Testosterone Replacement Therapy: Performance Enhancement for America’s ‘Elite Warriors’
Pete Hegseth, the hyper-masculine US Secretary of Defence/War, announced on 15 July 2026, in a video entitled “The High T Department of War”, that all American active-duty and reserve service personnel aged 30 and over will hitherto be screened for testosterone deficiency as part of their annual health assessment. Those under 30 can choose to opt out, presumably on the grounds that testosterone levels decline with advancing age and that younger active-duty personnel are well endowed with the hormone. The optimisation of the “natural capabilities” of “elite warriors” will be based on “well-established science.” In other words, deficient soldiers will have the option of being treated with testosterone.
There is no doubt that testosterone can be a good thing, and that deficiency may have bad consequences, which can be overcome by replenishing the body’s stock of deficient hormone. If only if it were that simple and straightforward. The primary male sex hormone builds up muscle and bone, making men stronger, and helps produce sperm and boosts sex drive, ensuring the propagation of the human species. In males, testosterone deficiency results from reduced production in the testicles, and a much lesser degree in the adrenal glands. This deficiency can have recognisable effects in adult males, and also in those yet to reach puberty. These effects can be relatively specific for testosterone deficiency, or may overlap with the symptoms of other conditions. Specific effects of deficiency in adults include a reduced libido, erectile dysfunction, reduced beard and body hair, and shrunken testicles. Other effects include changes in mood, impaired cognition, fatigue, increased body fat, enlarged breasts, and osteoporotic bones that fracture readily.
While suggestive tell-tale features on bodily examination might suggest testosterone deficiency, the diagnosis needs to be confirmed by blood tests. Low blood levels of testosterone should be confirmed on early morning samples of blood, obtained between 7 and 11 AM, on at least two occasions and preferably four weeks apart. The results should be interpreted in conjunction with symptoms. The precise level of testosterone at which deficiency is diagnosed varies between labs. In addition, blood levels of LH (Luteinising Hormone) and prolactin are also commonly measured at the same time. The protocol that will be followed by the US military, including follow-up, has yet to be revealed.
Having diagnosed testosterone deficiency, lifestyle changes should be considered, such as physical activity, weight reduction, a healthy diet, adequate sleep, and foregoing alcohol and other addictive substances. When testosterone replacement therapy (TRT) is being considered, there should be no contradictions to treatment, as judged by a medical professional. Testosterone can be administered by mouth; as a transdermal gel, cream, or patch; as a nasal gel; by intramuscular or subcutaneous injection; or as subcutaneous implants. TRT is not without risks. Apart from acne, tender enlarged breasts, and shrunken testes, it can make blood more viscous and prone to clots, and increase the risk of prostate disorders. Paradoxically, TRT suppresses sperm production and can cause infertility.
The growing popularity of testosterone appears to be a cultural phenomenon, during a crisis of masculinity. Online influencers, men’s health clinics, telehealth companies, and leading lights of the ‘manosphere’ are touting the benefits of testosterone therapy, encouraging “T-maxxing” as a panacea for many societal problems which can more readily be attributed to other causes. Official sanction for testosterone therapy comes from none other than 72-year-old US Health and Human Services Secretary Robert F. Kennedy Jr, who claims to be injecting testosterone as part of his anti-ageing campaign. Furthermore, a 2023 randomised, double-blind clinical trial-TRAVERSE- suggests that TRT does not increase the risk of “major adverse cardiac events”, such as heart attacks and stroke.
Most important, testosterone deficiency has no proven direct bearing on military capability-not that it appears to have been tested in this specific context. The move to introduce TRT seems to be driven by an ambition to transform America’s male combatants into hunky men, albeit with small testicles, who are perpetually ready for combat and capable of gladiatorial feats on the battlefield. Let the experiment begin! Let those who start it take the blame or maybe the praise, depending on the outcome!
Ashis Banerjee
PS: It is important to always seek professional medical advice before embarking upon hormone replacement therapy.