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Pete Hegseth wants a manly military. And he really, really wants you to know how badly he wants a manly military. In his 2024 book, The War on Warriors, Hegseth worried that the military risked becoming “effeminate, and apologetic”; he insisted that what liberals really want is “soft men, and a weak military,” and he scolded “Pentagon pussies” who refuse to stand up for soldiers on the battlefield. As secretary of defense, Hegseth has blocked the promotion of female military officers, removed the first woman to lead the Navy, and ordered a review of women’s “effectiveness” in ground-combat roles. He has also used the Defense Department’s social-media channels to post a steady stream of tougher-than-thou videos.
The latest entry in this genre came earlier today, when Hegseth announced that he is requiring every service member over 30 to have their testosterone tested annually. He let this be known in a video posted on X captioned “The High-T Department of War.” In the video, he tells soldiers that if they’re found to have low testosterone, they might be recommended testosterone-replacement therapy but that it won’t be mandatory. Then again, given what he then says about testosterone “restoring and optimizing your natural capabilities,” it sure seems like he believes that everyone should partake. How much this new initiative will cost taxpayers, and the question of whether the military health system’s labs even have the capacity for such testing, is unclear. But the bigger question is whether this is in any way a good idea.
At least within the general population, universal testosterone screening for men is not considered standard practice. The Endocrine Society recommends against testing for hypogonadism—the medical term for when the body doesn’t produce enough testosterone or sperm—unless a man has symptoms such as erectile dysfunction. The American Urological Association’s guidelines say that a low-testosterone diagnosis shouldn’t be made based solely on a test. That’s because testosterone levels can vary widely, and a man with a lower-than-average number might still be perfectly healthy. The threshold for diagnosing low testosterone remains a matter of debate even among medical organizations. Many of those who favor testosterone “optimization” argue that the cutoff has been set too low and that even men with hormone levels in the normal range would benefit from replacement therapy. A Department of Defense official declined to say whether it had settled on an acceptable baseline.
In the video, Hegseth notes that testosterone levels go down with age. That’s true of everyone; in men, levels usually start to decline around age 40. But they don’t fall off a cliff: They tend to dip about 1 to 2 percent a year. Other factors, such as maintaining a healthy weight and getting enough sleep, can also play a significant role.
Testosterone therapy is the only treatment Hegseth cites in the announcement video. But even if a man’s testosterone level drops below what’s considered normal, doctors don’t automatically recommend testosterone-replacement therapy. For starters, non-pharmaceutical interventions might work. It’s not obvious that, say, a 33-year-old man with low testosterone levels needs to start getting shots. It might be that he needs to start taking the stairs and going to bed at a reasonable hour. Cutting back on drinking could help too: Excess alcohol consumption is known to lower testosterone.
Testosterone-replacement therapy also comes with real side effects. Hegseth and other proponents of testosterone therapy, including Health and Human Services Secretary Robert F. Kennedy Jr., sometimes talk about the drug like it’s just another supplement. (Kennedy has acknowledged using testosterone himself; the Defense Department official didn’t respond to a question about whether Hegseth, who is 46, takes the steroid.) But taking testosterone is not the same as popping a vitamin for a B12 deficiency. Testosterone therapy suppresses a man’s natural production of the hormone and decreases sperm count. That’s why experts caution against its use by men trying to conceive. In 2023, a large study published in The New England Journal of Medicine alleviated decades-old fears that middle-aged and older men who take testosterone might be at increased risk of having a heart attack. But last year, the Food and Drug Administration added a warning to testosterone’s label noting that it can increase blood pressure.
The new edict doesn’t apply just to men. In response to a question about whether women will have to have their testosterone tested, the DOD official wrote that “everyone over 30 years old will be tested annually.” Although women do produce the hormone, albeit usually in much lower amounts than men, replacement therapy is rarely recommended except in cases of low sexual desire after menopause. (In practice, middle-aged women have recently been flocking to testosterone to alleviate all sorts of symptoms of menopause and perimenopause.) What women are supposed to make of their test results, and what it has to do with turning them into more effective soldiers, is unclear. Hegseth has made a point of emphasizing the differences between the sexes and of questioning the ability of women to serve in combat. But in this instance, he has inexplicably opted for a gender-neutral policy.
Checking the testosterone levels of military members isn’t necessarily going to hurt anyone. But it also isn’t supported by current medical guidelines. Neither, for that matter, was Hegseth’s decision in April to make the annual influenza vaccine optional. (After a flu outbreak at a base in San Antonio, Texas, last month, the military reinstated the mandate for some new recruits.)
Although Hegseth insists in his video that the new order is about keeping soldiers on “the leading edge of lethality,” it’s hard to see how requiring a blood test they probably don’t need contributes to military readiness. Instead, like Hegseth’s chest-thumping workout videos, his fat-shaming of generals, and his denouncement of anything he deems weak or woke, it is an exercise in projecting a masculine image. His announcement comes at a moment when the Iran war is once again heating up, which is certain to put more strain on the military’s already-depleted missile stockpiles. Maybe that’s the number Hegseth should be worried about.
About the Author
Tom BartlettTom Bartlett is a staff writer at The Atlantic.Explore More TopicsPete Hegseth, United States Department of Defense
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