Defense Secretary Pete Hegseth has announced a new Pentagon initiative to screen service members for low testosterone and offer hormone replacement therapy, a move that is drawing criticism because it comes after the military eliminated access to gender-affirming hormone care for transgender troops.
Under the new policy, all active-duty service members aged 30 and older will receive annual screenings for testosterone deficiency as part of their routine health assessments. Troops under 30 may request testing voluntarily. Those diagnosed with clinically low testosterone will be eligible for voluntary testosterone replacement therapy (TRT), which Hegseth said is intended to improve readiness, resilience, and long-term health—not artificially enhance performance.
The announcement was accompanied by a video from Hegseth referring to a “High-T Department of War,” reinforcing the administration’s emphasis on traditional concepts of masculinity and combat effectiveness.
Critics, however, argue the policy highlights what they see as a glaring contradiction.
Earlier this year, the Trump administration defended ending military coverage for gender-affirming hormone therapy for transgender service members by arguing in court that the treatment created unnecessary costs and reduced military readiness. That policy followed Executive Order 14183, which effectively barred most transgender people from military service and ended newly initiated gender-affirming hormone treatment through the Department of Defense.
LGBTQ+ advocates say the Pentagon is now embracing hormone therapy when it benefits cisgender men while denying medically necessary hormone treatment to transgender troops who have served honorably.
Medical experts note that testosterone replacement therapy is an established treatment for men with clinically confirmed hypogonadism, but it is not recommended simply to improve athletic performance or increase muscle mass. Professional medical organizations also caution that diagnosing testosterone deficiency requires multiple evaluations rather than a single blood test, and therapy carries potential risks alongside its benefits.
The Pentagon maintains that the new screening program is focused solely on ensuring service members are physically and mentally prepared for military service. Participation in testosterone treatment will remain voluntary for those who qualify medically.
For many transgender veterans and advocates, however, the optics are difficult to ignore. Hormone therapy is being promoted as an investment in readiness for one group of service members while similar hormone-based medical care has been deemed incompatible with military service for another.
The debate underscores the broader political battle over transgender rights in the United States, where access to the same class of medications can be celebrated as essential healthcare in one context and prohibited in another depending on who receives the prescription.
