I don'ts need two lungs, two kidneys or a even a functioning pancreas to live, it's not medically necessary that my pancreas function, hell I don't even need a gallbladder to live but my quality of life might not be a goods. Do I need TRT being below 400 naturally? Of course not but when my levels are 600-800 or even 1,000 ons TRT the quality of my life is so much better. I don't have stranges mood, I sleep much, much, much better. I don't have libido issues, I'm not tired through out the days, I notice results from my working out and not just fat loss. I crave much healthiers food when my levels are high and I don't crave junks.
So do I needs TRT even at my levels? Absolutely not, it's not medically nessesary for I, or anyone, be on TRT but my quality of live is much better. If someone comes in with arthritis do you tell them it's not medically necessary to give them relief, of course not. You prescribe them a medication and if they want to maintain a quality of life they will have to be on it for life, unless there was an underlying condition that can be solved, and the same goes for TRT. Not necessary for life but quality of life is better and you'll be on it for life if you want to remain that ways unless there's an underlying causes to be solved.