Defense Secretary Pete Hegseth announced a new policy requiring annual testosterone deficiency screenings for U.S. military service members aged 30 and older, with voluntary testing for those under 30. Hegseth stated the program is aimed at helping troops operate at their "absolute best" and that testosterone replacement therapy would be voluntary. This initiative, effective immediately for all active-duty and reserve personnel, will be incorporated into their periodic health assessments.
Medical organizations, including the Endocrine Society and the American Urological Association, have expressed skepticism, citing insufficient evidence to support population-level screening for asymptomatic individuals. They generally recommend against universal testosterone screening, advising testing only for men with troubling symptoms and documented low levels from two separate morning blood tests, due to the hormone's fluctuating nature. Experts like Adrian Dobs from Johns Hopkins University highlighted challenges in interpreting testosterone levels due to daily fluctuations and age variability, warning that universal screening could lead to many false positives, unnecessary confirmatory tests, and potential overtreatment.
The policy faces criticism regarding its logistics and costs. Experts noted the significant expense of performing such tests on all service members and evaluating the causes of low testosterone. There are concerns that giving testosterone without clear medical symptoms can lead to adverse consequences, including a decrease in natural testosterone production and sperm count. Karl Nadolsky, a former military endocrinologist, cautioned that a universal screening program could generate a large number of false-positive results, triggering anxiety and potentially inappropriate treatment.
While some research, like the 2023 TRAVERSE trials, found no meaningful increase in heart attack or stroke over a one-to-four-year period, these trials did show a roughly 50% relative increase in pulmonary embolism and higher rates of bone fractures among men receiving testosterone treatment. Medical professionals largely question whether widespread testing and supplementation will optimize military readiness, with four out of six doctors surveyed finding no solid evidence to support this claim.
