The Defense Health Agency this week rolled out the clinical guidelines military medical providers will use to begin screening men for low testosterone each year.

The guidance directs medical professionals to ask male troops over age 30, as well as new recruits, about symptoms and risk factors that could be linked to testosterone deficiency. If their answers raise red flags, medical providers can move on to blood tests and possible diagnosis and hormone therapy.

It offers the first concrete details of how the new policy would work, two months after Defense Secretary Pete Hegseth announced it in July in a brief video titled “The High T Department of War” that raised eyebrows inside the military and beyond.

“By proactively identifying and treating suboptimal hormone levels, the department continues to invest in the health of its warfighters, strengthen their performance and maximize force readiness,” Pentagon spokesman Sean Parnell said in a release Thursday.

To diagnose someone with low testosterone, a medical provider will first note whether the patient is experiencing erectile dysfunction, reduced libido, impaired memory, depression and a host of other symptoms that could point to a hormone imbalance, DHA said. Risk factors like obesity, diabetes, a prior traumatic brain injury or bone injury, or sleep apnea could also increase the likelihood that testosterone is out of whack.

Medical teams will add the testosterone screening into service members’ period health assessments, which determine their fitness to serve, or their annual physical. Brand-new troops will also encounter the questions upon entering the military. Men under 30 can request a screening, too.

Troops with testosterone prescriptions can still deploy with the right planning beforehand, DHA said. Their treatment supply must last as long as their deployment, plus 90 days — a requirement that could become tricky if their time overseas is extended. Where a person is headed can also complicate matters, if there aren’t temperature-controlled facilities around to store injectable testosterone or if troops aren’t allowed to use topical medications instead.

“A service member who is stable on testosterone therapy should be deployable without requiring a waiver, depending on the formulation,” the DHA guidance says. “Neither a diagnosis of testosterone deficiency nor stable maintenance therapy is, of itself, a basis for a duty limitation or a change in deployment status.”

But those who work in aeromedical, dive, submarine and nuclear fields may be disqualified for duty if diagnosed with testosterone deficiency, the guidance warns. Service officials make the final call on whether the condition may interfere with those critical missions.

Men who may want children can pick treatments that raise testosterone without stopping sperm production, or could pursue cryopreservation to keep their options open later, DHA noted.

The Pentagon has couched the initiative as one piece of a broader push to improve troops’ health, including those who have experienced “operator syndrome,” or a stress-induced drop in testosterone that appears more common in the special operations community. But some also question why the Pentagon is encouraging certain service members to explore hormone therapy while deeming hormone treatment for transgender troops incompatible with military service.

“This initiative … is not about artificial enhancement; it’s about restoring and optimizing your natural capabilities, protecting your longevity and ensuring you have the biological foundation required to sustain the fight,” Hegseth said in a release.

Defense officials are reviewing companion guidance on hormone screening and treatment for female troops, which could formalize a path to relief for women looking to manage the symptoms of perimenopause and menopause. The Pentagon did not say when that directive might be released.

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