Gender Affirming Care, the Military and the Manosphere

Since taking control of Congress in 2025, Republicans have launched relentless attacks on doctors who provide gender affirming care. This approach to care means responding to the medical needs of people whose gender identity misaligns with their biology. In December, 2025, Republicans tried to pass a law that would impose federal criminal penalties on doctors providing such care for minors.

In targeting trans people and those who defend their health care rights, such campaigns are symptomatic of the acute anxieties of the Trump Regime. Their sense of the natural order of things is unraveling. As a psychologist, I can also tell you that the image of the trans person occupies a special place in the disturbed psyches of these people.

Photo by Simone Pellegrini

War Abroad, Culture War at Home

A case in point: The war on Iran rages on into its fifth month and the US military is strategically adrift. Chaos reigns. Troops in ships and bases throughout the Persian Gulf are under attack, at least 18 US service members have been killed and there is an undisclosed number of casualties. Most of the service members in the Gulf are posted on ships and bases, eating bad food, breathing bad air, waiting and anxiously monitoring their screens. When I was carrying out interviews for Mind Zone, many veterans told me that the garrison position – waiting for the fight – is more stressful than actual combat. Paradoxical as it may sound, these more passive positions in warfare are acutely stressful.

Given the gravitas of the situation, we would expect, of course, a somber statement from the Pentagon, offering some clarity on military objectives and the worrisome situation of our troops. Trump lurches about like Odysseus, unable to defeat Troy/Iran or to find his way home. Deranged, he sloshes about, squeezed between the Scylla of the Iran Revolutionary Guard and the Charybdis of Israel and US Hawks.

Surprisingly (or not), Secretary Pete Hegseth’s mind turns in this period of national crisis to gender affirming care for our troops. In a July 15th X post, Hegseth called for a “High-T (testosterone) Department of War” and said in a video that war fighters age 30 and older would be screened as part of their annual health assessments. Service members under age 30 could voluntarily opt in, he said. If low testosterone treatment is recommended, a patient can choose whether to receive testosterone replacement therapy. The aim, the Secretary insists, is to better prepare service members for a modern battlefield that Mr. Hegseth describes as “brutal and unrelenting.”

The Manosphere's Military Medicine

This new approach to jacking up service members is actually not his own idea. Rather than consulting with Veterans Administration doctors (who explain patiently why this is a bad idea), Hegseth seems to have educated himself from the manosphere where influencers declare that low testosterone levels – or “low T” – is a national health crisis for men. Body dysphoria (in previous eras associated with women) is on full display. Ironically, the testosterone craze seems to have very little to do with actually having sex even though the hormone is promoted as an antidote to erectile dysfunction and low libido. The attraction seems to be achieving bigger, bulkier bodies to be admired by other men in the manosphere–bodies that are vulnerable over time to turning to fat. This body dysphoria is the male counterpart to the female anorexic, a condition characterized by extreme preoccupation with the body and an identification with an extreme gender stereotypical ideal.

Low-T is the new Low-IQ, the previous standard right-wing put-down. (These people work in crude bifurcated categories: high and low. They hate spectrums (e.g, neurodiversity), continuums (e.g, sexual orientation and gender), and overlapping categories (e.g., non-sexual dimorphic differences).

It took a woman Air Force veteran, Rep. Chrissy Houlahan (D-Pa) to challenge the prevailing hormonal policy. As a member of the House Armed Services Committee, Houlahan points out that “Testosterone is important for both men and women.” She adds that in Hegseth’s claim that testosterone merely builds on the natural biology of service members, he “clearly has only one sex in mind.” The men serving in the military are the most in need of hormonal therapeutic assistance.

Feminists Called to Duty

In working with Hegseth’s new policy, I am pleased to say that feminist scholars have a long history of research on sex hormones and the medical applications and misapplications of hormonal therapies. There is a robust literature on everything from influences of hormones on brain development, pre-menstrual syndromes, the role of hormones (progesterone, estrogen, and oxytocin) in childbirth, and extensive analyses of hormone replacement therapy (HRT) during menopause.

So feminists – and women more generally – are well prepared to educate the military on this subject. Since “going hormonal” has been thrown at us for centuries to shut us up, we have had to take various beliefs about hormones far more seriously than have men.

If needed, we could step up pretty quickly to organize seminars on the topic for the Department of Defense. We understand that the Pentagon is a trillion dollars short in keeping up with its wars, given the massive depletion of weapons in this current conflict. So in the spirit of Rosy-the-Riveter, we (or I, only speaking for myself) willingly contribute my expertise pro-bono.

We academics often start by taking up the premises behind the claim in question. Are there problematic or false assumptions that lead to faulty conclusions? One premise: higher testosterone levels produce more effective lethal fighters. A second premise: the current difficulties of service members are the result of low-testosterone levels and thus can be corrected by supplements.

A full essay on these premises exceeds the scope of this Substack. But I raise a few points here.

What Makes an Effective Warrior?

Concerning the first premise, what does it mean to be effective as a fighting force? In filming in Afghanistan for the Mind Zone film, I learned that 90 percent of the forces there were in support roles. They cooked, cleaned, ran IT services, provided mental health, spiritual guidance, physical therapy and other augmenting services. Lethality was counter to most of their MOS roles. For the small number in forward operating bases where the actual fighting took place, too much lethality could get you killed. (Hegseth himself was in a reckless situation in Iraq where lethality became a dominant drive.)

Hormones, Stress, and Military Reality

Concerning the second premise: Hegseth confuses, as many people do, correlation with causation. There are some reports of service members testing with lower levels of testosterone. Medical experts often point out that test results can be affected by a range of factors, however. Testosterone levels, like blood pressure, fluctuate considerably, depending on the time of day of testing and interactions with environmental factors. The range of normal levels is also an area of medical dispute.

Feminists tend to agree with those endocrinologists who approach hormones as intricate and dynamic signals of our health status and our relationship to our environments.

Stress, poor sleep and head injuries, which are part of military life, can cause lower hormone levels. Recent studies have identified a condition called “operator syndrome,” in which troops who have served long stretches in special operations units are more likely to report medical problems including decreased testosterone.

Feminists bring such contextual and long-term factors into the picture. For service members, moving from active duty to the chronic and long-term impacts of war managed by the VA is part of that broader picture. Anyone who has spent time in a VA medical center sees those impacts: veterans in wheelchairs, many with oxygen tanks to assist in breathing, others with bags of meds to manage their various chronic ailments.

The idea that their biggest problem in serving in America’s wars was low-T is perversely laughable.

VA clinicians, many who themselves served in the Long Wars in Iraq and Afghanistan, are keenly aware of the absurdity of Hegseth’s prescription for our fighting forces. The Veterans Administration has already documented difficulties in managing hormone therapy for veterans. This is not just a problem of short supply. Testosterone therapy can’t just stop abruptly. Dr. Adrian Dobs, a professor of medicine and oncology at Johns Hopkins University School of Medicine, explains how testosterone therapy can suppress the body’s natural production of the hormone and sperm, as well as create medical needs that persist after treatment stops. “We’re sort of creating a dependency on testosterone,” she said.

The Vulnerability Behind the Warrior Ideal

There is a strange irony to this situation, one perhaps symptomatic of the military manliness crisis that Hegseth claims to be addressing. The ideal warrior in all of his lethal manliness ultimately faces the dependency and vulnerability that are part of the human condition. Feminists have a lot to teach about these repressed parts of the human condition that are coded as feminine.

And witnessing the turbulent emotional swings of this Regime, we might also ask who are the true hysterics.

---

🎞️ Watch MIND ZONE for Free

MIND ZONE follows therapists with the 113th Army Combat Stress Control detachment as they carry out two conflicting missions: protecting soldiers from battle fatigue and keeping these same soldiers in the fight.

---

💬 Share Your Thoughts

Are concerns about military effectiveness best addressed through medical interventions, or by tackling broader issues such as stress, deployment, and veteran care? How can we build an effective anti-war movement?