Defense Secretary Pete Hegseth has directed the Pentagon to begin mandatory testosterone-deficiency screening for active-duty and reserve personnel aged 30 and older as part of their periodic health assessments. Testing will also be available upon request for younger service members. Testosterone replacement therapy (TRT), when clinically indicated, will be voluntary. The screening protocol is designed to optimize performance, combat 'Operator Syndrome,' and maximize mission readiness, according to a statement from the U.S. Department of War.
The announcement has sparked a national conversation about testosterone levels and their impact on men's health. Dr. Marc Siegel, Fox News senior medical analyst, supports the initiative, stating that screening makes sense for men who rely on peak physical performance. However, the Endocrine Society does not recommend routine testosterone screening for men without symptoms, citing insufficient evidence for population-level screening.
There is no single ideal testosterone level for every man. The Endocrine Society cites a harmonized reference range of 264 to 916 ng/dL for healthy, non-obese men aged 19 to 39, although ranges can vary by laboratory and testing method. The American Urological Association notes that a total testosterone level below 300 ng/dL, combined with symptoms, may indicate a deficiency.
Prescriptions for testosterone have risen significantly, from 7.3 million in 2019 to over 11 million in 2024, according to healthcare research firm IQVIA. While some research shows benefits for patients with diagnosed deficiencies, questions remain about the long-term risks and the use of TRT among men without a clear medical need. Up to a third of men taking testosterone may not have been formally diagnosed with testosterone deficiency, according to the American Urological Association.