Defense Secretary Pete Hegseth has unveiled a Pentagon initiative requiring annual testosterone deficiency screenings for U.S. service members aged 30 and older, framing the program as a way to strengthen military readiness. The proposal has immediately drawn criticism from public health experts and Democratic lawmakers, who question both the medical rationale behind broad hormone testing and what they describe as conflicting administration policies on hormone treatments.
Hegseth announced the plan Wednesday in a video posted on X, saying the military must ensure troops are physically and mentally prepared for modern warfare. Under the proposal, annual testosterone screenings would become part of routine medical assessments for personnel aged 30 and above, while younger service members could choose to participate voluntarily.
"As we know, the modern battlefield is brutal and unrelenting," Hegseth said in the video.
He added that troops require "maximum psychological and mental readiness" and said any treatment, including testosterone replacement therapy, would be voluntary and intended to help service members by "restoring and optimising" natural capabilities rather than enhancing performance beyond normal levels.
The announcement quickly ignited debate among physicians and public health researchers, many of whom questioned whether routine testing for an entire age group is supported by current medical evidence.
Eric Feigl-Ding, a public health scientist and epidemiologist who said he previously conducted testosterone research, argued that widespread screening without medical indications could lead to unnecessary testing and treatment.
"I used to do testosterone research," Feigl-Ding wrote on X. "T levels is not associated with higher cognitive function."
He noted that testosterone levels often decline temporarily because of stress, fatigue or intense physical activity-conditions frequently experienced by military personnel-and cautioned that testosterone replacement therapy does not consistently improve physical performance.
"Mixed at best," he wrote.
Feigl-Ding also emphasized that diagnosing hypogonadism, or clinically significant testosterone deficiency, requires more than a single laboratory result. He said physicians generally evaluate symptoms, repeat blood testing and consider alternative explanations before reaching a diagnosis.
Current medical guidelines largely support that approach. The American Urological Association recommends confirming testosterone deficiency through multiple morning blood tests and clinical evaluation before beginning hormone replacement therapy. Experts say treatment decisions should consider symptoms, underlying health conditions and fertility goals, rather than relying solely on hormone levels.
Critics argue the Pentagon has yet to explain how those clinical standards would be incorporated into the new screening program. Feigl-Ding warned that without additional guidance, the initiative could become "very confusing at best, and potentially harmful at worst," particularly if treatment decisions are based primarily on screening results.
The proposal has also triggered political criticism because of the Trump administration's broader position on gender-affirming medical care. Administration officials, including Hegseth, have previously opposed hormone treatments for transgender individuals, describing such care as inappropriate in many circumstances.
Opponents say testosterone replacement therapy is itself a form of hormone treatment, creating what they view as an inconsistency in policy.
"Are we now suddenly paying for gender-affirming hormone treatment that Hegseth tried to ban before?" Feigl-Ding wrote. "This is a real head scratcher."
Democratic Rep. Pramila Jayapal echoed that criticism, writing that the policy "completely debunks" Republican arguments against hormone treatment for transgender patients.
