The real reason behind Hegseth's viral military testosterone screening order

Military veteran Chad Robichaux was home from Afghanistan, eating well and training hard enough to compete as a professional athlete. Still, something felt wrong.

Some days, the force recon Marine vet was irritable and agitated. Other days, he was deeply depressed. He was tired, struggled to focus and felt what he described as "a real sense of doom."

VA doctors prescribed antidepressants, he said. Only after seeking blood testing elsewhere did he learn his hormones were severely out of balance.

"Once I got my hormones in check, I didn’t need to be on SSRIs anymore," he said, referring to selective serotonin reuptake inhibitor medication. "I felt like I knocked 10 to 15 years off the way I felt."

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Now, the Pentagon is requiring every active-duty and reserve service member age 30 and older, man and woman, to be screened for testosterone deficiency each year — a sweeping new mandate shaped in part by veterans like Robichaux who say hormonal problems have gone undetected for years.

Service members younger than 30 will be permitted to request the screening as part of their annual periodic health assessment .

Secretary of War Pete Hegseth recently ordered the new protocol, saying it would establish a comprehensive baseline across the force and allow military doctors to offer "targeted testosterone therapy" when medically appropriate.

The order is expected to reach hundreds of thousands of troops, although the Pentagon has not said exactly how many people will be subject to mandatory screening.

More than 451,000 active-duty service members were age 31 or older in 2023, according to the department’s demographic data. That figure excludes 30-year-olds and members of the reserve components.

Roughly 82% of the active-duty force is male, but the directive also applies to women. The Pentagon did not immediately provide a breakdown of how many male and female service members will be screened.

The directive does not yet explain how testosterone deficiency will be defined in women, for whom diagnostic and treatment standards are less established.

It also is unclear whether testosterone deficiency is more common among service members than among similarly aged civilians. The Pentagon has not published a force-wide prevalence estimate, and Hegseth described the new screening program as a way to establish a comprehensive baseline across the military.

Fox News Digital has reached out to the Pentagon for more details.

The Pentagon's new policy reflects a broader debate within medicine over whether symptoms such as fatigue, depression and cognitive decline are too often treated with medication before physicians rule out underlying physiological causes — including hormonal disorders — that can produce similar symptoms.

Testosterone testing was available to service members before Hegseth’s directive, but it was generally ordered when a physician believed a patient’s symptoms or medical history warranted it. It was not previously a required component of every annual periodic health assessment after age 30.

For Robichaux, the issue was personal.

"I’m kind of a grinding-through-things person," he told Fox News Digital. "I was trying to grind and grind through that state, and it was super frustrating because I’m like, ‘Man, what’s wrong with me?’"

That experience helped propel Robichaux into a yearslong campaign urging military and veterans’ health providers to look for hormonal deficiencies in troops experiencing fatigue, depression and other symptoms that can also signal mental health conditions.

Interviews with several people involved pushing policy makers for the screening requirement show how the mandate was promoted by an alliance of former special operators, members of Congress, physicians and private hormone-treatment executives — some of whom say the Pentagon has asked for their help implementing it.

Robichaux said his experience was not unusual. Through his work with the Mighty Oaks Foundation, which provides faith-based programs for veterans and service members, he encountered others reporting similar combinations of exhaustion, depression and diminished physical performance.

He came to believe that counseling and psychiatric treatment alone could not address every underlying problem.

"This shouldn’t be like an either-or," Robichaux said. "It should be an ‘and.’ We should bring them all together."

That conviction eventually brought together an unusual coalition on Capitol Hill.

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Hours before Hegseth announced the new screening requirement, Robichaux organized a forum in the Cannon House Office Building featuring veterans, lawmakers, physicians and private-sector health executives.

Rep. Eli Crane, R-Ariz., a former Navy SEAL, agreed to serve as its congressional host. Crane said he first became aware of the issue around the time he left the Navy in 2014, when other SEALs told him that doctors had detected low testosterone among members of the special operations community.

"It actually really surprised me. I thought it would be the exact opposite," Crane said.

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They attributed the problem to the chronic stress, physical demands and sleep deprivation associated with their work, he recalled. But at the time, Crane said, service members struggled to access testing and treatment.

"I think this is a tremendous step forward for our men and women in the service, whether they’re a part of special operations or not," he said.

Testosterone generally declines with age, but low levels can also result from obesity, diabetes, testicular injury, pituitary disorders and medications including opioids and corticosteroids. Severe illness, inadequate nutrition and excessive exercise can temporarily lower a reading as well.

Some of those risk factors may be especially relevant in a military population exposed to demanding training, irregular sleep, injuries and prolonged stress.

Also participating in the effort was Sidney Gordon, CEO of Core Medical Group, a private clinic specializing in hormone replacement therapy. Gordon said he has spent roughly a decade pushing military and veterans’ health providers to more closely examine hormonal deficiencies.

His affiliated nonprofit, Core Medical Foundation, has paid for veterans to receive hormone replacement therapy, Gordon said. His for-profit clinic also treats veterans, active-duty service members, first responders and civilians.

Gordon argued that military and VA providers have too often prescribed SSRIs for symptoms such as fatigue, depression and difficulty concentrating without first conducting sufficiently broad hormonal testing.

But Gordon and the other advocates stressed that the goal is not to place every service member on testosterone.

Dr. Gerry Stanley, a family physician and advisor to Core Medical, said physicians must evaluate a patient’s symptoms alongside multiple laboratory markers and consider other potential causes of a low reading.

"One of the axioms of medicine is you treat people, not labs," Stanley said.

Some service members may ultimately require testosterone, he said, while others could benefit from improved sleep, reduced stress, lifestyle changes or treatments that help the body produce more of the hormone naturally.

"This isn’t cookie cutter," Stanley said. "It’s not that everybody we’re talking about gets testosterone."

Under widely accepted medical guidelines, one low result is not sufficient to diagnose testosterone deficiency. Physicians generally seek at least two early-morning readings, evaluate the patient’s symptoms and investigate whether the result could be connected to medication, illness, obesity, sleep or another potentially reversible cause.

A low result would also not automatically mean testosterone shots. Depending on the cause, treatment could involve lifestyle changes, addressing an underlying condition or adjusting another medication. Testosterone replacement, when medically appropriate, can be administered through injections, gels, patches or other formulations.

The Pentagon has said military doctors will be able to provide "targeted testosterone therapy," but has not detailed which treatments will be covered or whether service members will receive fertility counseling before beginning therapy.

The advocates’ involvement did not end with the announcement.

Robichaux said he, Gordon, Stanley and other participants met with Pentagon officials and were asked to help connect the department with physicians and industry leaders as it develops the screening and treatment protocols.

The screening itself is a blood test, but hormone specialists caution that treatment following a low result can carry significant consequences.

The broad mandate has drawn caution from the Endocrine Society, which represents physicians and researchers specializing in hormonal conditions.

"There is insufficient evidence to support a general recommendation to perform population-level screening for hypogonadism in asymptomatic men," the organization said in a statement responding to the Pentagon initiative.

The society said a diagnosis should require symptoms and consistently low readings from at least two early-morning, fasting tests. It also stressed that potentially reversible contributors—including obesity, opioid use and corticosteroids—should be considered before testosterone is prescribed.

For male service members, one of the most immediate is fertility. Taking external testosterone can sharply reduce sperm production, sometimes suppressing it entirely. The Endocrine Society recommends against prescribing testosterone therapy to men planning to have children in the near term.

The Endocrine Society also responded to the Pentagon announcement by saying there is insufficient evidence to support population-wide screening of men without symptoms. The organization warned that testosterone measurements can vary by time of day, laboratory method, sleep, illness and other factors, creating a risk of both overdiagnosis and missed diagnoses.

The advocates involved in the Pentagon push said they agree that screening should not automatically lead to treatment.

"We’re not asking to give guys testosterone," Robichaux said. "What we’re asking to do is, before you give them a handful of SSRI pills, give them a blood panel."

Women also can experience hormonal disruption from prolonged stress, intense training and inadequate nutrition, though it does not present as a direct equivalent of testosterone deficiency in men.

Those conditions can interfere with ovulation and reduce estrogen and progesterone, potentially affecting menstrual cycles, fertility and bone density. The Pentagon has not yet detailed how the new screening program will account for those broader hormonal issues in female troops.

Perimenopause is generally evaluated through symptoms and menstrual changes rather than routine hormone testing. TRICARE covers FDA-approved hormone therapy when medically appropriate.

The details of the new directive will now fall to Pentagon health officials. Hegseth directed the department to update its policies by Aug. 15, make testing available across the Military Health System and establish an advisory council of outside experts to guide implementation.

Those guidelines will determine how an initial low result is confirmed, when treatment is appropriate and whether service members receive fertility counseling before beginning testosterone therapy.