Defense Secretary Pete Hegseth’s new initiative to screen service members over 30 for low testosterone has sparked plenty of debate about hormones. But the larger issue reaches far beyond one Pentagon policy. The government should not be making sweeping ideological decisions about Americans’ access to healthcare or dictating which medically appropriate treatments deserve public support.Â
The real question isn’t whether testosterone therapy is appropriate for some patients. Clearly, it is. What’s called in to question is our government believing it can decide whose healthcare deserves protection, who becomes a political target and who gets to define what a healthy body looks like.
Announcing the policy, Hegseth insisted, “This initiative … is not about artificial enhancement; it’s about restoring and optimizing your natural capabilities, protecting your longevity, ensuring you have the biological foundation required to sustain and fight.”
The Pentagon says annual testosterone screenings and voluntary hormone replacement therapy will help improve military readiness.
The irony is difficult to ignore. The same administration that has worked to eliminate access to medically recognized gender-affirming care for transgender service members is embracing hormone therapy in alignment with their very narrow definition of masculinity. The treatment isn’t the issue. The difference is the story we tell about the people receiving it.
Medical experts have already cautioned that widespread testosterone screening and hormone therapy is not supported by current evidence. “Testosterone even in low doses increases heart problems, kidney problems, infertility and fractures, which hardly seems like a good way to keep soldiers in fighting form,” Georgetown University pharmacology professor Adriane Fugh-Berman told The Hill. Other physicians have warned that testosterone replacement is an appropriate treatment for clinically diagnosed hypogonadism – not a performance enhancer for otherwise healthy men.
The financial argument is equally revealing. Court records show the Defense Department spends roughly $5.2 million annually on healthcare related to gender dysphoria for transgender service members. By comparison, reporting has found the military spends an estimated $42 million each year on erectile dysfunction medications for active-duty personnel, with costs reaching $84 million annually when the broader military community is included. PBS News found the military spent about $8 million total on transgender-related care between 2016 and 2019 – an amount that represented a tiny fraction of the Defense Health Program’s multi-billion dollar budget.
The debate has become a flash point in the broader conversation about masculinity. Public health researcher Brooke Nickel of the University of Sydney has warned that renewed interest in testosterone “appears to be happening in tandem with mis- and disinformation about masculinity circulating on social media.”
Rep. Becca Balint (D-Vermont) argued the proposal reflects a much deeper cultural obsession. “I think it’s indicative of the fact that there are so many people in this administration that have some weird, like, intense homoerotic feelings towards men while also being incredibly homophobic,” Balint told reporter Scott MacFarlane with MeidasTouch.
“And not just homophobic, but like hate-mongering [and] fear-mongering about the LGBTQ community.” Balint, who is openly gay, added that she does not find the homoeroticism to be “the weird part.” Whether one agrees with Balint’s colorful characterization or not, her comments point toward a larger truth: this debate is less about medicine than it is about masculinity.
The administration isn’t simply proposing a healthcare policy. It’s promoting a particular vision of what service members should be – strong, virile and more traditionally masculine – while rejecting healthcare that affirms gender identities outside that narrow ideal. Whether the issue is testosterone, estrogen or any other medically appropriate treatment, the standard should remain the same: Decisions belong to patients and their healthcare providers, guided by evidence rather than ideology.
This story is brought to you by Rosedale Health and Wellness and Dudley’s Place.
