The Pentagon said transgender hormone care costs too much. Now Pete Hegseth wants testosterone boosts

The Pentagon is preparing to test service members for low testosterone and offer replacement therapy when military doctors recommend it, expanding access to the same class of hormone treatment the Trump administration has cited as an unnecessary expense when provided to transgender troops.

Defense Secretary Pete Hegseth announced the initiative Wednesday in a video titled “The High-T Department of War,” presenting hormone therapy as an investment in military readiness, physical strength and long-term health.

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“We owe our warriors the absolute best medical care in the world, and this program delivers on that obligation,” Hegseth said.

Under the program, service members age 30 and older will receive annual testosterone testing as part of their periodic health assessments. Younger troops may request testing. Those diagnosed with a deficiency may voluntarily receive testosterone replacement therapy if it is recommended by a medical provider, he said.

“This initiative, it’s not about artificial enhancement,” Hegseth claimed. “It’s about restoring and optimizing your natural capabilities, protecting your longevity, ensuring you have the biological foundation required to sustain the fight.”

The Pentagon has not said how much the program will cost or what testosterone levels will qualify as deficient. What is already clear is the administration’s starkly different treatment of hormone therapy depending on who receives it.

For service members presumed to be cisgender, testosterone is now being promoted as evidence-based care that may enhance resilience, longevity and combat readiness. For transgender service members, hormone therapy has been portrayed as costly, disruptive and incompatible with military service.

The cost argument

The Trump administration has repeatedly invoked medical costs while defending its decision to remove transgender people from the armed forces and restrict their access to gender-affirming care.

In court, the government cited more than $52 million in military spending on care associated with gender dysphoria between 2015 and 2024. The figure covered nearly a decade of treatment across the entire active duty force and included more than hormone prescriptions alone.

That amounts to an average of about $5.2 million each year, which is a vanishingly small share of a military budget measured in hundreds of billions of dollars.

The administration nevertheless offered the figure as part of its argument that allowing transgender people to serve created an unnecessary financial burden.

U.S. District Judge Ana Reyes rejected that reasoning in March 2025 while blocking the administration’s policy in Talbott v. Trump. She noted that the military had spent roughly $41 million on Viagra in 2023 alone, several times the average annual amount spent on transgender health care.

The Advocate previously reported that Reyes described the cost of transgender care as so small in relation to total military spending that it was “not even a rounding error.”

Hegseth’s new program makes the contradiction harder to avoid.

Hormones, but only for some

Rep. Pramila Jayapal, a Washington Democrat and a prominent supporter of transgender rights, called attention to that disparity during a congressional hearing Wednesday.

“Just an hour ago, the Secretary of Forever Wars, Pete Hegseth, said that they are going to provide hormone therapy for male service members who don’t have enough testosterone,” Jayapal said. “This, by the way, is gender affirming care.”

Related: Trump Pentagon chief Pete Hegseth enacts harshest anti-trans military policies yet

Doctors routinely prescribe hormones to help patients develop or maintain physical characteristics associated with their sex or gender. For a cisgender man with clinically low testosterone, the treatment may restore muscle mass, energy, sexual function or other characteristics associated with male physiology. For a transgender man, testosterone may produce many of the same physical changes.

The medication does not become more expensive, more dangerous, or less medically legitimate because the patient is transgender. What changes is the administration’s judgment about whose body should be affirmed.