Defense Secretary Jim Mattis has six months to consult with experts and establish policy regarding President Trump's military transgender ban and how it will affect those currently serving. Sens. Kirsten Gillibrand, D-N.Y., and Susan Collins, R-Maine, even proposed an amendment to the National Defense Authorization Act intended to reverse the ban.
Emotions are running high, and facts are being ignored.
With his un-presidential July tweet, President Trump set the stage for the visceral opposition that has followed. He was shocking and insensitive, especially to honorably serving transgender service members. A policy change of such magnitude should have been announced in a deliberate and respectful manner, with accompanying comprehensive policy.
Regardless, reconsideration of the Obama-era transgender policy is necessary.
Most recent news reporting maintains that military provision of gender transition medical procedures amounts to a negligible portion of the defense budget. Advocates often refer to a 2016 RAND Corporation analysis, which estimated military expenses associated with gender transition between $24 million and $84 million for a ten-year period.
But this estimate seems grossly inaccurate in light of the fact that 250 service members are presently in some stage of gender transition. A complete gender transition costs between $124,000 and $140,000. If all 250 servicemembers currently in the pipeline fully gender transition, medical costs alone will exceed $31 million just for these 250 individuals. The Williams Institute estimates there are as many as 8,800 transgender service members serving on active duty. President Trump highlighting the immense cost of providing gender transition healthcare is not unreasonable.
Moreover, the true cost must be considered. The military healthcare budget has been in crisis for some time and cannot absorb the massive additional cost of gender transition healthcare. The Congressional Budget Office even addressed the urgent situation in a 2014 report entitled, "Approaches to Reducing Federal Spending on Military Healthcare." Adding substantial services to the already overwhelmed military healthcare system exacerbates the serious problem.
In fact, shortage of medical resources is one reason why people afflicted with many preexisting conditions are prohibited from joining the Armed Forces. Army Regulation 40-501 states that medically qualified individuals should be "free of medical conditions or physical defects that would require excessive time lost from duty for necessary treatment or hospitalization…" The regulation goes on to list hundreds of disqualifications, some as minor as insufficiently healthy teeth, acne, eczema, pollen allergies, past bariatric surgery, past eating disorders, ADHD, and varicose veins. Including gender dysphoria and gender identity disorder (which do not affect all transgender individuals) as medically disqualifying conditions is no more discriminatory than any other disqualification.
Combat considerations are also relevant. Transgender individuals requiring hormone therapies are unavoidably at greater risk on the battlefield. According transgender military veteran Jamie Shupe, hormone therapies can have serious side effects. And if therapies become unavailable or inaccessible in wartime, the impact on a transitioning individual could be devastating.
The Obama administration's transgender policy compromises privacy of both non-transgender and transgender service members. Close quarters and minimal privacy are military norms. Current Army policy allows gender identifier change in the Department of Defense personnel system, DEERS, per service member request. Additional gender reassignment procedures are elective for the individual. Army training states:
"All Soldiers must use the barracks, bathroom, and shower facilities associated with their gender marker in DEERS. Understand that you may encounter individuals in barracks, bathrooms, or shower facilities with physical characteristics of the opposite sex despite having the same gender marker in DEERS. All Soldiers should be respectful of the privacy and modesty concerns of others. However, transgender Soldiers are not required or expected to modify or adjust their behavior based on the fact that they do not 'match' other Soldiers."
While the majority of service members may have no issue working alongside a transgender individual, sharing an open bay shower facility, barracks room, or tent with someone possessing organs of the opposite biological sex still violates the privacy expectations of many.Military transgender policy change appears imminent. Those who favor reinstating transgender identity as a disqualifying condition likely harbor no more ill-will for transgender individuals than they do for those with high blood pressure. Instead, they are concerned with the ongoing military healthcare crisis, personal privacy, and safety of transgender individuals in a theater of war.
Julie Pulley is a former U.S. Army captain and veteran of the Afghanistan conflict.
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