The Pentagon will begin annually testing service members 30 and over for testosterone deficiencies, Defense Secretary Pete Hegseth announced Tuesday.
Hegseth said in a video posted to social media that the new screening would become part of the Defense Department’s periodic health assessment for military personnel. The health exam has been mandatory since 2016 and is used to measure medical condition, behavioral health, mental health and readiness to deploy.
Service members who are recommended for treatment will have the choice to receive testosterone replacement therapy, Hegseth said. Personnel under 30 can volunteer for an examination.
Hegseth’s post referred to “High-T,” a social media fad pushed by influencers that encourages men to seek higher levels of testosterone to maintain their strength and masculinity. Discussions around masculinity have seeped into culture wars and national politics. In May, James Talarico, the Democratic nominee for Senate in Texas, defended his masculinity after personal attacks from conservatives about his physical appearance.
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“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,” Hegseth said in the video. “We owe our warriors the absolute best medical care in the world, and this program delivers on that obligation.”
Testosterone levels in males decline about 1% a year after the age of 30 or 40, according to the Mayo Clinic. It is considered a typical sign of aging.
The U.S. Food and Drug Administration does not approve testosterone replacement therapy for males without specific forms of hypogonadism, a medical condition associated with a malfunction of the organs that produce testosterone. Testosterone replacement therapy consists of injections, pellets, patches or gels that release hormones into the body.
Some medical groups, such as the Endocrine Society and the American Urological Association “recommend against routine screening” for hypogonadism in the general male population, according to Helen Bernie, a urologist and director of male sexual and reproductive medicine at Indiana University.
Bernie said testing could still be valuable in some military populations with symptoms or certain risk factors, but warned that a single low testosterone result should not lead directly to a diagnosis or treatment. Instead, testosterone levels should be measured twice in the early morning and considered alongside symptoms and possible underlying causes.
“Screening should open the door to a thoughtful medical evaluation, not automatically to a prescription,” Bernie told NOTUS.
Sleep deprivation, intense physical training, weight changes, illness and certain medications can temporarily lower testosterone, Bernie said. Doctors should evaluate those factors before determining that a service member has a testosterone deficiency.
Bernie said testosterone therapy is generally safe for appropriately selected and monitored patients, but it can “impair their sperm production or impair their fertility,” especially in young men.
She said service members should be counseled about fertility and other risks before beginning therapy and monitored throughout treatment.
“If the Pentagon moves forward with a screening program, I do think it’s important that there’s clear evidence-based guidelines in place so that every service member is evaluated consistently and safely.”
“The goal should be appropriate diagnosis, appropriate treatment, not simply increasing the number of men receiving testosterone,” she said.
The Defense Department declined to comment further on Hegseth’s video. It did not answer questions regarding the FDA’s guidance on testosterone replacement therapy.
The FDA did not immediately respond to requests for comment.
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