Ending healthcare discrimination against trans soldiers isn't a very hard thing to do


The Pentagon is one step closer to lifting a ban that prevents trans service members from serving openly, according to Defense Secretary Ash Carter.

“The Defense Department’s current regulations regarding transgender service members are outdated and are causing uncertainty that distracts commanders from our core missions,” Carter said in a statement released Monday. “At a time when our troops have learned from experience that the most important qualification for service members should be whether they’re able and willing to do their job, our officers and enlisted personnel are faced with certain rules that tell them the opposite.”

Carter also announced that he would establish a working group to assess costs and questions of military readiness related to lifting the ban. Lucky for Carter, many of those questions—particularly about healthcare for trans service members—have already been answered.

The Palm Center, an organization that conducts research and makes policy recommendations on issues related to gender and sexuality in the military, has already released several reports analyzing the impact the ban has on current service members. (Calling the regulation a ban on trans people in the military isn’t exactly accurate: there are more than 15,000 trans people actively serving, but the policy keeps them from doing so openly, exposes them to arbitrary discharge, and prevents them from accessing necessary healthcare.)

One of the questions the Pentagon working group was set up to answer is about whether or not the military will pay for gender-affirming healthcare. A 2014 report from the Palm Center offered the following bit of perspective on why opening up healthcare to all service members isn’t all that difficult.

The report found that, for example, allowing trans people to openly seek hormone therapy doesn’t really change current policies since “many non-transgender military personnel rely on prescribed medications, including anabolic steroids, even while deployed in combat zones.”

So hormone therapy isn’t new territory for the military, but giving trans people equal access to it would be:

[T]he military consistently retains non-transgender men and women who have conditions that may require hormone replacement. For example, gynecological conditions [that require hormone therapy]… require referral for evaluation only when they affect duty performance. And, the only male genitourinary conditions that require referral for evaluation involve renal or voiding dysfunctions. […]
The military also allows enlistment in some cases despite a need for hormone replacement… Polycystic ovarian syndrome is not disqualifying unless it causes metabolic complications of diabetes, obesity, hypertension, or hypercholesterolemia. Virilizing effects, which can be treated by hormone replacement, are expressly not disqualifying.

The American Medical Association (AMA) rejected the ban on trans healthcare for the same reason. In a resolution adopted earlier this year, the major medical group said that the military’s “transgender exclusion policy is sustained by claims that transgender individuals require more burdensome medical care in the field than other members of the military” and that the organization, by adopting a resolution agains the ban, had “joined a chorus of expert voices showing this assertion to be false.”

And while not all trans people are interested in gender-affirming surgery, the Palm Center report found that, again, the military’s current policy on surgeries that service members can access and take leave for wouldn’t need to chance very much, because people in the military have surgery and need recovery time for all kinds of reasons.

The Pentagon working group will take an estimated six months to make its determination about the policy, according to Carter. And the panel of military and civilian leaders will undoubtedly be looking to the research that already exists—research that makes clear that the ban is arbitrary, discriminatory, and that it is long past time it ended.

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