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Actually this foolishness is encouraged by hundreds or perhaps thousands of doctors whose practices include TRT management. With few exceptions, it seems the more a doctor specializes in TRT and grows in clinical experience, the more they are inclined to deviate from physiological ranges in the direction of more.  The examples are too numerous to count, but just a couple off the top of my head: the entire Defy Medical group, madman's urologist, who targets a trough free T of 16-31 ng/dL, and highpull from T-Nation, whose average patient reporting satisfaction with results has a total T of 1029 ng/dL, a trough free T of 29 ng/dL, and an E2 of 57 pg/mL.  I wonder what you make of that and how you are able to integrate that information with your views on the efficacy and tolerability of higher vs lower dosing.

I think boosting a man from hypogonadal to normal physiological range can certainly be beneficial in many cases, enough to support successful clinical trials.  Is it maximally beneficial though, for a maximum number of patients?  They aren't interested in exploring that question.  It is more important to limit side effects and liability from a manufacturer perspective.  You can see that in their dosing guidelines, which completely ignore symptoms and focus exclusively on the numbers:

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