy-nilly.

53:07We're only doing it because the science says this is where we should go. Amen. Yeah. Well, Jordan, talk to me. You got questions. It's not very often we have an admiral. In fact, the first time we've ever had an admiral in the mail room. So, you know, chime in. You're the guy on the street. Two doctors are just talking and we're talking shop. But what do you got for us? You know, I had a couple of things planned, but I want to go a different direction for something I just thought of now listening to you. You were speaking earlier about educating the public, specifically educating men about basically making healthy choices.

53:40And, you know, I mean, I can't throw stones here. I'm one of those guys who went a decade without getting a physical. Just not, you know, and I'm just now, you know, in the last couple of years really starting to see a trainer and really trying to take much more of an active hands-on interest in my own health and not taking this. Yeah, I think I heard radio did this just so that I can act as your doctor. That's part of your, you know, their budget cuts is like, hey, do a podcast with Mills and he'll take care of you. So we were, you were mentioned getting the word out there and educating the public.

54:09I wanted to ask you more just about sort of messaging. And Dr. Rills and I were talking just last week about the Bruce Springsteen biopic and how fascinating I thought it was and we thought it was that his sort of legacy shaping film was essentially about how I discovered therapy and got mentally healthy, which was not something that would have been immediately apparent to me for somebody of his sort of demographic in a sense. and I just thought that was so cool because I thought it maybe legitimized getting therapy to a whole subsection of men that maybe ordinarily would have you know there's still a stigma around it so I just wanted to ask you you know educating the public is one thing but how do you make men listen and what kind of challenge has that been like yeah it is no it is it's out Jordan that's a great question and a couple things one number one kudos if you're working out the trainer you're you're taking your diet more seriously you're taking your exercise and your lifestyle more seriously.

55:06Praise God. Good for you. I love it. Thumbs up. And listen, as men, we need to support, we need to, we need, what do they say? Iron sharpens iron. We need to support each other when we make those decisions. Because listen, I struggle with poor dietary choices and not exercising sometimes when I should. I mean, I get it. We need to be there for each other and to confirm each other in these things. So I'm proud of you for doing that. I think that kind of thing is important in the messaging for men. Men need men. Men need men for healthy, to be healthy in life, which obviously doesn't need men. Men don't need women in their life.

55:41I'm not saying that, but men need men to support each other and stand up for each other. I am a Catholic Christian, right? And so when I look at things and I read the Bible or I read the gospels and all, I think about you've got Christ, Jesus, and he's got his 12 apostles, all men, right? But what's part of the reason? Men need men. I mean, if I could go back in time, by the way, if I could turn the clock back and go back in time, I really would like to hang out with Jesus and the apostles for a couple days because I'm sure they were just, I'm sure they were men, right? Talking about the things probably not dissimilar to what we're talking about, supporting each other, right?

56:17Standing for each other. Men need men. Young men need, young men and boys need men as role models and guides. And so men need men. And so in this journey, in this battle, in this fight for men's health, we have to stand up for each other. We have to be willing to say where we've fallen and we have to help ourselves back up and help men to understand that we really do need to take our health more seriously. That's why I think evangelization, spreading the good news of what we could do with men's health is really important. And, you know, I referenced yesterday at that conference, you had these young men and women who were talking about side effects with taking medications, SSRIs, what side effects they've had.

56:58They were really brave to talk about these things. It's in the public forum now. A young man talking about his struggle with mental health who's crying on the stage. A young woman talking about her sexual side effects. A college student, incredibly brave. I think it's important for us men to be able to say to each other as we evangelize, hey, listen, I've got these issues going on, too. I've never shied away from this. I'm on testosterone. I'm a 62-year-old man. I'm on testosterone. My levels got very low, and it was really wreaking havoc in a lot of ways in my life. I'm on testosterone, and I have one of our peers, an individual who Jesse knows very well, another urologist who we're good buddies with, who manages my testosterone for me.

57:36incredibly important. I'm a 62 year old guy in terms of intimacy. I struggle a bit and I've got to manage that as well. So I think being able to talk about these things as men, men, we're talking here, you know, to each other, but we, that conversation needs to go out wider. And I think men need to sharpen other men. Iron sharpens iron. We need to be able to willing to talk about these things, uh, talk about how important they are and really evangelize about this. I think that helps. I think women are better at that. Hell yeah. I think women are better at that. You know, but I, you know, Jesse, I found in my practice, when I have a guy, when I have a man I'd be talking to, he'd come in and incredibly embarrassed talking about erectile dysfunction, sexual dysfunction.

58:21Yeah. Patient would be incredibly, you know, Brian, this is so hard to talk about. When I'd say, yeah, I get you because I know because I am there with you. Yeah. This is what I'm using to help me. Let me talk to you. That's really important. And that's not a pat on my back. That's just the way men have to support men. We got to be better about that on the broader national level, better about talking about it, being willing to talk about it, being willing to evangelize, willing to expose ourselves a bit. Because I think that's going to draw men into saying, yeah, you know what? I really got to take charge of this and I'm not alone.

58:53Yeah, no, I mean, we do a lot of work on this show on male vulnerability. We had a clinical psychologist, Stephen Poulter, on a little bit that talks about, you know, shame. And, right, I mean, it's so hard to be that strong guy and especially, you know, in a very masculinized culture to then have that vulnerability. But say, but look, you know what, that's part of being a guy is being able to make those discussions, have those discussions with guys and say, no, bro, we're, you know, we're in this together. I love, I'm just, I'm trying to imagine, you know, being in biblical times, hanging out with the apostles and what that conversation would look like.

59:28I love that you even brought it up, you know, that that is the foundation of a lot of what we do is men congregating to figure out, you know, how to be better, how to work together to improve our culture and society. Certainly, that's what you're doing in Washington. No, and I'm sure if you could go back, Jordan and Jesse, if you could go back and I could go back and hang out with the apostles and with our Lord Jesus. Jesus. I am sure that as the apostles were talking about things with men, right there with them, you're going to have Mary Magdalene and Mary, the mother of Jesus, the Mary, the mother of our Lord being like, guys, listen, let me, let us women, let us tell you the way things should be.

1:00:06Again, you know, you've, you've got it. We, as we focus on men, we never forget about women's health. We never forget about the incredibly important role women play in society. If we want to make, And we talk about make America healthy again. We talk about make America great again under President Trump. If we want this country, and I truly believe this and understand I'm a political appointee. You know, I am tremendously grateful to President Trump and Secretary Kennedy for giving this opportunity to serve. If we want to make America healthier than she's ever been, if we want to make America greater than she's ever been, We need strong, healthy men with strong, healthy women because that's going to lead to strong, healthy families in a strong, healthy country.

1:00:48I really believe those things. Yeah, and it's not subtractive. You know, it should be additive. It's not as if, you know, we're not talking about saying, okay, we're going to take$100 million out of women's health initiatives and put it over in men's. I mean, the beautiful thing is it can be cumulative. That's right. And it could and should be synergistic, just like any good relationship, right? I mean, it's give and take, but together you're stronger than you are alone. And whether you're with men and women together or a group of guys together, we should figure out how to find that strength in numbers.

1:01:18And that's truly what it actually means to be an American, right? Is to work together on an agenda and push it forward. So that's pretty cool. What can I do to help? I mean, I'm a director of a men's clinic and I'm an academic urologist. What can I bring back to my guys today to help them evangelize? As you said, I truly love the term in this context. Yeah, I think it's important that all men become evangelists for men's health. I think all men need to talk about this. All men need to spread that word and to build this momentum for building or build momentum to develop this national focus on men's health that hopefully will carry on long after I'm in this office.

1:02:01and ultimately we want to have an office of men's health to help perpetuate this. I think all men should be advocates for their health. You know, women, a lot of times are great advocates for women's health. Yeah. Right. I mean, you look at it. We have. So when I went through my Senate confirmation process, the committee, the Senate committee that I sat before was called the HELP Committee, Health, Education, Labor and Pensions. That's a committee. And you've got Republicans and Democrats on that committee. One of the Republicans senators was Lisa Murkowski from the state of Alaska, an incredibly effective politician, an incredibly strong advocate for this country, and obviously a strong and certainly a strong advocate for women and women's health.

1:02:40You know, it's mandated that there be reconstruction after radical breast cancer surgery. There's mandated insurance companies have to cover reconstruction after that, right? There's no commiserate mandate that men have to have, that insurance has to cover reconstruction in men after radical prostate or bladder cancer surgery. Right. There is that mandated for women. Well, Senator Murkowski was one of the ones back in the day who drove that forward for women. I am incredibly grateful she did that. Right. You know, again, this is an example of a strong woman who was an advocate for women's health.

1:03:18We need men to be advocates for men's health in Washington, but also out in the community. So, you know, I take my, and I told you this, I take my hat off to Senator Murkowski for standing behind that because it's incredibly important. You know, the effects of radical mastectomy on a woman, right? I don't mean just physical, I mean the emotional and self-perception. We know the effects of a radical prostatectomy or radical systoprostatectomy taking out the bladder and such. For bladder and prostate cancers on men, when you lose your ability to have that penetrative intimacy with the person that you love, when you lose the ability to control your urine flow, when you can't get out in the yard and play with your grandkids because you're in each year.

1:04:00We know the devastating effects. We need a champion and champions to stand up for men's health. Put me in, coach. I love it. I love it. Well, hey, so there's one last segment we always do. And you may actually, we kind of led with it. But there's a, whenever I have a specialist on, that is living the life they should live and the living the life that I think you could, people could learn from. I always ask, you know, what is the one thing that Brian Christine does before he puts on his uniform every day? What is it that makes you you so that you can be as successful and be a champion? What is a must have for you on a daily basis?

1:04:38you know i think so i would say this is i'd say this let's let's say this is going to go in ascending order of importance so not starting with the most important but i do think getting up exercising getting in physical activity during the i like to do it in the morning but getting up exercising uh you know incredibly important that's really important to me to start to do that and then probably on top of the list is to for me to say and i'm not i don't do this every morning. I should, but sometimes I get in a rush, but I try every day just to say to God, I say, listen, thanks for the things that I have.

1:05:12And thanks for the things I don't have to be grateful for where I am because every job has pluses in my, you know, this every job has highs and lows, pluses and minuses. Trust me, there have been times in the last, you know, 10, 11 months that I've been here in Washington when I'm like, you know, this is so hard. What have I done? Right, exactly. You know, I was I had a great surgical practice and I was able to see my grandkids every day and see my wife every day. And, you know, at the end of the evening, kiss her good night and hold her and, you know, go to sleep. I mean, you know, so this is all different now.

1:05:43So every job has pluses and minuses. But I really want to try to be grateful and say thanks for this opportunity and for the things that I don't have, meaning the things that I think that I might think that I want, the grass or greener things. I'm sure there's a reason I don't have them. So I think that's really important for me to do that. Oh, man, I just, yeah, that gave me chills. I think that that's right. You know, and you, I just, you delivered on the mailroom, Jordan. Admiral Christine came in and boy, he opened himself up. Also tell about the great things that are happening in DC. And I'm glad to know you as a friend and as a colleague.

1:06:15And I really appreciate you taking this time to evangelize, to evangelize to the audience about what we're doing. And again, I just can't thank you enough for the time you spent with us. Oh, I really appreciate it. It's a privilege to be on. Again, thanks for this opportunity. It's one of the things that I have. Thank you. Thank you, Jesse. Thank you, Jordan. You know, Jordan, I mean, Jesse, there's certainly some things I'm envisioning. You know, we talked about getting together some expert panels on fertility, a panel on male and a panel on female fertility. I'm envisioning just an expert panel and a roundtable on men's health and why we need an initiative.

1:06:52So I'll be talking to you more about those. Let's do it. I want you to be part of that. I'll keep my calendar open. And you let me know. And my son is actually an attorney working in Ben Klein's office on the Hill. So I'll have a place to crash in D.C. if you need me there. So let me know, Coach. I'll be on a plane. All right. I appreciate you both. Hope you all have a blessed day. All right. Thanks so much, Brian. I'll see you soon. Thank you. All right. Bye-bye, guys. See you. See you.

1:07:51The Mail Room with Dr. Jesse Mills was a production of iHeartRadio. It was executive produced by Jordan Runtog. It was edited, mixed, and mastered by Bahid Frazier. And the theme was provided by Long Transit. If you liked what you heard, please subscribe and leave a review. For more podcasts from iHeartRadio, check out the iHeartRadio app, Apple Podcasts, or wherever you listen to your favorite shows. This program is intended for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Consult your health care provider for any medical or other related questions or concerns.

1:08:31The views and discussions aired on this podcast are those of Dr. Mills and do not represent the official positions of UCLA or UCLA Health.

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