在测试部队的力量、耐力和射击技巧近250年后，美国军方开始测试他们的睾酮水平。
After nearly 250 years of testing its troops’ strength, endurance and marksmanship, the U.S. military is starting to test their testosterone.
国防部长皮特·赫格塞斯表示，这将为他们提供“维持作战所需的生物学基础”，他淡化了现役和退役军人——包括一名前陆军总外科医生——的担忧，这些人认为该计划建立在不牢靠的科学基础上。
Defense Secretary Pete Hegseth says it will give them “the biological foundation required to sustain the fight,” brushing off concerns from current and former service members — including an ex-Army surgeon general — that the initiative rests on shaky science.
一些退伍军人担心，新的强制性筛查可能威胁到部队的生育能力和职业生涯，使其中一些人终身依赖注射，而退伍军人事务部并不保证继续承担这些费用。
Some veterans fear the new mandatory screening could threaten troops’ fertility and careers, tying some of them to lifelong injections the Department of Veterans Affairs is not guaranteed to continue covering.
赫格塞斯在7月宣布的一项计划下，30岁及以上的现役人员将在常规健康评估期间每年接受一次睾酮缺乏筛查。被检测出水平偏低者将被提供激素治疗。
Under a program Hegseth announced in July service members 30 and older will be screened each year for testosterone deficiency during their routine health assessments. Those found to have low levels will be offered hormone therapy.
赫格塞斯表示治疗将是自愿的，尽管五角大楼尚未说明拒绝接受推荐治疗的军人是否会面临后果。
Hegseth said treatment would be voluntary, though the Pentagon has not said whether troops who refuse recommended treatment would face consequences.
“我们正在打造一个专注于力量、表现和杀伤力的‘高T’部门，”五角大楼首席发言人肖恩·帕内尔在9月中旬写道，呼应了近期在播客和其他论坛中使用的语言，这些论坛最近聚焦于男性气质的定义。
“We are building a High-T department focused on strength, performance, lethality,” the Pentagon’s chief spokesman, Sean Parnell, wrote on in mid-September, echoing language used in podcasts and other forums with a recent focus on the definition of masculinity.
该推广进展坎坷。五角大楼于9月2日发布了针对男性和女性的筛查临床指南，次日将其撤下，一名官员称其为需要更新的草案；大约两周后，又重新发布了针对男性的指南。五角大楼表示女性的指南将稍后发布，但未说明具体时间。
The rollout has been bumpy. The Pentagon posted clinical guidance for the screenings, for men and women, on Sept. 2; pulled it the next day with an official calling it a draft that needed updates; and reissued it for men about two weeks later. The Pentagon has said guidance for women will come later but has not said when.
首次，五角大楼也给出了一个具体目标。根据国防卫生局的指南，在部署期间继续接受治疗的军人必须在四到六周后的随访中证明，他们的睾酮水平处于每分升300至600纳克的目标范围内。
For the first time, the Pentagon has also put a number on what it wants. Troops who continue therapy while deployed must show, at a follow-up four to six weeks later, that their testosterone sits within a target range of 300 to 600 nanograms per deciliter, according to the Defense Health Agency’s guidance.
该项目出现之际，特朗普政府正推动扩大男性接受睾酮治疗的渠道。在近十年的下降之后，自2022年左右起，处方数量又开始回升，美国泌尿外科协会表示，接受睾酮治疗的男性中多达四分之一在开始治疗前从未检测过其水平。五角大楼未回应MS NOW的置评请求。
The program comes as the Trump administration pushes to widen access to testosterone therapy for men. After nearly a decade of decline, prescribing has been rising again since about 2022 and the American Urological Association has said up to a quarter of men who receive testosterone never had their levels tested before starting. The Pentagon did not respond to MS NOW’s request for comment.
赫格塞斯于7月15日在题为《高科技战争部》的演讲中公布了该项目，将其描述为让军队保持在“致命性领先边缘”的一种方式。这是一项更广泛运动的一部分，旨在提升全军的体能和仪容标准。
Hegseth unveiled the program on July 15 in a titled “The High-T Department of War,” casting it as a way to keep the military on the “leading edge of lethality.”It is part of a broader campaign to toughen fitness and grooming standards across the force.
两个多月后，他仍在推销该项目。9月30日，他在弗吉尼亚州海军陆战队基地昆蒂科对初级军官和列兵领导人发表“武装力量状况”讲话时，吹嘘该项目：“意识形态的小丑已经出局。爱国的牛仔已经进驻，睾酮检测名列前茅。”
More than two months later, he was still selling it. In a Sept. 30 “State of the Force” address to junior officers and enlisted leaders at Marine Corps Base Quantico in Virginia, he boasted about the program: “The ideological clowns are out. The patriotic cowboys are in, with testosterone testing on top.”
国防部长亲自制定医疗政策极为罕见，这一工作传统上由各军种的总外科医生和国防卫生局负责。4月，赫格塞斯终止了军队数十年老旧的流感疫苗接种要求，称该部门正“恢复自由”于武装力量。到6月初，圣安东尼奥的拉克兰德空军基地基础训练中爆发疫情。到6月下旬，每个训练营都重新实施了该要求。曾任1996年至2000年陆军总外科医生的退役中将罗纳德·布兰克博士表示，该项目“显然是那些对医学知之甚少的人试图提升侵略性和男子气概的尝试。”军队长期以来一直能够通过国防健康保险计划Tricare获得睾酮检测和治疗。
It is highly unusual for a defense secretary to set medical policy himself, a job traditionally left to the services’ surgeons general and the Defense Health Agency. In April, Hegseth ended the military’s decades-old flu vaccine requirement, saying the department was “restoring freedom”to the force. By early June, an outbreak was spreading through basic training at Lackland Air Force base in San Antonio. By late June, every boot camp had reinstated the requirement Dr. Ronald Blanck, a retired lieutenant general who was the Army’s surgeon general from 1996 to 2000, said the program “was clearly an attempt” by people “who really don’t know very much about medicine to increase aggressiveness and masculinity.”Troops have long been able to get testosterone testing and treatment through Tricare the military’s health insurance program.
常规筛查感觉良好的人是新做法。医学指南不建议对没有缺乏症状的男性进行检测，内分泌学会也表示，证据不支持对全体人群进行筛查。
What is new is routinely screening people who feel fine. Medical guidelines do not recommend testing men without signs of a deficiency, and the Endocrine Society has said the evidence does not support screening entire populations.
五角大楼尚未说明将有多少人接受强制性筛查。截至2024年，现役军人和预备役人员约有200万，这是国防部提供的最新数据。其中约三分之一年龄超过30岁，约80%为男性。布兰克表示，该项目源于一个错误的前提。
The Pentagon has not said how many people would be subject to mandatory screening. There were about 2 million members of the active-duty military and reserves as of 2024, the most recent figures available from the Department of Defense. About a third of them are over 30, and about 80% are male. Blanck said the program stems from a flawed premise.
他写道：“‘如果男性有睾酮，那么更多的睾酮就会更好，’”他这样描述了这种思维方式。“事实并非如此。”布兰克说，当筛查能发现医生可以治疗的隐藏问题时，筛查才有意义，比如高胆固醇，可以通过他汀类药物治疗。相比之下，睾酮会随着年龄增长而自然下降。
“‘If men have testosterone, then more testosterone would be better,’” he said, describing the thinking. “It’s not the way it works.”Screening makes sense, Blanck said, when it finds a hidden problem that doctors can fix, like high cholesterol, which can be treated with statins. Testosterone, by contrast, declines naturally with age.
“我80岁，快85岁时的睾酮水平，已经不及我25岁时的水平了，”84岁的布兰克说。“如果我补充睾酮呢？我会恢复到25岁那会儿的身体、活力等等吗？不会，这远比想象中复杂。”对于真正存在缺乏的男性，治疗可以缓解疲劳并增加肌肉。但对于那些睾酮水平符合其年龄正常范围的男性，他表示，这会增加血栓风险，并且几乎肯定会导致不育。
“I don’t have the level of testosterone at 80, almost 85, that I did when I was 25,” said Blanck, 84. “What if I took testosterone? Would I regain my 25-year-old body, virility and all that? No, it’s far more complicated.”For men with a true deficiency, treatment can ease fatigue and build muscle. But for those whose levels are normal for their age, he said, it raises the risk of blood clots and will almost certainly cause infertility.
他对一名通过体能测试且可能想要孩子的35岁现役军人的建议很直接：“不要服用睾酮。你会变得不育。”根据一名在军队服役23年、已接受该疗法五年的现役军人的说法，接受睾酮替代疗法意味着每月就诊、每季度抽血以及每周注射。
His advice to a 35-year-old service member who is passing fitness tests and might want children was blunt: “Don’t take testosterone. You will become infertile.”Getting testosterone replacement therapy means monthly appointments, quarterly blood work and weekly injections, according to a service member with 23 years in the military who has been on the therapy for five years.
这名现役军人是匿名接受MS NOW采访的众多人之一，因为军队不允许其成员公开谈论五角大楼的政策。针头和药瓶随军队走到哪里，包括到睾酮受控制的国家。
The service member was among those who spoke to MS NOW on the condition of anonymity because troops are not authorized to speak publicly about Pentagon policy. The needles and vials go everywhere the military does, including to countries where testosterone is a controlled substance.
该军人表示，临时旅行时，选择可能只剩下在边境携带受控药物或将其留下，让激素水平在数周内崩溃。在野外，部队可能数周不洗澡，这可能意味着在不洁的皮肤上注射或漏服剂量。“在野外是我最需要发挥作用的地方，”该军人说。
With last-minute travel, the service member said, the choice can come down to carrying a controlled drug across a border or leaving it behind and letting hormone levels crash for weeks. In the field, where troops can go weeks without a shower, it can mean injecting through dirty skin or skipping doses. “In the field is where I need to perform the most,” the service member said.
一个长期担忧是费用。这种疗法通常是终身的，因此一名30岁在现役期间开始治疗的人可能需要依赖退伍军人事务部数十年。“国会有什么保证会为我的强制注射提供资金？”该军人问道。
One longer-term worry is cost. The therapy is usually lifelong, so a 30-year-old who starts while on active duty could rely on the VA for decades. “What is the guarantee that Congress is going to fund my mandatory injections?” the service member asked.
另一名服役19年的军人表示，治疗真正的缺乏症“有实际价值”，但警告不要让该项目成为“捷径”或“以行政手段将T评分低的人分离出去”的方式。该军人表示，治疗应“紧密关联医学指南”。五角大楼自身的指南也给予了这一担忧一定的重量。其指出，睾酮缺乏症的诊断本身不会限制军人的职责或部署，但航空、潜水、潜艇和核岗位的军人若被诊断出此病，可能被取消这些岗位的资格。这些领域本已执行军队最严格的医疗标准，新诊断和用药通常需要特别审查。
A second service member, with 19 years in the military, saw “real value” in treating genuine deficiencies but warned against the program becoming “a shortcut or a way to administratively separate those with low T scores.”Treatment, that service member said, should be “closely tied to medical guidelines.”The Pentagon’s own guidance gives that concern some weight. It says a testosterone deficiency diagnosis does not by itself limit a service member’s duty or deployment, but troops in aviation, diving, submarine and nuclear jobs may be disqualified from those roles if diagnosed. Those fields already carry the military’s strictest medical standards, where new diagnoses and medications typically require special review.
曾服役28年、曾指挥肯塔基州坎贝尔堡陆军医院的退役陆军准将斯蒂芬·塞纳基斯博士表示，普遍筛查违背了医学基本原则。“你不该治疗化验结果，而应治疗患者，”他说。
Dr. Stephen Xenakis, a retired Army brigadier general who served 28 years on active duty and once commanded the Army hospital at Fort Campbell, Kentucky, said blanket screening breaks a basic rule of medicine. “You don’t treat the labs, you treat the patient,” he said.
他还质疑谁会看到检测结果。“这会完全保密吗？我们的指挥官能获取这些数据吗？”他说。“我看到的所有备忘录中，没有一份阐述过这些信息将如何披露。”他设想这份命令送到他曾服役的医院时说，每名医师助理、军医和飞行外科医生都需要接受培训，了解低检测结果意味着什么，以及谁应该接受治疗。“我认为我们无法有效实施，”他说。布兰克表示，睾酮检测计划给军方带来的成本将超过其收益。
He also questioned who would see the results. “Is it going to be held completely confidential? Is our commander going to have access to that data?” he said. “There was nothing I saw in any of the memoranda that worked through what would be the disclosure of that information.”Picturing the order landing on his old hospital, he said every physician assistant, medical officer and flight surgeon would need training on what a low result means and who should be treated. “I don’t think we can implement it effectively,” he said. Blanck said the testosterone program would cost the military more than it gained.
“他们在浪费时间和金钱，做一件可能几乎没有积极影响，甚至很可能产生大量负面影响的事情，”他说，“相反，他们应该专注于那些真正能带来改变的事情。”《赫格塞斯的军方在科学担忧声中推行睾酮检测》MS NOW
“They are wasting time and money on something that probably will have very little positive, quite possibly a lot of negative effect,” he said, “and instead they should be focusing on stuff that really will make a difference.”The post Hegseth’s military imposes testosterone testing despite concerns about the science MS NOW