Defense Secretary Pete Hegseth ordered mandatory annual testosterone screening for all service members 30 and older, a readiness initiative that has drawn fire from medical experts who question the science and from Democrats who call it contradictory.
Hegseth announced the program, dubbed "High-T," in a video message on July 15, directing the Pentagon to fold testosterone-level checks into the periodic health assessments already required of active-duty and reserve troops. Service members under 30 can volunteer for the test. Anyone diagnosed with low levels will have the option, not the obligation, to receive testosterone replacement therapy, The Hill reported.
The policy affects roughly two million service members and arrives without a public cost estimate. The Department of Defense has not cited any specific research or academic studies behind the decision, and it has not explained how it will measure whether the program actually improves military readiness.
In his video announcement, Hegseth tied the initiative to the physical demands of modern combat and to the well-documented decline in testosterone that accompanies aging. He cast the screening as a health obligation, not a performance-enhancement shortcut.
"The modern battlefield is brutal and unrelenting. It requires and demands maximum psychological and mental readiness, and by addressing these health markers early, we're keeping you on the leading edge of lethality."
He went further, drawing a line between what the program does and what critics might assume it does:
"This initiative, it's not about artificial enhancement. It's about restoring and optimizing your natural capabilities, protecting your longevity, and ensuring you have the biological foundation required to sustain the fight."
The screening is part of a broader fitness overhaul Hegseth has imposed since taking over the Pentagon. He has already rolled out sweeping personnel changes and tightened physical standards across the services, requiring every service member to meet what the department describes as a single "male standard."
The initiative puts the Pentagon at odds with the medical establishment's consensus on testosterone testing. The Endocrine Society advises against routine screening for low testosterone in men who show no symptoms. The FDA has for decades recommended testosterone be prescribed only to men with medical conditions that directly impair testosterone production, not as a blanket treatment for age-related decline.
Derek Griffith, who directs the program for research on men's health at the University of Pennsylvania, told The Hill that only about two percent of the male population suffers from clinically low testosterone. He questioned why the Pentagon would prioritize a condition that rarely affects healthy, physically active men.
"I imagine for most active-duty military, they're pretty much at a healthy weight. So I would be curious what percentage they're expecting to identify who have low testosterone and would be in need of a treatment."
Griffith added bluntly that he does not "fully understand" the new guidelines and has not seen the data the Defense Department used to justify them. "It's not what's usually a major issue for healthy men," he said.
Joel Heidelbaugh, a clinical professor of urology at the University of Michigan, flagged a different problem: the risk of overdiagnosis. Normal testosterone levels in men range from 300 to 1,000 nanograms per deciliter, and levels fluctuate throughout the day, spiking in the morning and dropping later. Screening an entire population without requiring symptoms first, Heidelbaugh said, "is probably a little bit aggressive."
A separate concern emerged from Just The News, which reported that the Hegseth memo uses a threshold of 400 nanograms per deciliter to define "low" testosterone, significantly higher than the 250-to-270 range used in standard clinical practice. That gap means far more troops would be classified as deficient under the Pentagon's standard than under a civilian doctor's.
Adriane Fugh-Berman, a professor of pharmacology and physiology at Georgetown University, warned that the therapy the Pentagon is offering carries documented risks that cut directly against the program's stated purpose.
"Testosterone even in low doses increases heart problems, kidney problems, infertility and fractures, which hardly seems like a good way to keep soldiers in fighting form."
Fugh-Berman also challenged Hegseth's suggestion that testosterone supports longevity, saying there is "no evidence for that." She called the entire screening effort misguided: "It's ridiculous to screen a population for a questionable condition which has a treatment with unproven benefits and proven risk."
Griffith raised the fertility question specifically. TRT can suppress sperm production, a side effect that could matter to younger service members planning families. For troops in their thirties, that trade-off is not trivial.
University of Michigan endocrinologist Dr. Richard Auchus was more direct. "I fail to see how they'll be a better fighting force," he told the Washington Examiner. Dr. Chris Frueh, a psychologist who coined the term "Operator Syndrome" to describe the cumulative physical toll on special operators, cautioned that the program should not become a vehicle for handing out testosterone "like M&Ms to soldiers."
Brooke Nickel, a public health researcher at the University of Sydney, warned that the Pentagon's move tracks with a broader cultural trend she considers harmful. "Young, healthy men are being told that common experiences like tiredness, stress or changes in libido are signs that something is medically wrong and that testosterone is the solution," Nickel said. She added that there is "little science" supporting routine annual screening for men over 30.
Congressional Democrats moved quickly to attack the initiative, though not all of their criticisms stayed on medical ground. Sen. Tammy Duckworth, an Iraq War veteran who lost both legs in combat, compared the testosterone program to gender-affirming care, a pointed jab given the administration's opposition to such treatments for transgender service members. "Like gender-affirming care to me," Duckworth said, AP News reported.
Rep. Pramila Jayapal of Washington State made a similar argument. "This, by the way, is gender-affirming care," Jayapal said. Rep. Chrissy Houlahan, a Pennsylvania Democrat and Air Force veteran, said the policy "proves that Secretary Hegseth takes direction from the far corners of the manosphere."
Rep. Becca Balint, a Vermont Democrat, went furthest. She told a reporter that Hegseth's testosterone focus "is indicative of the fact that there are so many people in this administration that have some weird, like, intense homoerotic feelings towards men while also being incredibly homophobic." Balint, who is openly gay, added: "The weird part is that they pretend that that's not what it's about."
Those comments say more about the state of Democratic messaging than about the merits of the policy. Voters asked whether the Pentagon should screen troops for a hormone deficiency are unlikely to find the answer in accusations about homoeroticism. The legitimate medical questions, about overdiagnosis, side effects, cost, and whether the program will actually improve readiness, deserve a serious debate. Balint's remarks do not advance one.
Several practical details remain unresolved. The Pentagon has not said what specific testosterone threshold will trigger a TRT recommendation, though the July 15 memo reportedly uses 400 nanograms per deciliter, well above standard clinical cutoffs. The department has not published a cost estimate for screening roughly two million service members annually, nor has it explained who within the military health system will administer or oversee the therapy.
One question carries particular weight for troops on the ground: Hegseth's new fitness standards require every service member to meet a single, more demanding physical benchmark. Whether a service member who fails that benchmark and is subsequently found to have low testosterone can receive TRT and retest remains unclear.
The initiative also fits a pattern beyond the Pentagon. HHS Secretary Robert F. Kennedy Jr. has publicly extolled testosterone replacement therapy as part of his personal "anti-aging protocol" and has called the slow global decline in testosterone levels over recent decades an "existential" threat to humanity. Kennedy has made his own physical fitness a public performance, including a February video in which he rode an exercise bike in a sauna alongside musician Kid Rock. The New York Post noted that military erectile-dysfunction prescriptions hit a record 108,332 in 2025 for active troops, a data point that may have contributed to the administration's focus on hormonal health.
Hegseth has not been shy about challenging institutional norms at the Pentagon. He has publicly broken with senior officials who resisted his direction, imposed new fitness requirements that upend decades of gender-differentiated standards, and drawn sustained scrutiny from both the press and Congress.
A federal judge recently blocked one of his Pentagon policies, and lawmakers from both parties have pressed him in contentious hearings on everything from war costs to funding priorities.
The testosterone program is the latest entry in that pattern. Whether it produces fitter, more lethal troops or just more paperwork and more prescriptions will depend on details the Pentagon has not yet provided.
Hegseth's instinct, that the military should care about the physical foundations of the men and women it sends into combat, is sound. But good instincts do not excuse sloppy execution, and a screening program built on thresholds higher than clinical norms, offered without a cost estimate, and launched without the research to back it up is asking troops to trust the Pentagon's judgment on the same kind of question the Pentagon has not yet answered for itself.