TRT in the Military Under the 2026 Screening Policy

TRT in the military is allowed when a military physician confirms testosterone deficiency and prescribes treatment through the military medical system. The 2026 policy requires testosterone screening during periodic health assessments for service members aged 30 and older. Stable testosterone replacement therapy (TRT) does not automatically limit duty or deployment, although each Service authority controls qualifications for aviation, diving, submarine, and nuclear duties.^1,2

The 2026 Testosterone Screening Policy

A July 15, 2026 Secretary of War memo directed testosterone screening for service members aged 30 and older during their periodic health assessment, inside military medicine.¹

The Department of War guidance states that replacement therapy or other hormone treatment will be an option for service members with testosterone deficiency.¹ Treatment is an option after a physician reviews your labs, symptoms, health history, and duty requirements.

The screening requirement does not mean every service member aged 30 or older will receive TRT. Screening identifies a possible issue. Your physician then determines whether the lab pattern and clinical picture support a diagnosis and whether treatment fits your medical needs.

TRT should not be treated as a quick fix for one symptom or one low result. A physician first looks for the cause and confirms that the full clinical picture supports treatment.

The testosterone blood testing guide explains how the test itself works.

Active-duty service members should complete this process through their military medical system. Your command may also need to address duty-specific requirements, especially if you serve in aviation, diving, submarine, or nuclear operations.

The DHA Treatment and Duty Framework

The guideline posted by the Defense Health Agency (DHA) in September 2026 recognizes testosterone therapy as a treatment option for a confirmed deficiency. The document also addresses deployment timing, stable treatment, and specialized duty qualifications.²

Under the DHA guideline, treatment may begin within 90 days of a deployment. Stable maintenance therapy does not require a deployment waiver. The guideline also states that a testosterone deficiency diagnosis or stable maintenance therapy alone does not create a duty limitation.²

The DHA deployment rules do not guarantee clearance for every assignment. Aeromedical, dive, submarine, and nuclear duty qualifications remain under the authority of the relevant Service. Your medical team and Service authority decide whether your condition or treatment affects a specific duty.

Your individual response also matters. A physician needs to review follow-up labs and any symptoms after treatment begins. Stable treatment is the relevant policy standard, so continuing medical supervision remains part of the process.

The DHA document posted in September 2026 contains draft placeholders. It should be read as the guideline DHA posted at that time rather than as a numbered final clinical practice guideline. For your current status, use the military medical and command channels responsible for your care and assignment.

Testosterone Prescriptions and Military Drug Testing

Military drug-testing policy separates prescribed testosterone treatment from illicit anabolic steroid use. Testosterone is a Schedule III controlled substance under the DHA guideline and the Drug Enforcement Administration controlled-substance list.^2,3

Department of Defense Instruction (DoDI) 1010.16 states that random steroid testing and steroid unit sweeps are not authorized. Steroid testing may occur when there is probable cause, command direction, or a medical basis.⁴

A positive result does not end the review. The medical review process examines whether you possess a valid medical prescription. DoDI 1010.16 states that the process protects service members with valid prescriptions from adverse disciplinary action based on that authorized medical use.⁴

Prescription records need to be current. Under DoDI 1010.16, Schedule II through V prescriptions without a stated period are treated as expired six months after the last fill.⁴ If you receive prescribed testosterone, keep the prescription and refill record available through the systems your military medical team uses.

Illicit possession or use is treated differently. DoDI 1010.01 identifies illicit possession or use of anabolic steroids as an offense under the Uniform Code of Military Justice (UCMJ). Its glossary defines an anabolic steroid as a substance chemically and pharmacologically related to testosterone.⁵

The practical distinction is authorization. A current prescription issued through proper medical care gives the medical review process documentation to evaluate. Illicit possession or use of testosterone falls under the UCMJ offense described in DoDI 1010.01.⁵

Deployment and Special-Duty Decisions

Stable TRT does not automatically prevent deployment under the DHA guideline. The document states that stable maintenance therapy requires no deployment waiver, and treatment may begin within 90 days of deployment.²

Your duty category can change the review. Aviation, dive, submarine, and nuclear positions have separate qualification authorities. A general deployment rule cannot override the standards that apply to one of those assignments.

If you are active duty, discuss deployment timing with your military physician before treatment begins. Your physician can document the diagnosis, monitor your response, and coordinate with the authority responsible for your duty status.

Command communication also matters when a medical condition or controlled prescription intersects with assignment requirements. Follow the reporting process for your Service and role. That gives your medical team and command the information needed to make a documented decision.

Military Research on Testosterone Treatment

A 2026 JAMA research letter by Hennigar SR, et al. was designed to estimate Army-wide prevalence of testosterone concentrations below the lower limit of normal among healthy active-duty men aged 19 to 39.⁶ Earlier prescription data provide a different view. Larsen, Clausen, and Stahlman reported that 5,093 of 1,076,633 active-component service men filled a TRT prescription in 2017. That equals a period prevalence of 4.7 per 1,000 male service members.⁷

Only 44.5% of the service members who received TRT that year met the 2018 American Urological Association (AUA) clinical practice criteria cited in the report.⁷ The report does not show that the other prescriptions were inappropriate, because the published figure leaves out the clinical detail behind each one. It does show why your physician needs to connect laboratory findings with symptoms and medical history before prescribing.

A prescription count and a deficiency rate answer different questions. Prescription data show how many service members received medication. Screening research examines how many meet a laboratory definition in the population studied. Your treatment decision still rests on your own workup.

Age, Sleep, and the Testosterone Pattern

Age can affect testosterone levels, but age alone does not establish a deficiency. The Baltimore Longitudinal Study of Aging followed 890 men and found that testosterone declined with age independently of measured health factors.⁸

Using the study’s total testosterone criteria, hypogonadal levels occurred in about 20% of men over 60, 30% over 70, and 50% over 80.⁸ Those figures describe an aging research cohort. They do not provide a screening threshold or determine whether you need treatment.

Sleep can also influence a testosterone result. In a small laboratory study, young healthy men restricted to five hours of sleep per night for one week had daytime testosterone levels decrease by 10% to 15%.⁹ The study did not examine older men or military performance.

Your physician should interpret testosterone alongside your symptoms, sleep, health history, and related laboratory findings. If low energy, sexual changes, or body-composition concerns led you to testing, review the broader symptoms and causes of low testosterone before treating one result as the full explanation.

A laboratory range can show whether your result meets a clinical threshold. Your symptoms and related biomarkers help your physician determine whether the overall pattern explains how you feel.

Active-Duty Care Compared With Post-Service Care

Your care route depends on whether military medical and command rules currently apply to you.

Decision Point	Active-Duty Service Member	Veteran or First Responder Outside Military Medicine
Initial evaluation	Military medical system	Physician-led civilian evaluation
Treatment decision	Military physician under DHA guidance	Civilian physician based on labs, symptoms, and health history
Duty review	Service and command requirements may apply	No active-duty qualification review
Prescription documentation	Military medical and drug-review procedures apply	Civilian controlled-substance and clinical requirements apply
Ongoing monitoring	Military medical follow-up	Follow-up through the prescribing medical practice
Best path	Begin with your military clinician	Choose a program that includes labs and continuing physician review

If you are on active duty, your evaluation and any testosterone prescription run through your military clinician. The Service authority responsible for your assignment decides any duty questions.

If you are a veteran or first responder outside military medicine, choose care that starts with labs and includes physician follow-up. The TRT guide explains the broader treatment process. You can also review TRT costs and how VA and TRICARE coverage works for TRT separately.

Physical readiness remains a separate issue from treatment authorization. The military fitness test guide covers each branch's fitness test events and standards.

TRT for Veterans and First Responders

Veterans and first responders outside the military medical system can pursue a physician-led testosterone evaluation. A proper evaluation starts with laboratory testing and a review of symptoms, medical history, existing conditions, and current medications.

Opt Health offers military veterans and first responders 50% off the initial blood labs and consultation, as well as 30% off the monthly membership fees. The full terms are available on the military veteran and first responder program page.

The discount does not determine whether TRT is appropriate for you. Your labs and physician review drive that decision. Treatment may include TRT when the clinical findings support it, while another plan may fit a different lab pattern.

The Opt Take on Testosterone Care for Service Members

A physician should confirm testosterone deficiency from a full laboratory pattern, then interpret those results against your symptoms, health history, medications, and existing conditions. One low testosterone result does not provide enough information to build a treatment plan.

Opt Health begins with a blood panel of 55+ biomarkers taken at home or at a local partner lab. An Opt Health physician reviews the results with you during a 1:1 consultation and sets a personalized plan. Full blood panels and physician consultations repeat every 3 to 4 months, so your plan can change based on your follow-up results.

This care model applies to veterans and first responders outside active-duty military medicine. Active-duty service members should continue through the military medical and command channels responsible for prescribing, deployment review, and special-duty clearance.

Get started: Begin with Opt Health, where a physician reads your labs, builds your plan, and adjusts it over the loop.

Frequently Asked Questions

This content is for informational purposes and does not replace evaluation, diagnosis, or treatment by a qualified medical professional.