U.S. Military Transgender Policy

[Colin Parkinson]

How about no money for sex changes unless the member has been in combat?

 

[Halifax Tar]

How about no money for sex changes unless the member has been in combat?

Who defines what combat is ?  What about sailors ?  We haven't heard an angry shot since Korea...

I have no issue with anyone going through this.  I cant imagine how traumatic it must be to be in the wrong gendered body.  These people have my full sympathies and support.

My issues with the military aspect is that we have a job to do.  As we continue to cater to more and more issues that keep people from being fit and fully deployable for extended periods the knock on effect is that we continue to ask more of a shrinking group of fit and deployable group of people, these people will burn out. 

We deepened on everyone in our service to pull their weight; if you can not then others must carry your load.  Perhaps if one is going through this situation the military isn't for them until such time that they have achieved their desired gender scenario and they are considered OFP.  For those already in the CAF, well we have a medical system and it should be utilized.

 

[Strike]

How about no money for sex changes unless the member has been in combat?

Then you're discriminating within the transgendered community itself, since very few get the surgery done.

 

[EpicBeardedMan]

Then you're discriminating within the transgendered community itself, since very few get the surgery done.

Are there statistics that show this? Would be interesting to see how many get it done and also how many get the surgery done during their initial 3-4 year contract in the armed forces and then leave after completion of both contract and surgery, essentially spending their entire contract at the MIR while getting paid a salary.

 

[Strike]

Are there statistics that show this? Would be interesting to see how many get it done and also how many get the surgery done during their initial 3-4 year contract in the armed forces and then leave after completion of both contract and surgery, essentially spending their entire contract at the MIR while getting paid a salary.

Don't have that info, but I do believe that the first person to get transition surgery is still serving in the RCAF, and that was almost 20 years ago if I recall.

 

[Colin Parkinson]

Who defines what combat is ?  What about sailors ?  We haven't heard an angry shot since Korea...

I have no issue with anyone going through this.  I cant imagine how traumatic it must be to be in the wrong gendered body.  These people have my full sympathies and support.

My issues with the military aspect is that we have a job to do.  As we continue to cater to more and more issues that keep people from being fit and fully deployable for extended periods the knock on effect is that we continue to ask more of a shrinking group of fit and deployable group of people, these people will burn out. 

We deepened on everyone in our service to pull their weight; if you can not then others must carry your load.  Perhaps if one is going through this situation the military isn't for them until such time that they have achieved their desired gender scenario and they are considered OFP.  For those already in the CAF, well we have a medical system and it should be utilized.

We have definitions already, messy as they are, but really this is more to the US question where it appears some people join up purely to get the system to pay for the operations. Sex change operations are not critical to the core task and are not related to the duties. If someone has served for X period of time, seen combat or has done something out of the ordinary (rescuing people , etc) then they can qualify. That way you avoid the people that want to use the system and don't punish the few who served honourable and want the change.

 

[RCPalmer]

We have definitions already, messy as they are, but really this is more to the US question where it appears some people join up purely to get the system to pay for the operations. Sex change operations are not critical to the core task and are not related to the duties. If someone has served for X period of time, seen combat or has done something out of the ordinary (rescuing people , etc) then they can qualify. That way you avoid the people that want to use the system and don't punish the few who served honourable and want the change.

As I understand it, U.S. military pers incur a minimum of an 8 year service obligation (including Reserve, Guard and IRR time).  It seems like a significant obligation to undertake if you are not actually willing to serve. 

 

[EpicBeardedMan]

Don't have that info, but I do believe that the first person to get transition surgery is still serving in the RCAF, and that was almost 20 years ago if I recall.

http://www.macleans.ca/news/canada/being-transgender-in-the-canadian-military/

"Right now, it’s believed around 300 transgender members serve in the CAF. That amounts to about 0.45 per cent of the active armed forces that in May totalled 66,225. About half a per cent of the general population is believed to be trans. Dewitt and others believe the 300 figure is low. That best guess is based on word of mouth and the number of people accessing the medical system for hormone therapy or surgery."

 

[Blackadder1916]

As I understand it, U.S. military pers incur a minimum of an 8 year service obligation (including Reserve, Guard and IRR time).  It seems like a significant obligation to undertake if you are not actually willing to serve.

And what makes you think that a transgender individual is not willing to serve or that even one whose (possibly) primary motive to enlist is access to health care is any different from many who join for a variety of reasons, not all some patriot sense of service before all else.  If you made that the only acceptable singular motive, then when do you start refusing entry to those who join for education, adventure, personal and family health care coverage, good job, travel, experience to get an airline job, want to shoot guns, . . . ?

As I read through this thread I started wondering how the US military health system was dealing with the glut (sarcasm) of transgendered soldiers, sailors, airmen and Marines (and Coasties) making a beeline for the clinic demanding SRS.  So far there has been little to none, actual, hard and fast data posted on this forum about this change in US military personnel policy, either the change to allow or the more recent reversion statements by the current president.

I found only one professional journal article concerning the military and medical aspects written by serving military physicians.
Military Considerations in Transsexual Care of the Active Duty Member

ABSTRACT

Retention standards and policies applied to active duty members in the U.S. military who identify as transgender have recently been in evolution. The Secretary of Defense recently released a new directive allowing transgender members to serve openly with the option to transition gender while in active duty, abrogating the old policy disqualifying transgender members from continued service. There is a reasonable expectation that some may pursue medical and surgical options toward gender transition. The clinical pathway for gender transition relies heavily on Mental Health and Endocrinology services. This article highlights the medical aspects of gender transition and how they can affect readiness and the delivery of military health care.

Unfortunately, the full text of articles in "Military Medicine" that have been published within the last year are not available to non-subscribers.  You can wait a month or so to access the full article or you may be able to get access to it through your local public library (that's where I originally found it through a periodical search).

The article also provided some references that should be read by anyone wanting to make an informed comment about the existing current in-flux policies re transgender in the US military.

A few of them can be accessed though this site http://www.pdhealth.mil/clinical-guidance/transgender-mental-health

Since there sometimes seems to be a misconception that the change in policy (the Obama change) was an open door to permit individuals to enlist and immediately seek SRS, I've excerpted this for those who won't be bothered to research further.

DOD INSTRUCTION 1300.28
IN-SERVICE TRANSITION FOR TRANSGENDER SERVICE MEMBERS  (a pdf)

3.5. INITIAL ENTRY TRAINING AND CONSIDERATIONS ASSOCIATED WITH THE FIRST TERM OF SERVICE.

a. A blanket prohibition on gender transition during a Service member’s first term of service is not permissible. However, the Department recognizes that the All-Volunteer Force readiness model is largely based on those newly accessed into the military being ready and available for multiple training and deployment cycles during their first term of service. This readiness model may be taken into consideration by a commander in evaluating a request for medical care or treatment or an ETP associated with gender transition during a Service member’s first term of service. Any other facts and circumstances related to an individual Service member that impact that model will be considered by the commander as set forth in this issuance and implementing Military Department and Service regulations, policies, and guidance.

b. The following policies and procedures apply to Service members during the first term of service and will be applied to Service members with a diagnosis indicating that gender transition is medically necessary in the same manner, and to the same extent, as to Service members with other medical conditions that have a comparable impact on the member’s ability to serve:

(1) A Service member is subject to separation in an entry-level status during the period of initial training (defined as 180 days per DoDI 1332.14) based on a medical condition that impairs the Service member’s ability to complete such training.

(2) An individual participant is subject to separation from the Reserve Officers’ Training Corps in accordance with DoDI 1215.08, or from a Service Academy in accordance with DoDI 1322.22, based on a medical condition that impairs the individual’s ability to complete such training or to access into the Armed Forces, under the same terms and conditions applicable to participants in comparable circumstances not related to transgender persons or gender transition. As with all cadets or midshipmen who experience a medical condition while in the Reserve Officers’ Training Corps Program or at a Service Academy, each situation is unique and will be evaluated based on its individual circumstances; however, the individual will be required to meet medical accession standards as a prerequisite to graduation and appointment in the Armed Forces.

(3) A Service member is subject to administrative separation for a fraudulent or erroneous enlistment or induction when warranted and in accordance with DoDI 1332.14, based on any deliberate material misrepresentation, omission, or concealment of a fact, including a medical condition, that if known at the time of enlistment, induction, or entry into a period of military service, might have resulted in rejection.

(4) If a Service member requests non-urgent medical treatment or an ETP associated with gender transition during the first term of service, including during periods of initial entry training in excess of 180 days, the commander may give the factors set forth in Paragraph 3.5.a significant weight in considering and balancing the individual need associated with the request and the needs of the command, in determining when such treatment, or whether such ETP may commence in accordance with Paragraph 3.2.d.

And a more expanded document
Transgender Service in the U.S. Military
An Implementation Handbook
https://www.defense.gov/Portals/1/features/2016/0616_policy/DoDTGHandbook_093016.pdf

As to transgendered individuals who have tried to join since the first announcement in 2015 that they could enlist (if they met all criteria including medical) the change in policy only permitted accession as of 1 July 2017 (i.e. 2 months ago) and according to one document that I found (and have since been unable re-find online) the processing for enlistment could not start until that date.  I wonder how many have completed processing in the 27 days that elapsed before President Trump started twiting.

 

[RCPalmer]

And what makes you think that a transgender individual is not willing to serve or that even one whose (possibly) primary motive to enlist is access to health care is any different from many who join for a variety of reasons, not all some patriot sense of service before all else.  If you made that the only acceptable singular motive, then when do you start refusing entry to those who join for education, adventure, personal and family health care coverage, good job, travel, experience to get an airline job, want to shoot guns, . . . ?

As I read through this thread I started wondering how the US military health system was dealing with the glut (sarcasm) of transgendered soldiers, sailors, airmen and Marines (and Coasties) making a beeline for the clinic demanding SRS.  So far there has been little to none, actual, hard and fast data posted on this forum about this change in US military personnel policy, either the change to allow or the more recent reversion statements by the current president.

That is exactly my point.  I was responding to the comments from several posters implying that large numbers of people would join the U.S. military to fund their assignment surgery, spending their entire (short) careers in the U.S. military as MIR commandos.  In the context of an 8 year service obligation, I don't see that being a particularly realistic prospect.  I suppose a few individuals might be so motivated, but I would view them as no different from ROTP applicants in the Canadian context motivated by the subsidized undergraduate degree, incurring a 9 year service obligation in the process.  I fully acknowledge that member's motivations for joining the military will vary, and if a member completes their service obligations, I have no heartache. 

Overall, I thought that the 2016 RAND study (which is the main piece of research quoted in the mainstream media on this topic) provided a reasonable analysis of all the implications (operational, cost, etc.) and acknowledged the data gaps where they exist.  The most compelling argument for me in that study was the feedback from the Canadians, Aussies, Brits, French and Israelis who have all elected to accept transgender members over the last 20 years without any discernible readiness implications.

Of course, the most disingenuous part of this whole initiative has been the executive level roll-out.  Cheap political points scored with the base via twitter followed by an EO that was much closer to the status quo, leaving DoD, the service chiefs, and eventually the courts to clean up the mess.  If there is a operational readiness impact, I think that distraction is much more worrisome than a few gender reassignment surgeries.   

 

[Blackadder1916]

That is exactly my point.  I was responding to the comments from several posters implying that large numbers of people would join the U.S. military to fund their assignment surgery, spending their entire (short) careers in the U.S. military as MIR commandos.  In the context of an 8 year service obligation, I don't see that being a particularly realistic prospect. . . .

My apologies that I may have misconstrued the intent of your post which included ". . . if you are not actually willing to serve".  I focused entirely on that phrase and failed to make any possible conclusion that it could have been in rebuttal to previous posts, especially the one you quoted which (in hindsight) I should have quoted as the lead-in to my post since it includes a common misconception of the issue.

. . . it appears some people join up purely to get the system to pay for the operations. Sex change operations are not critical to the core task and are not related to the duties. If someone has served for X period of time, seen combat or has done something out of the ordinary (rescuing people , etc) then they can qualify. That way you avoid the people that want to use the system and don't punish the few who served honourable and want the change.

To repeat my rebuttal to that idea:
. . . the change in policy only permitted accession (enlistment) of transgendered persons as of 1 July 2017 (i.e. 2 months ago) and according to one document that I found (and have since been unable re-find online) the processing for enlistment could not start until that date.  It therefore seems unlikely that many some any people have been able to complete processing by a recruiting office, enlist, complete initial training, get to their first permanent duty station and then start the process to get "the operation" in the 27 days before President Trump had one of his early morning flights of fantasy.

Anyone who has already been approved for the US military funded surgery and/or other necessary medical care related to his/her condition was already serving when the policy changed.  They enlisted when it was not permitted to be open about their circumstances and from most accounts their service has been fine, in some cases exemplary*.  They obviously did not join in order to get their surgery paid for.  Of course, optics and social beliefs play a major role in the current administration's (and some segments of Congress) thinking.

* And before anyone tries to rebut my comments about the quality of service by mentioning former Pvt. Manning, let's just say that is an aberration of the norm; though of course, her successful legal action to get the Army to pay for her medical care could be seen as one impetus for the change in policy.