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Inside the testosterone boom dominating your algorithm

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I was in the middle of writing a different Optimizer column this week when I learned that Pete Hegseth is getting ready to roid out America’s armed forces.

The announcement came in an X post, because of course it did. “The High-T Department of War,” the post read. There was a two-minute, 30-second video underneath. As I hit play, my soul morphed into that meme of a screaming, crying cat.

“We have a sacred duty to maintain t …

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On Wednesday, Defense Secretary Pete Hegseth announced that routine annual health assessment for troops over 30 would now include testosterone screening, which younger troops could also request. In a video posted to X, Hegseth said if providers recommend treatment, “it’s entirely your choice to receive testosterone replacement therapy.” 

Hegseth’s announcement echoes an emerging focus on testosterone-related health issue in the special operations world in recent years, widely discussed among veterans and medical experts as “operator syndrome.” The phenomenon, which Hegseth referenced in a memo Wednesday announcing the new program, was first noted in a 2020 research paper in the International Journal of Psychiatry Medical by Chris Frueh.

Frueh described operator syndrome as a widely reported series of similar health issues and hormonal deficiencies among special operators over 30, a pattern he noticed while working with active duty and veteran special operators across the U.S. and other countries. Some police and firefighters, Frueh said, have also reported similar health issues. 

“The high op tempos, the sleep deprivation, the circadian disruption, the repetitive repeated blast exposures, all of these have a profound effect on hormones,” Frueh told Task & Purpose. “If you’re not sleeping, your hormones aren’t being properly released and regulated. But it has a bidirectional effect, so it hurts sleep, it hurts brain health, it hurts metabolic functioning if your hormones aren’t in alignment.”

Often more needed than just a shot

Experts told Task & Purpose that treating a testosterone imbalance is more complex than just giving service members access to oral or injectable testosterone. They also said treatment should address other health factors like sleep, stress, substance use, diet and more.

“Our medical care is siloed. My sleep doctor has never spoken to my oncologist, has never spoken to my podiatrist. Everything gets treated in isolation,” Frueh said, adding that “the whole point of what we’ve been calling operator syndrome” is that these health issues are “interconnected” and require a more holistic treatment. 

As veteran and active troops have looked outside traditional medical paths, a cottage industry has emerged for non-traditional treatment plans. Dr. Mark Gordon studies neuroendocrinology and translates his research into treatments for special operations troops and veterans who come to him on their own dime.

“Just looking at testosterone is like only filling up one tire on your car with air and the other three being flat, you need to have all the key hormones optimized,” Gordon told Task & Purpose in an interview for a story in 2024. “This is why in some people when they get testosterone replacement therapy, or TRT, they don’t get better because we’ve totally missed other hormones.”

Testosterone replacement therapy, or TRT, carries risks, including reduced sperm count (it has been studied for use as a male contraceptive) and a reduction in the body’s ability to produce it naturally.

Gordon said that he “rarely” recommends testosterone. If someone accepts a testosterone-based treatment protocol, they’re “on the hook for the lifetime of that individual as opposed to fixing the cause for the deficiency.”

Dr. Richard Auchus, an endocrinology section chief at the VA Ann Arbor Healthcare System who sits on the board of the Seal Future Foundation, said there’s long been “tension” between expanding the use of testosterone versus addressing the underlying causes of conditions that might cause low readings, like sleep apnea.

“If you put them on CPAP and they get a good night’s sleep and they can get into REM sleep and recover their pulsing, then their testosterone comes back to normal. That’s an example of a reversible cause, and it would be a disservice to this individual to treat them with testosterone rather than treating them with treating the underlying cause,” he said. “Just giving them testosterone is not going to restore them to normal health because they still have sleep apnea, and actually can make sleep apnea worse.”

Looming in the background of the Pentagon’s new screening and treatment program is the history of special operators, which has included cases of abuse of steroids and performance enhancing substances.

Regular drug tests in the military do not test for these substances, though Navy commanders can order tests that do if they suspect abuse. All services ban unregulated steroid use and service members, and users can face punishment under the Uniformed Code of Military Justice. 

“People dope with testosterone all the time because it’s performance enhancing,” he said. “It’s a very gray line between where it’s restored to normal health and where doping comes in when you’re using testosterone.”

Auchus, who was in the Air Force medical corps, said part of his job was evaluating whether troops were abusing androgens, which include testosterone He said service members might not always be forthcoming about their past use but that it’s important for the best care.

“There’s the risk of taking androgens in and of itself. And then if you don’t come clean about that, I mean, I can’t help you,” he said. “If you’re not honest with me, then it just it’s going to perpetuate the problem. 

The post Pentagon’s testosterone program builds on ‘operator syndrome’ worries in special operations appeared first on Task & Purpose.

Following Secretary of War Pete Hegseth’s announcement that the military would begin screening for testosterone deficiency, Democratic leaders quickly took to social media to mock the program as a return to “gender-affirming care.”

“Pete Hegseth comes out in favor of gender-affirming care…,” wrote Schiff, while Hirono wrote, “So the Pentagon is promoting gender-affirming care now?” Several other Democrats piled on with similar posts.

Their posts, however, were met with immediate pushback.

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Commenting on Schiff’s post, one user wrote, “Giving testosterone to men is gender-affirming and not harmful. Chemically castrating a boy or a double mastectomy on a girl is gender-denying, irreversible and harmful. [Schiff] is not only a liar, he is stupid.”

In response to a post by Sen. Tammy Duckworth, D-Ill., saying, “Sounds like gender-affirming care to me,” conservative influencer “Just a Bama Gal” shot back, “Not even close.”

Rep. Pramila Jayapal, D-Wash., even brought up the program during a House hearing, bashing it as “absurd” and suggesting that the government could begin testing whether representatives are “male enough to be in Congress.”

“The Secretary of Forever Wars, Pete Hegseth, just announced they are going to provide hormone therapy to male service members who don’t have enough testosterone,” Jayapal wrote on X. “Let’s be clear: This is gender-affirming care, and it completely debunks all of Republicans’ attacks on trans people.”

In response, one user who goes by the name Ellie May wrote, “Let’s be clear your ignorance is showing. Giving your body more of something that it naturally produces is not the equivalent of giving your body the exact opposite it needs to thrive and survive.”

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“Are you crazy???” responded another user named Leah Babcock, “When a woman goes through menopause and gets hormone replacement she’s not suddenly a trans person.”

Hegseth announced the program in a post on Wednesday. He explained the military would begin testosterone screening for service members over 30 and optional screening for those under 30 as part of its annual health assessment.

Hegseth said that if treatment is recommended, service members will have the choice of undergoing testosterone replacement therapy. He clarified, “This 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.”

In an X post, he labeled his announcement “the High-T Department of War.”

Meaghan Mobbs, a former Army paratrooper and president of the nonprofit the R.T. Weatherman Foundation, posted on X, “If you are one of the people melting down because the Department of War wants to screen men over 30 for testosterone deficiency, I am begging you to spend ten minutes reading the science before letting Hegseth Derangement Syndrome rob you of common sense.”

“Testosterone is not some cosmetic ‘masculinity’ metric,” Mobbs explained. “It is a major endocrine signal tied to muscle mass, bone density, red blood cell production, metabolism, sexual function, energy, concentration, mood, recovery, and physical performance. Clinically low testosterone can present as exhaustion, loss of strength and muscle, impaired concentration, irritability, depressed mood, reduced motivation, and diminished sexual function.”

She said that “for years, veterans, clinicians, and military families have begged the system to [take] endocrine health more seriously,” adding, “Now someone finally is. Thank God.”

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Likewise, Assistant Secretary of Health and Human Services Admiral Brian Christine wrote, “I fully support Secretary Hegseth’s initiative at the Department of War in recognizing the importance of healthy testosterone levels in its warfighting men!”

“Optimizing testosterone supports strength, endurance, healthy body composition, cognitive performance, mission readiness, and overall well-being—ensuring America’s fighting force is prepared to perform at its highest level,” wrote Christine.

One day perhaps Pete Hegseth will make the news for doing something worthwhile, something that makes his mother proud. One day perhaps we’ll see a headline about the defense secretary that doesn’t involve allegations of sexual misconduct or bigotry, claims about past drinking on the job, possible war crimes, Christian nationalism, or his weird fixation on male facial hair.

Alas, today is not that day. Rather, we are gathered here today because Hegseth is very het up about testosterone. On Wednesday, the defense secretary proudly announced a new screening program for “war fighters” 30 and older that would ensure they had the “right testosterone levels”. In a video posted on X, captioned “the High-T Department of War”, Hegseth explains: “By addressing these health markers early, we’re keeping you on the leading edge of lethality.”

Arwa Mahdawi is a Guardian columnist

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