Omar Bustamante/FUSION

Thanks to a procedural tweak at the Pentagon, transgender soldiers are now less likely to get kicked out of the military.


But any praise for that move would be premature: There is no official review of the policy that still prohibits trans people from openly serving, a Department of Defense spokesman confirmed to Fusion. And the estimated 15,000 trans soldiers currently enlisted (and in the closet) have no access to the medical care they may need, such as hormone therapy.

Not all trans people opt for hormone therapy. For those that do, it is essential to their physical and emotional stability. TRICARE, the health-care program for uniformed service members and their families, "doesn't cover hormone therapy for gender identity disorder," said the spokesman, Lieutenant commander Nate Christensen.


The prohibition of hormones for trans troops is “based on inaccurate understandings of the complexity, risks and efficacy of such treatments,” reads a recent report from the Palm Center, a think tank that studies LGBT troops and the military.

In fact, the report suggests, there’s a double standard for transgender troops, because non‐transgender military personnel use similar medications.

“You can have a postmenopausal woman allowed to serve and use hormone replacement therapy and it’s not a big deal,” says Aaron Belkin, the founder and executive director of Palm Center. “It’s the exact same hormones that some transgender troops need.”

Christensen, the DoD spokesman, said the military provides "both medical and non-medical counseling to assist service members and their families manage the challenges and stress that they may face."


Defense Secretary Ashton Carter first signaled a potential shift in policy last month when he said transgender people shouldn't be banned from serving in the U.S. military solely based on their gender identity.

"I don't think anything but their suitability for service should preclude them," Carter said at a town-hall event in Kandahar, Afghanistan.


But there’s a disconnect between Carter’s statement and the lack of action the DoD is taking to prepare to welcome transitioning transgender troops in to the military. The military is acknowledging a move toward a policy of inclusion and at the same time not providing transgender service members with necessary health care.

“The ban on transgender service has long been a policy in search of a rationale," said Dr. Joycelyn Elders, who served as Surgeon General from 1993 to 1994, in a statement ahead of the release of a report commissioned by the Palm Center. (Elders left her Surgeon General position amid controversy after making comments about masturbation being "part of human sexuality” and saying “perhaps it should be taught” in schools.)

Except from DoD's manual: "Medical Standards for Appointment, Enlistment, or Induction in the Military Services."
Excerpt from DoD's manual: "Medical Standards for Appointment, Enlistment, or Induction in the Military Services."

Beginning in 2012 the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders 5th ed. (DSM–5) no longer classified gender non-conformity as a mental illness. The Palm Center report says the military has updated regulations to reflect revisions of DSM for non- transgender-related conditions but “regulations have not been amended to reflect scientific consensus about gender non-conformity.”


Last month the Boston University School of Medicine released a study they said is the most comprehensive review of hormone therapy for transgender adults. The study found hormone therapy did not lead to heightened risks of cancer or mortality. However they did find that about 1 percent of people undergoing a male to female transition experienced blood clots.

"We looked hard for any type of sound rationale and found none. Reforming the policy [in the military] is really a simple matter of updating references to outdated medical science and removing unnecessary barriers to enlistment and retention," said Dr. Elders in the statement.


“It undermines military readiness when commanders can’t provide their troops with medically necessary health care that they require and that’s a big problem,” said Belkin, of the Palm Center.

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