Judge asks Pentagon how troop TRT differs from care denied to trans men

A US judge has asked the Pentagon to explain how testosterone therapy for troops differs from hormone treatment for transgender men. The order sharpens scrutiny of the military's unequal medical standards as Trump's ban remains in force.

In Short

• Defence Secretary Pete Hegseth announced annual low-testosterone screenings for troops over 30
• Service members under 30 may opt in, while treatment remains voluntary
• Court sought details on medical similarities between therapies for trans men

A US judge has asked the Pentagon to explain how testosterone replacement therapy for troops differs from hormone treatment given to transgender men in the military, as she hears a legal challenge to President Donald Trump’s ban on transgender service members.

US District Judge Ana Reyes in Washington raised the issue after Defence Secretary Pete Hegseth announced a new initiative to screen troops for low testosterone and offer voluntary treatment. Reyes said the court wanted both sides to address the medical and logistical similarities and differences between testosterone replacement therapy, or TRT, for trans men and for other service members, including cis individuals.

In her order on Wednesday, Reyes pointed to language in Trump’s ban which says “the Armed Forces must adhere to high mental and physical health standards ... without the benefit of routine medical treatment or special provisions.” She also sought information on the Pentagon’s “basis for treating trans men and other service members differently between this new policy and the Military Ban”.

The order came a week after Hegseth said the Pentagon was launching a screening programme for “testosterone deficiency” among troops, saying it was needed to help them perform at their “absolute best”. He said annual screenings would be part of mandatory medical checks for service members aged 30 and above, while those under 30 could choose to be tested. In a video posted on social media, Hegseth said testosterone replacement therapy would be voluntary.

The issue comes amid wider advocacy by other Trump administration officials for easier access to testosterone replacement therapies for men. However, the messaging from Hegseth and others has mixed established science on the hormone with broader claims that are less substantiated. Testosterone levels in men naturally decline with age and have long been linked to problems such as erectile dysfunction, low libido, mood changes and weight gain. Experts, however, have debated for years how such problems should be diagnosed and whether replacing the hormone is the right treatment.

Reyes, who was nominated by President Joe Biden, is handling one of the lawsuits against Trump’s transgender military ban. Transgender active-duty service members and former personnel seeking to re-enlist filed the case in late January 2025, soon after Trump began his second term. Reyes had earlier ruled against Trump’s executive order excluding transgender troops, but a divided federal appeals court panel later sent the case back to her after partly upholding her order and finding that the ban was unlawful and that the service members who sued could not be removed. She has since granted the case class-action status, meaning any eventual outcome could apply to all service members.

For now, Trump’s ban on transgender troops remains in force, with the US Supreme Court allowing the Pentagon to enforce it while the legal battle continues. Reyes’ latest order has brought fresh focus to how the military is treating testosterone therapy for different groups of service members.

With PTI Inputs

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