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The Pentagon testosterone plan creates an enforcement problem that military leaders have not explained how they will resolve. Testosterone can be a legitimate prescription treatment for a service member with a diagnosed medical condition, but it can also be used without authorization to increase muscle, accelerate recovery, and gain a physical advantage.

The difference does not rest on the substance alone. Diagnosis, dosage, medical supervision, laboratory results, and the purpose of treatment all help determine whether testosterone is medicine or a performance-enhancing drug.

USA Herald previously reported that troops aged 30 and older will undergo annual testosterone screening, while younger service members may volunteer. Any resulting hormone treatment would remain optional, but the Pentagon testosterone plan leaves a separate question unresolved: How will the department expand access while military commands continue testing troops for unauthorized testosterone use?

Pentagon Testosterone Plan Meets Existing PED Rules

The Pentagon testosterone plan is intended to “restore and optimize” troops’ natural hormonal capabilities, according to Hegseth. He also insists that the initiative is not intended to provide artificial enhancement, yet military drug policy already recognizes that testosterone can cross from legitimate treatment into prohibited performance enhancement.

Troops may receive prescription medication for a diagnosed condition, but they may not use steroids, testosterone-related substances, human growth hormone, or selective androgen receptor modulators without proper authorization. That distinction is clearest within Naval Special Warfare, where the Navy has spent several years expanding performance-enhancing drug testing.

The command introduced random, force-wide testing in 2023 to identify unauthorized PED use among SEALs, Special Warfare Combat Crewmen, candidates, and other personnel. Naval Special Warfare described the program as necessary to protect health, safety, discipline, and operational readiness while acknowledging that some personnel may have legitimate conditions requiring prescription treatment.

Its policy targeted unauthorized and unsupervised use, not properly diagnosed and monitored care. The Pentagon testosterone plan could significantly increase the number of service members evaluated for prescriptions, making the boundary between approved treatment and prohibited enhancement more important than ever.

SEAL Training Death Prompted Expanded Testing

The Navy’s PED crackdown followed investigations connected to the 2022 death of SEAL candidate Kyle Mullen. Mullen died from acute pneumonia after completing the grueling Hell Week portion of Basic Underwater Demolition/SEAL training.

A Navy investigation did not determine that performance-enhancing drugs caused his death, but vials and syringes were found in his vehicle. The broader investigation identified PED use as a significant concern within the training environment and exposed the difficulty of identifying hormone misuse through ordinary military drug testing.

Naval Special Warfare began random testing across the force after obtaining Pentagon authorization. Four units were to be selected each month, with approximately 15% of their personnel tested, and positive findings could lead to preliminary inquiries, removal from training or assignments, and disciplinary action when a service member lacked a lawful medical explanation.

The program has continued to expand. Naval Special Warfare said in May 2025 that it had tested more than 20,000 samples for over 150 prohibited substances while giving medical personnel greater visibility into sailors’ prescriptions and the possible effects of those medications on training and operations.

The command framed PED prevention as part of maintaining lethality and warfighter readiness. Those are nearly the same readiness goals Hegseth is now using to promote testosterone screening and possible treatment.

Elevated Testosterone Does Not Prove Doping

The Navy’s early screening results show why hormone testing is more complicated than identifying a high or low number. Between February 2022 and March 2023, the Naval Special Warfare Center conducted more than 2,500 screening tests among SEAL and Special Warfare Combat Crewman candidates.

Seventy-four candidates showed elevated testosterone levels, but only three ultimately tested positive for performance-enhancing drugs. The elevated screenings were less precise than the follow-up testing required to identify an anabolic substance, and a high hormone level alone could not establish whether someone had used a prohibited drug.

The Pentagon testosterone plan approaches the issue from the opposite direction by searching for hormone levels considered too low. The same principle still applies because a single laboratory result does not establish why a hormone level is outside a reference range or whether medication is appropriate.

Testosterone levels can be affected by the time of testing, sleep, illness, weight, medication, nutrition, stress, and other health conditions. They may also vary from one day to another, meaning military physicians will need more than a numerical cutoff before recommending treatment.

Without that evaluation, routine screening could move troops toward prescriptions without establishing that they have a persistent medical deficiency. It could also complicate future drug testing if medical providers and command authorities apply different standards to the same service member.

A Low Result Is Not a Diagnosis

The Endocrine Society recommends diagnosing hypogonadism only when a patient has symptoms associated with testosterone deficiency and consistently low hormone levels. Its guidance calls for an initial fasting morning measurement followed by a second morning test to confirm the result.

Providers should then investigate whether the deficiency originates in the testicles, pituitary gland, hypothalamus, medication use, or another medical cause. Those steps matter because testosterone therapy is not risk-free, and providers must consider fertility plans, elevated red-blood-cell levels, untreated severe sleep apnea, prostate concerns, recent cardiovascular events, and other conditions before recommending treatment.

The military may establish screening rules that differ from civilian population guidance. Troops face occupational demands, deployment requirements, irregular sleep, physical stress, and environmental exposures that may justify specialized medical standards.

However, the Pentagon has not released the diagnostic rules that will govern the Pentagon testosterone plan. It has not said whether an abnormal result must be confirmed, whether symptoms are required, or whether specialist evaluation will occur before treatment is offered.

Those unanswered questions affect more than medical care because they will also determine whether a testosterone prescription remains clearly distinguishable from performance enhancement. A program built around treatment must define the medical condition being treated before it begins prescribing the hormone.

Pentagon Testosterone Plan Blurs Treatment Standards

Treating a documented deficiency is not the same as raising a healthy service member’s testosterone to improve strength, recovery, or physical performance. Hegseth’s use of the word “optimize” blurs that distinction because optimization can mean restoring a deficient service member to a normal physiological range or moving a healthy person toward a higher preferred level.

The Pentagon has not defined which meaning of “optimization” will govern the Pentagon testosterone plan. That matters because FDA-approved testosterone products remain tied to low hormone levels associated with a medical condition, not general strength, readiness, anti-aging, or performance goals.

The FDA has reconsidered portions of testosterone labeling and encouraged manufacturers to study possible new uses. Even with those changes, current product labeling warns against using testosterone for athletic enhancement, and higher-than-recommended doses or combinations with other anabolic substances can lead to abuse and serious health consequences.

The military must decide whether Hegseth’s program is designed to diagnose disease or enhance performance. Describing the goal as both medical treatment and warfighter optimization leaves too much room between those two standards.

That ambiguity also creates enforcement risk. A troop who receives a prescription to correct a deficiency is not in the same position as someone seeking higher hormone levels to improve physical output, but the Pentagon has not explained how military doctors will distinguish the two when results fall near the edge of a laboratory range.

Prescriptions Could Complicate PED Enforcement

Naval Special Warfare’s current policy protects personnel who receive legitimate treatment through military medical channels. The Pentagon testosterone plan could make that verification process more complicated as more service members enter treatment and more prescriptions become relevant during PED investigations.

A valid prescription should explain why a service member has testosterone or related metabolites in a test result. It should not automatically excuse taking more than prescribed, obtaining additional testosterone outside the military health system, sharing medication, or combining treatment with prohibited substances.

Military officials will need procedures for determining whether a service member followed the prescribed dosage and treatment plan. They will also need to address prescriptions obtained from civilian clinics, including direct-to-consumer hormone clinics and telehealth providers that may use diagnostic and treatment standards different from those used by military physicians.

The Pentagon must decide whether civilian testosterone prescriptions will be accepted automatically, reviewed by military medical personnel, or restricted when they conflict with deployment or readiness standards. That policy cannot be left to individual commands or installations because inconsistent rules could create disciplinary and career consequences for troops receiving similar treatment.

Disagreements could become serious. A service member accused of unauthorized PED use may face removal from training, loss of an elite assignment, disciplinary proceedings, or separation from service.

The military therefore needs a clear review process for cases in which a medical provider authorizes treatment but a command or drug-testing authority questions the dosage, source, or purpose. Without that process, service members could be caught between the military’s medical and disciplinary systems.

Medical Privacy and Command Access Need Rules

The Pentagon testosterone plan may also create tension between medical privacy and command responsibility. Military commanders do not receive unrestricted access to every detail in a service member’s medical record, but protected health information may be disclosed for fitness-for-duty, assignment, and mission-related determinations.

Testosterone prescriptions could raise questions in each of those areas. The Pentagon must determine whether low testosterone will become a reportable readiness concern, whether treatment will create temporary duty restrictions, and what information commanders will receive about prescriptions.

The department must also explain how PED-testing authorities will verify legitimate treatment without disclosing more medical information than necessary. A poorly defined system could create opposite problems, with excessive disclosure discouraging troops from seeking legitimate care while insufficient coordination makes it harder to identify prescription misuse.

Uniform rules are necessary to protect medical privacy and the integrity of military drug enforcement. Troops should know what information remains confidential, what information may be shared with commanders, and how that information could affect assignments or deployability.

Voluntary Treatment Can Still Create Pressure

Hegseth has emphasized that testosterone replacement therapy will remain voluntary. That protection matters, but voluntary treatment can still create pressure in highly competitive military environments where service members compete for promotions, schools, special operations assignments, flight status, physically demanding jobs, and leadership positions.

Many of those opportunities depend partly on strength, endurance, recovery, and performance under stress. Troops may feel compelled to pursue treatment if they believe testosterone will help them keep pace with peers, recover more quickly, or remain competitive as they age.

That pressure could become especially strong if commanders begin describing hormone levels as a marker of lethality or combat readiness. A medical option can become functionally coercive when service members believe declining it could place them at a disadvantage.

The Pentagon should make clear that declining treatment will not damage a service member’s career when the individual otherwise meets medical and performance standards. It must also prevent the program from creating an unofficial expectation that older troops should pursue hormone therapy to remain competitive.

Without those protections, a technically voluntary program could become a new standard troops feel compelled to follow. The military would then be using medical treatment to shape competition inside the force while continuing to punish unauthorized hormone use outside the system.

Pentagon Testosterone Plan Needs One Standard

The military cannot allow each service, installation, or clinic to create its own definition of testosterone deficiency and optimization. Uniform standards should establish when testing occurs, what reference ranges apply, when results must be repeated, and which symptoms or diagnoses justify treatment.

The policy should also specify permissible dosage ranges, required monitoring, procedures for civilian prescriptions, and the point at which treatment becomes unauthorized enhancement. Those rules must align with the military’s existing PED enforcement system so medical and disciplinary standards do not conflict.

A service member receiving treatment at one installation should not face suspicion or disciplinary risk after transferring to another. Likewise, a prescription should not become a shield for hormone use that exceeds the medical purpose for which it was issued.

The Pentagon also needs a transparent appeal or review process for disputed test results. Decisions involving medical care, drug enforcement, and military careers should not depend on informal interpretations that vary from one command to another.

A uniform standard would protect service members while giving commanders and medical providers a shared framework. Without one, the department risks creating different definitions of acceptable testosterone use across the force.

The Pentagon Must Draw the Line

The Pentagon testosterone plan could identify troops with genuine medical conditions and connect them with appropriate care. Untreated hormone disorders can affect health, sexual function, bone strength, mood, body composition, and quality of life.

The policy could also bring more medical oversight to service members who might otherwise seek testosterone from unregulated or poorly supervised sources. Neither benefit eliminates the enforcement problem created when the military expands access to a hormone it also monitors as a potential performance-enhancing drug.

Naval Special Warfare has spent years building a system to detect unauthorized testosterone-related substances while preserving treatment for legitimate medical conditions. The Pentagon is now preparing to search the broader force for troops who may qualify for that treatment.

The department must define what counts as a deficiency, what qualifies as medical necessity, and how it will prevent treatment from becoming sanctioned performance enhancement. Hegseth says the goal is to help troops operate at their natural best, but the Pentagon must now explain where restoring that natural ability ends and doping begins.