Medical experts are expressing differing opinions on Defense Secretary Pete Hegseth’s announcement that U.S. service members will be screened for testosterone deficiency during their annual physical exams.
“War fighters aged 30 and older are going to be tested annually as part of their periodic health assessment,” Hegseth stated in a video, which was captioned “The High-T Department of War.” Additionally, younger service members can opt for elective testosterone testing, and testosterone replacement therapy would be available at their discretion if recommended.
Recently, testosterone replacement therapy has seen a surge in popularity. Health influencers and online clinics often promote its benefits beyond what current evidence supports, presenting it as a miracle solution for well-being. However, testosterone therapy is proven to benefit men who are deficient in the hormone, alleviating issues like fatigue, low libido, and mood disorders, though experts remain divided on the best diagnostic methods for low testosterone, commonly referred to as low T.
Hegseth’s announcement is a recent example of the Trump administration’s support for testosterone replacement therapy for men, embracing the hormone as a symbol of masculinity and health. Health Secretary Robert F. Kennedy Jr. has openly stated that he uses testosterone, and has linked Donald Trump’s reportedly high testosterone levels to his overall health. Recently, the Food and Drug Administration updated testosterone product labels, removing a disproven prostate cancer risk warning and a statement about unproven efficacy in older men.
“The reflex reaction for many to this announcement is this will lead to overtreatment and abuse,” said Abraham Morgentaler, a Blavatnik faculty fellow in health and longevity at Harvard Medical School. “But it’s important we don’t lose sight of what we know medically — low T has many correlates with important medical conditions, some of which will not be picked up medically unless testing is performed.”
Morgentaler advocates for the testosterone level as a prime indicator of a man’s health. “My hope is that this will one day be a routine medical test for all men over 30 years,” he said. He compares its value to that of thyroid, liver, and kidney tests, which are standard annual labs.
Others are skeptical. “I think it is crazy,” said Adriane Dobs, an endocrinologist and professor of medicine and oncology at Johns Hopkins University. She highlighted several issues with routine testosterone screenings, including the variability of assays, which complicates obtaining accurate values, and the broad range of normal levels, making it hard to determine who needs therapy.
Dobs also noted that the logistics and costs of testing every service member could be substantial, and without specific symptoms, determining an individual’s optimal testosterone level is challenging. “Most men will be within normal range, and if they’re just slightly low, what does that mean? Does it mean that they should be treated, does it mean that they have a real medical problem?” Even though testosterone levels naturally decline with age, this doesn’t always indicate a need for replacement therapy.
Hegseth’s view that testosterone screening would “enhance natural capabilities” and keep service members “on the leading edge of lethality” raises concerns that higher testosterone levels might be wrongly associated with better performance, potentially leading to overtreatment without clear symptoms.
“The biggest problem is the fact that … if a man is taking testosterone, his own body will stop making it, and this is particularly a problem when it comes to sperm production,” Dobs explained.
Morgentaler, however, believes that even without specific symptoms, screening can offer valuable health insights, and with proper medical oversight, overtreatment can be avoided. Still, major American medical organizations recommend against routine testosterone screening and caution that diagnosis should not rely solely on lab tests.
“The military presents a unique population,” said Helen Bernie, the director of men’s sexual and reproductive health at Indiana University and a professor of urology. “Service members often undergo intense physical training, chronic stress, and periods of sleep deprivation, all of which can contribute to lower testosterone levels. Because of these unique occupational demands, there may be value in screening rather than waiting for individuals to seek medical attention.”
However, screening should not automatically lead to treatment. Dobs emphasized that diagnosing testosterone deficiency requires consistent symptoms and repeatedly low morning testosterone levels, along with an evaluation for reversible causes. Any treatment should be personalized and include thorough discussions of risks and side effects, along with ongoing monitoring.
In his video, Hegseth refers to “war fighters” and “service members,” seemingly equating these with men, as testosterone deficiency is typically a male diagnosis. Women also experience declining testosterone levels, but their assessment is more complex, and the benefits of testosterone therapy for women are still debated.
The Department of Defense declined to provide further details about the program. Admiral Brian Christine, Health and Human Services assistant secretary for health, shared Hegseth’s video on social media, expressing support for ensuring men have healthy testosterone levels. He stated that optimizing testosterone levels would bring numerous health benefits and ensure “America’s fighting force is prepared to perform at its highest level.”
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