Trump Administration Push for Testosterone Screening Amid Claims of a National Decline

Since taking office, Defense Secretary Pete Hegset and Health and Human Services Secretary Robert F. Kennedy Jr. have repeatedly highlighted concerns about falling testosterone levels among American men. Personnel whose results fall below established thresholds may elect to begin voluntary hormone-replacement therapy.

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A study funded by the U.S. Army Medical Research and Development Command measured morning testosterone in active-duty male soldiers. Using the American Urological Association’s 300 ng/dL cutoff, 25.7 % of participants recorded levels below the threshold. The researchers also applied a 264 ng/dL cutoff derived from prior work on healthy, non-obese young men. A separate 2018 civilian study cited by the Army researchers found 30.8 % of men aged 20 to over 60 fell below the 300 ng/dL level.

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Researchers caution that a single low measurement does not constitute a diagnosis of hypogonadism. As Claire E. Berryman explains:

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“A diagnosis generally requires both consistent signs or symptoms of testosterone deficiency and unequivocally and repeatedly low testosterone concentrations. Clinical guidelines recommend confirming low testosterone concentrations with a second morning measurement,” — Claire E. Berryman

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Endocrinology professor Sandeep Dhindsa attributes much of the observed decline to demographic shifts, noting that “aging population” and “obesity” reduce average levels, though they do not erase the trend. He adds:

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“I think most of the decline in testosterone that would be noticed in studies is going to be the fact that we have an aging population. We have obesity. And when you take into account those factors, then the differences become smaller, but they don’t go away completely,” — Dhindsa. Whether

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Dhindsa also emphasizes that acute stressors can suppress testosterone dramatically, citing soldiers in combat as an example:

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“In fact, you would be surprised to know that soldiers, for example, if they are going to a war, they have very, very low testosterone levels,” — Dhinsa

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The Endocrine Society’s brief on testosterone therapy reiterates that hormone levels naturally wane after age 30 and can fluctuate with recent exercise, nutrition, or illness, recommending multiple tests before treatment.

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Kennedy and allied commentators have linked low testosterone to environmental chemicals and even suggested a link to gender-identity trends, positions that medical experts say lack supporting evidence.

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• “A diagnosis generally requires both consistent signs or symptoms of testosterone deficiency and unequivocally and repeatedly low testosterone concentrations. Clinical guidelines recommend confirming low testosterone concentrations with a second morning measurement,” — Claire E. Berryman, former Pennington Biomedical researcher, Purdue University

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• “I think most of the decline in testosterone that would be noticed in studies is going to be the fact that we have an aging population. We have obesity. And when you take into account those factors, then the differences become smaller, but they don’t go away completely,” — Sandeep Dhindsa, professor of medicine, Saint Louis University School of Medicine

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• “In fact, you would be surprised to know that soldiers, for example, if they are going to a war, they have very, very low testosterone levels,” — Sandeep Dhindsa, professor of medicine, Saint Louis University School of Medicine

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