Right-wing advocates who push testosterone supplementation for male soldiers as a performance enhancer are using the same hormone they call dangerous and ideological when trans people take it. The contradiction is not incidental. It reveals that the objection was never really about hormones.
What is actually being proposed?
Reports have emerged of Pete Hegseth, the US Secretary of Defence, directing interest in testosterone optimisation programmes for military personnel, framed as a readiness and performance initiative. The idea is that supplementing testosterone levels in male soldiers makes them stronger, sharper, more capable. The military wins, the argument goes, when its men are operating at peak hormonal capacity.
I am not going to take issue with the underlying physiology. Testosterone does influence muscle mass, energy, and certain aspects of physical performance. That is not in dispute. What I want to focus on is the political context in which this proposal lands, because that context is everything.
The medicine is identical
Testosterone supplementation in gender-affirming care for trans men works through the same biological mechanisms, uses the same or equivalent preparations, and is monitored in the same ways by doctors following the same pharmacological principles. A trans man taking testosterone to bring his levels into alignment with his gender is taking the same hormone that Hegseth now wants to give soldiers to make them more formidable.
The molecule does not change. It does not become experimental when a trans person takes it and evidence-based when a soldier does. It does not become ideological in one context and patriotic in another. Testosterone is testosterone, and the clinical considerations, the monitoring requirements, the risks and benefits all apply equally regardless of who is sitting in front of the prescriber.
So when the same political movement that has pushed to ban testosterone for trans young people, restrict it for trans adults, strip funding from gender-affirming clinics, and describe hormonal treatment as a form of harm now champions testosterone supplementation as a tool of national strength, something is exposed. The argument was never about the hormone.
Why the inconsistency matters
The anti-trans position on hormones has relied heavily on language of caution. Testosterone, in that framing, is a powerful, potentially dangerous, life-altering substance that children and young people should be protected from, that adults should have to clear extraordinary hurdles to access, and that clinicians who prescribe it for gender-affirming purposes are reckless or ideologically captured. The Cass Review in the UK leaned into precisely this register, and its recommendations have been used to justify sweeping restrictions on access to care.
But caution applied selectively is not caution; it is targeting. If testosterone is so powerful and so serious that trans people must be protected from it, then that protection should apply universally. If it is safe enough to be used as a military performance supplement, then the clinical concerns about gender-affirming prescribing need a different, honest explanation, because "we are worried about this hormone" no longer works as one.
What the Hegseth directive reveals is that the objection was always about trans people specifically, not about hormone therapy in general. The hormone was never the problem. Trans people were the problem. That is the only reading that makes both positions simultaneously coherent.
This is not new, but it is unusually clear
Culture war politics has always relied on double standards, but they are usually presented with enough rhetorical complexity to be deniable. This particular contradiction is unusually stark. You cannot simultaneously argue that testosterone supplementation is dangerous enough to justify banning trans healthcare and beneficial enough to justify administering it to soldiers, at least not with any intellectual honesty. The positions cancel each other out.
People have pointed this out on social media, in comment threads, and in conversations with me. Trans men, in particular, have noted the bitter irony with a sharpness that no policy paper could match. The government that wants to take testosterone away from them is considering giving it to the people they are not allowed to serve alongside. Trans men are banned from the US military, and soldiers who are not trans may soon be encouraged to take the same hormone trans men take. The logic, if we are being kind enough to call it that, does not hold.
What this tells us about the evidence debate
One of the persistent features of the anti-trans position is that it wraps itself in the language of evidence-based medicine. Concerns about the evidence base. Uncertainty about long-term outcomes. The need for more research. These framings sound scientific, and they land with credibility on audiences who are not steeped in the actual literature.
But the same people deploying that language are not applying it to testosterone supplementation for soldiers. They are not calling for randomised controlled trials before military testosterone programmes proceed. They are not citing uncertainty about long-term cardiovascular effects, which are well-documented and real. They are not demanding independent review of the evidence base before a single soldier receives a prescription. The scientific caution is available for trans people, but not for the political project they are simultaneously advancing.
Gender-affirming hormone therapy is supported by decades of clinical practice, endorsed by the World Health Organisation, the Endocrine Society, WPATH, the American Medical Association, and many others. The evidence base for gender-affirming testosterone therapy in trans men is not the weakest link in the clinical literature. It is robust, accumulating, and consistent in its findings that people do better with access to affirming care than without it. The framing of it as experimental or unproven has always been selective. This latest development makes the selection impossible to ignore.
The people caught in the middle
Trans men and transmasculine people are not abstractions in this debate. They are people who have navigated significant barriers to access care that many describe as life-saving, only to watch politicians invoke safety concerns about their medication while proposing the same medication as a performance booster for a military they are banned from joining.
Many trans men who have shared their experiences with me describe a particular kind of exhaustion that comes not just from fighting for access, but from fighting for it against arguments that visibly do not apply to them consistently. When you are told that testosterone is too serious, too risky, too uncertain to prescribe for your care, and then you watch that same substance promoted as a tool of national readiness, the message is plain. The rules were written for you, not about the thing.
That exhaustion is legitimate, the contradiction is real, and naming it clearly, without softening it, is the least the rest of us can do.
What follows from this
None of this means that testosterone supplementation in military contexts is necessarily a good idea. There are genuine clinical and ethical questions about performance enhancement in institutional settings, about consent, about long-term monitoring, about what happens when soldiers leave the service. Those are worth asking. But they are exactly the questions that should also be asked, with equal seriousness and equal rigour, about any use of hormone therapy, including in gender-affirming care, and they should be asked consistently, not deployed as a gatekeeping tool for one population and waived for another.
The standard that applies to trans people's hormones should apply to everyone's hormones. The scrutiny directed at gender clinics should be directed at military supplementation programmes. The caution invoked for trans healthcare should not evaporate the moment a different population is proposed as the beneficiary.
If it does evaporate, then we know what the caution was always for. And trans people, who have known this for a long time, deserve to hear the rest of us say it out loud.
If there is a topic that you would like me to cover, just let Sammy know.
Dr Helen Webberley is a Gender Specialist, Medical Educator, writer, and advocate, and the founder of GenderGP. She writes about gender diversity, trans healthcare, and the lives of trans and gender-diverse people.
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