Hegseth Said Warfighter Performance Will Be Optimized
Earlier this year, U.S. Army Spc. Kienone Wilkins, assigned to 3d Cavalry Regiment, 1st Cavalry Division, executed a bench press during a 500 to 1,000-pound competition at Fort Hood, TX. Defense Secretary Pete Hegseth announced last month that the military will begin screening servicemen for low testosterone to make sure their performance is optimized overall. U.S. Army photo by Staff Sgt. Christopher Neu
WASHINGTON, DC — When Secretary of Defense Pete Hegseth announced last month that the military will begin screening male servicemembers for low testosterone, the new policy drew criticism and questions from Democrats. But, the proclamation also fell into line behind a larger effort by current public health officials to loosen rules around testosterone therapy.
Hegseth made the announcement in a video released on X captioned “The High T Department of War.”
“While we invest heavily in our weapon systems, platforms and gear, our most decisive tactical advantage will always be the individual warfighter. We have a sacred duty to maintain that advantage. That is why we must always look for new ways to optimize your performance, your resilience and your long-term health,” he said. “To meet that commitment today, I’m authorizing a new screening program for testosterone deficiency for our servicemen, ensuring you have the right testosterone levels to operate at your absolute best. It’s established science that, as we age, testosterone levels often naturally drop. Under the supervision of our world-class medical professionals, warfighters 30 and older are going to be tested annually as part of their periodic health assessments.”
The screening will be voluntary for servicemembers under 30. Should screenings indicate a low testosterone level, treatment will not be mandatory, Hegseth added.
“It’s entirely your choice to receive testosterone replacement therapy,” he assured servicemembers. “This initiative is not about artificial enhancement. It’s about restoring and optimizing your natural capabilities, protecting your longevity and ensuring you have the biological foundation needed to sustain life.”
The announcement was met with widespread criticism. Some raised concerns because the screening runs counter to most clinical guidelines. (See accompanying article, page xx). Others contrasted the new policy against the Trump administration’s broader efforts to limit the availability of gender-affirming care.
Rep. Pramilla Jayapal (D-WA). decried “the hypocrisy in banning trans servicemembers and then prescribing testosterone for members of the military.”
Jayapal said that the policy would be absurd if it wasn’t also dangerous and set a precedent of “invasive screenings of people to determine what their hormone levels are.”
A number of high-ranking Senate Democrats, including Sen. Richard Blumenthal (D-CT), the ranking member on the VA Committee and Sen. Elizabeth Warren (D-MA), the ranking member on the Armed Services Committee, sent a letter to Hegseth demanding the medical justification for the new policy.
“The department has provided no evidence that this sweeping new policy will improve force readiness or health, nor has it explained the scientific basis, costs, or risks associated with implementing it across the force,” they wrote. “Routine population-wide screening for testosterone deficiency is not recommended by many major medical organizations because the benefits of screening asymptomatic individuals have not been established. Currently, less than six percent of men between 30 and 79 have testosterone deficiency. While testosterone replacement therapy is appropriate for certain patients with clinically confirmed hypogonadism, treatment carries known risks and requires careful diagnosis and long-term medical monitoring.”
The senators noted that, as of 2025, the DoD reaffirmed its long-standing belief that routine screening is not recommended and that testosterone checks should be based on symptoms. They brought up the 2022 death of a Navy SEAL, who was found to be taking several performance enhancing drugs, including testosterone. An investigation into the death shed light on the broader issue of unauthorized use of testosterone among servicemembers.
The lawmakers demanded to know the medical guidance behind the policy change, as well as what quality control measures DoD intends to implement to prevent overdiagnosis, inappropriate treatment, or non-medically indicated requests for testosterone therapy, particularly by younger servicemembers who might be influenced by media and other messaging promoting testosterone.
They also expressed concern that those who decline testosterone therapy will face adverse career consequences.
“How will the department ensure that participation in testing or treatment does not become coercive in practice, particularly in operational units where readiness pressures are high?” they asked.
Even though the history of testosterone therapy has been rocky, broadening the use of testosterone has been a subject of interest for Trump administration health officials. In June of this year, HHS announced that it was requesting FDA remove the limitation of use stating that the safety and effectiveness in men with age-related hypogonadism have not been established, as well as softening warnings around prostate cancer and enlarged prostate risks.
“As our understanding of testosterone therapy continues to evolve, prescribing information should reflect the best available science,” said Brian J. Christine, MD assistant secretary for health. “This action helps ensure patients and healthcare providers have accurate, up-to-date information when considering treatment options.”
Christine, a urologist and four-star admiral in the Public Health Service Commissioned Corps, has been taking the lead at HHS in promoting testosterone therapy, arguing that this expansion will provide much-needed treatment options for men who have low testosterone without a specific known cause.
Of the new DoD screening policy, Christine said in a post on X, “Optimizing testosterone supports strength, endurance, healthy body composition, cognitive performance, mission readiness and overall well-being—ensuring America’s fighting force is prepared to perform at the highest level.”
