While Pentagon chief Pete Hegseth faces an impeachment vote in Congress, we're looking back at his controversial plan to test U.S. troops' testosterone levels as a way to "optimize performance" on the battlefield.
In July, a statement released by the Department of War,
formally the Department of Defense, and a video of Hegseth said it will be the choice of service members whether they receive "testosterone replacement therapy." He did not mention female troops.While some commenters celebrated the news and many questioned the switch-up around gender-affirming care, others raised a concern: that increased testosterone levels could impact men's sexual desires and even lead to sexual violence, a long-reported issue in the military. Experts said these
concerns are largely unfounded, but the conversation is highlighting a bigger issue at hand than testosterone deficiency − an obsession with and major misunderstanding about masculinity.
Misconceptions about testosterone
Testosterone, which is a hormone produced in both men and women, plays an important role in maintaining muscle mass, bone density, red blood cell production, energy levels, mood and sexual function.
While bringing testosterone into a mainstream health conversation helps remove stigma around discussing symptoms that many experience, Dr. Arthur Burnett, professor of urology and oncology at the Johns Hopkins University School of Medicine, previously told USA TODAY he is concerned "a program like this could unintentionally reinforce misconceptions about testosterone."
When it comes to treatment, it should be aimed at restoring a true deficiency back to normal, not "enhancing performance or redefining masculinity," Burnett added.
"For men with clinically confirmed testosterone deficiency, testosterone replacement therapy can help restore normal libido, improve erectile function, increase energy and improve overall well-being," Burnett explained. "The goal is to normalize sexual desire in men who have true testosterone deficiency − not to create excessive sexual interest, aggressive behavior or supernormal performance."
Plus, taking testosterone without needing it can be harmful.
"If someone has a normal production of testosterone and is given exogenous (or, external) testosterone, we can shut down the normal endogenous (or, internal) production of testosterone, meaning the patient becomes 'dependent' of external testosterone. This can cause infertility in men," said Dr. Rocio Salas-Whalen, an endocrinologist and obesity specialist.
In his video, Hegseth said the initiative was not about "artificial enhancement," but instead "restoring and optimizing your natural abilities, protecting your longevity and ensuring you have the biological foundation required to sustain the fight."
However, testosterone naturally decreases over time. "That's part of normal biology − not every lower value represents a medical deficiency," Burnett added, noting a lab test showing a low testosterone level is not typically enough to justify treatment.
Instead, testosterone deficiency should be diagnosed through both appropriate laboratory testing and symptom evaluation. Other potential causes of symptoms, such as thyroid disease, sleep apnea, obesity, medication effects or depression, should also be considered and addressed, he said.
The false promise of masculinity
While testosterone deficiency is a real issue for some, Hegseth's testosterone program may be more about the idea of masculinity rather than actually meeting a medical need, suggested Ronald Levant, a professor emeritus of psychology at The University of Akron and co-author of “The Problem with Men: Insights on Overcoming a Traumatic Childhood from a World-Renowned Psychologist."
"Masculinity is essentially a set of social norms that change from generation to generation … any connection to biology is tenuous at best," Levant said.
The idea that being more macho will fix young men's problems is an underlying message of the manosphere, which puts an emphasis on hypermasculinity, Levant explained. Extreme fringes of the manosphere have also praised violent attacks against women. "Looksmaxxers" are another subset of this group, some of whom turn to surgeries and supplements in an effort to achieve financial, romantic and overall happiness.
"They take testosterone and all sorts of other harmful compounds in the belief that it'll make them more attractive," he said, adding they don't tend to consider nuance or evidence-based science. "You're either 'high T' (testosterone) or 'low T;' you're either alpha or beta."
It's a false promise, Levant said, explaining often it's men's emotional issues − not physical ones − that hinder their relationships.
"More emotional self-awareness, emotional intelligence among young men would make a huge difference," he said.
This article originally appeared on USA TODAY: As Pete Hegseth faces impeachment vote, a reminder about that military testosterone plan
