JAMA study: Hegseth's mandatory testosterone screening could flag up to 25 percent of the Army

Why This Matters

• As many as one in four active-duty Army members could receive a low testosterone result, potentially flooding the military health system with unnecessary evaluations.
• Unnecessary testing and treatment carry real risks, including inaccurate diagnoses and harm such as infertility.
• The screening is a Defense Department policy decision with implications for military readiness, medical resources and service member health.

Background

The screening program stems from a push by Defense Secretary Pete Hegseth for a high-testosterone military. In July he announced mandatory screening, and in September the Defense Health Agency released clinical guidance on testosterone deficiency in male service members. Endocrine specialists have long cautioned against screening asymptomatic men because testosterone levels are highly variable, and a single low reading is often not diagnostic. The new JAMA study appears to illustrate the scale of that problem within the Army.

Key Perspectives

Pentagon: Moving forward with the mandatory screening program, releasing clinical guidance in September, and framing the effort as a matter of military readiness. Medical experts: The Endocrine Society and the American Urological Association recommended against blanket screenings, warning of unnecessary medical evaluations, overtreatment and potential harm. Study authors: The JAMA research suggests the screening could flag up to 25 percent of active-duty Army members, far exceeding the likely true prevalence, and demonstrates why testosterone is not measured in men without symptoms.

What to Watch

• Whether the Pentagon adjusts the screening program in response to the JAMA findings.
• How many service members are actually flagged as the September clinical guidance is implemented.
• Any reports of overtreatment or adverse effects, such as infertility, among service members who receive testosterone therapy.