The Pentagon on Wednesday issued clinical guidelines establishing a new mandatory testosterone deficiency screening policy for active-duty and reserve service members ages 30 and older, according to documents obtained by news outlets.
Defense Secretary Pete Hegseth announced in July that he was authorizing the screening program to ensure troops have optimal hormone levels for operational effectiveness. The new guidance is effective immediately.
Under the policy, men ages 30 and older will undergo mandatory testosterone blood tests as part of their routine health assessments. Younger service members will be tested only if requested or if clinicians identify warning signs during examinations.
Service members found to have low testosterone levels may undergo further evaluation and, if clinically appropriate, may be offered voluntary hormone replacement therapy. The guidelines emphasize that treatment remains optional and requires medical justification.
Women will not be required to undergo routine testosterone testing under the new guidance. Instead, female service members will be subject to screening for fatigue and disrupted menstrual cycles associated with hormonal dysregulation and conditions known as low-energy availability and relative energy deficiency in sport.
Testosterone use for non-medical purposes, including performance enhancement without a doctor's prescription, remains prohibited in the military.
What the Right Is Saying
Conservative defense hawks and supporters of the policy have praised the initiative as a commonsense approach to troop welfare and military readiness. They argue that maintaining optimal physical conditioning has always been part of military service requirements.
Defense Secretary Hegseth has framed the program as part of a broader effort to ensure service members remain strong, resilient and capable throughout their careers and after leaving the military. 'Taking care of your long-term health means ensuring you remain strong, resilient and capable — not just for your next deployment, but for the rest of your life,' he said when announcing the initiative.
Republican lawmakers on the House Armed Services Committee have largely supported the policy, with several noting that the Pentagon has historically implemented various health screening programs as part of fitness standards. They argue this is a logical extension of existing practices.
Conservative commentators have argued that critics are overstating concerns about government overreach in what they characterize as a voluntary treatment program focused on medical care rather than punitive measures against service members.
What the Left Is Saying
Democratic lawmakers and progressive advocacy groups have expressed concerns about the policy, raising questions about government intrusion into personal medical decisions. Some have noted that while troop health is important, mandatory hormone screening raises ethical considerations about bodily autonomy within the military context.
Rep. Seth Moulton, D-Mass., a Marine veteran who has publicly discussed his own experiences with testosterone levels during service, said in a statement that he supports exploring all avenues to optimize troop readiness but urged caution about implementing broad screening without robust medical evidence supporting its effectiveness for operational performance.
Progressive health policy advocates have argued that the science around universal low-testosterone screening remains contested. The Endocrine Society has previously noted that there is insufficient evidence to support population-wide screening for testosterone deficiency in asymptomatic individuals, raising questions about whether this approach meets established medical standards.
Some Democratic members of the House Armed Services Committee have requested a briefing from Pentagon officials on the evidentiary basis for the policy and its projected costs to taxpayers.
What the Numbers Show
Testosterone levels naturally increase during puberty and typically begin declining between ages 30 and 40, according to the Mayo Clinic. The average annual decline is approximately 1% to 2% per year after age 30.
The Endocrine Society's clinical guidelines note that testosterone deficiency affects an estimated 2% to 6% of men, with prevalence increasing with age. However, the society states there is insufficient evidence to recommend population-wide screening in asymptomatic patients.
Military fitness standards already include body composition and physical fitness assessments. The Army recently unveiled a new combat fitness test designed to better simulate battlefield conditions.
The Pentagon has stated that standardized screening and treatment pathways for men and women seek to boost military readiness by identifying and managing hormonal and energy-availability issues before they impact operational capability.
The Food and Drug Administration intends to hold a meeting later this month with experts to discuss the medical use of testosterone, which may provide additional regulatory guidance on hormone replacement therapy protocols.
The Bottom Line
The Pentagon's new mandatory testosterone screening policy represents one of the most significant changes to military health assessments in recent years. While supporters argue it addresses an overlooked aspect of troop wellness, critics question whether the scientific evidence supports universal screening for a condition that often presents without clear symptoms.
Service members will begin undergoing tests under the new guidelines immediately. Those found to have clinically low testosterone levels may elect to pursue hormone replacement therapy on a voluntary basis, though such treatment requires medical justification and ongoing monitoring.
The policy is likely to face continued congressional scrutiny. Democratic lawmakers have requested additional briefings on the evidentiary foundation for the screening mandate and its projected implementation costs. The FDA's upcoming expert meeting on testosterone use could also influence how treatment protocols are ultimately structured within the military health system.
Medical experts will be watching closely to see whether widespread testing leads to increased hormone therapy prescribing rates, which could raise questions about overdiagnosis and overtreatment in an otherwise healthy population.