The Pentagon has announced that new clinical guidance will be released establishing mandatory testosterone deficiency screening for active-duty and reserve cisgender male service members ages 30 and older, advancing a policy that expands hormone-related care for cisgender troops.
The Defense Department said the existing clinical guidelines, which are not currently available on the Defense Health Agency’s website, are being updated and that the final guidance will be issued shortly.
The announcement comes amid a wave of anti-transgender policies from both the DoD and the Trump-Vance administration, which continue to prohibit trans men from receiving the same treatment.
Under the forthcoming guidance, men ages 30 and older will be forced to undergo testosterone blood tests as part of their medical care. Younger male service members will be tested if they request screening or if clinicians identify warning signs of low testosterone.
The new guidelines formalize a screening program Defense Secretary Pete Hegseth announced in July, when he said the Pentagon would begin testing service members to ensure that “you have the right testosterone levels to operate at your absolute best.”
“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, so you can thrive long after you take off the uniform,” Hegseth said at the time.
The Defense Health Agency’s clinical guidance says the program is intended to address “hormonal and energy-availability issues.” Hegseth said in July that testosterone replacement therapy would remain voluntary for service members if treatment is recommended.
The Food and Drug Administration is also scheduled to hold a meeting later this month with experts to discuss the medical use of testosterone.
The Pentagon’s push to routinely test testosterone levels runs counter to current medical guidance, which generally recommends considering testosterone therapy only for men who have symptoms consistent with low testosterone and have documented low hormone levels on two separate blood tests.
Testosterone is a sex hormone naturally produced by people of all sexes. It plays a role in regulating muscle mass, bone density, and sex drive. Testosterone levels in men naturally decline with age and have been associated with symptoms including erectile dysfunction, low libido, mood changes and weight gain, although experts continue to debate when testosterone therapy is medically appropriate.
The policy has drawn scrutiny from LGBTQ advocates because the Pentagon and Hegseth have simultaneously cited hormone therapy as part of the rationale for removing trans service members from the military.
Under President Donald Trump’s 2025 executive order, “Prioritizing Military Excellence and Readiness,” the military has moved to bar trans people diagnosed with gender dysphoria from serving and has begun formal administrative separation proceedings against trans personnel.
The Pentagon continues to pursue implementation of the trans military ban as litigation over the policy proceeds. As a result, some trans service members have had their gender-affirming hormone therapy halted even as the Pentagon expands testosterone screening and potential treatment for cisgender service members.
SPARTA Pride, a nonpartisan nonprofit organization made up of trans service members, veterans and their allies, criticized the disparity to the Washington Blade when Hegseth first announced the screening program.
“If hormone therapy helps warfighters perform at their best, then it cannot simultaneously be used as evidence that transgender service members are unfit to serve,” said Kara Corcoran, executive director of SPARTA Pride. “The same class of evidence-based medical treatment cannot be characterized as readiness-enhancing for one group and readiness-destroying for another.”
On June 1, the U.S. Court of Appeals for the D.C. Circuit ruled that trans service members already serving in the military could continue to do so while allowing the armed services to continue refusing to enlist new trans recruits.
The Blade reached out to the Pentagon when the testosterone screening program was first announced in July, asking why cisgender service members could receive testosterone therapy while transgender service members could not. The Pentagon did not respond.
