Hegseth mandates testosterone screening for US troops over 30, drawing fire from medical experts

The announcement

Defense Secretary Pete Hegseth unveiled the policy in a video posted to X on Wednesday, accompanied by the text "The High-T Department of War." All service members aged 30 and older will be tested for testosterone deficiency during their annual periodic health assessment. Those under 30 may opt in. If a deficiency is detected, testosterone replacement therapy will be offered on a voluntary basis.

If treatment is recommended, it's entirely your choice to receive testosterone replacement therapy.

Hegseth described the initiative as restoring natural capabilities rather than artificial enhancement. He said it would preserve longevity and ensure troops have the biological foundation to sustain combat. The Pentagon has not clarified whether the therapy will be available to the more than 231,000 women serving in the armed forces, though the memorandum does not explicitly exclude them.

Scientific pushback

Medical specialists quickly challenged the premise. Laurent Vaucher, a urologist at Geneva University Hospitals, told RTS that testosterone levels vary widely among men and that performance depends on cellular and metabolic efficiency, not just hormone concentration.

It's not your testosterone level that determines your performance.

Adrian Dobs, a Johns Hopkins researcher, told Wired she was surprised by the policy. She noted that diagnosing hypogonadism is complex: levels fluctuate with circadian rhythms, the type of assay used, and an individual's recent physical exertion. A soldier returning from basic training, she said, cannot be assessed the same way as a desk worker. Vaucher also warned that testosterone supplementation can reduce sperm quality, potentially causing infertility, and increase blood clotting risk, leading to thrombosis.

Political and cultural context

The screening mandate fits a broader pattern. Hegseth has long advocated a more masculine military, renaming the Defense Department the War Department, mocking overweight generals, and banning beards. He previously argued women should be excluded from combat roles, though he softened that stance during his confirmation hearing. The policy also aligns with Health Secretary Robert F. Kennedy Jr.'s push to make testosterone prescriptions easier to obtain. The FDA proposed rule changes in June to relax restrictions for age-related low testosterone.

He has this masculinist vision of the military, sweating in gyms like him. He wants troops only in his own image.

Testosterone use has surged in the United States, multiplying 13-fold over the past five years according to Vaucher. The Navy SEALs came under scrutiny after a 2022 recruit death revealed widespread use of performance-enhancing substances, prompting the Navy to launch an anti-doping program in 2023.

What happens next

The annual screenings will begin with the next health assessment cycle for personnel 30 and older. Service members found to have low testosterone can choose therapy, but the Pentagon has not detailed how deficiency will be defined or which treatments will be offered. The policy's silence on female troops leaves open questions about its scope. Meanwhile, the FDA's proposed rule changes are still under review, and the broader administration effort to promote testosterone therapy continues to draw both support and criticism from medical professionals.