The Pentagon is touting holistic medical solutions and flexibility for transgender service members, but some conservative military observers believe the Defense Department is not doing enough to ensure its approach will not hinder operations.
Then-President Barack Obama initiated a policy in 2016 allowing for and providing medical treatment short of surgery for transgender service members. Obama’s policy was reversed by the Trump administration, but transgender service members were allowed to remain in the military. In his first days in office, the Washington Examiner first reported that President Joe Biden restored the Obama policy and went further, expanding treatment options to include paying for expensive gender reassignment surgery.
In announcing the April 30 implementation of new transgender policies, the Pentagon on Wednesday declined to comment on a Washington Examiner question about how unit cohesion might be affected, citing ongoing litigation. A 2016 RAND study indicated “little or no impact,” and in testimony before Congress, military leaders have touted the benefits of diversity and inclusion.
Retired Lt. Gen. Thomas Spoehr, director of the Heritage Foundation’s center for national defense, said Thursday that the RAND study was flawed, and DOD is writing a policy with a solution already in mind.
“They haven’t looked at unit cohesion. They really haven’t even looked at the aspects of military readiness, which is the part that troubles me the most,” he said.
Spoehr was particularly worried about transgender service members who might be entering extended therapy and have numerous absences from their unit.
“There’s no guidance in this policy that says, ‘OK, how am I supposed to accommodate all this? And yet, also keep the mission going,’” he said. “If this one person in your unit is playing a critical role, like he is the unit armor or communications person, and you only have one of them, and he or she is gone doing all these things, there’s no way that it can’t have a readiness impact on your unit.”
Asked to explain how the policy will be implemented, DOD Director of Ascension Policy Stephanie Miller instead focused Wednesday on the holistic support and flexibility available to transgender service members.
“It starts with working with the medical provider and receiving that diagnosis of gender dysphoria,” she told the Washington Examiner.
“Then the medical provider or a team then designs a medical transition treatment plan. And that usually includes the primary care provider, an endocrinologist, surgical specialists, and even case managers,” she said. “We have wonderful teams that are led by regional chairs across the Defense Department and major [military treatment facilities] that really specialize in this and are prepared to work with service members to help them have a successful transition.”
A plan is then designed and coordinated with the service member’s unit and commander.
“Making sure that they are looking at the timing of different interventions,” she continued. “Whether or not there needs to be an adjustment to any of that to help support the service member and support the unit and then the command supports the individual as they affect that transition.”
Service members may even delay deployment in order to accommodate their treatment plan, Miller said.
Readiness ‘will improve’
The Department of Defense routinely makes accommodations for service members with medical conditions, disabilities, and pregnant women. The population of transgender service members is relatively small, estimated to be about 2,200 among 1.3 million active-duty members.
In an email response to the Washington Examiner Thursday, DOD spokeswoman Lisa Lawrence admitted that military readiness for medical treatment will be affected but will improve in the end.
“We expect that military readiness will improve as we provide transgender Service members with medically necessary treatment,” she said. “Although we expect some military readiness impact from medical treatment associated with gender transition, we believe that this is likely to be in line with the impacts of other medical treatments.”
Lawrence listed a series of tools available to commanders, including adjusting the date when a transition will begin, advising extended leave status, arranging for transfer, referral to a determination of fitness in the disability evaluation system, or initiating administrative or other proceedings.
Defense Secretary Lloyd Austin declared his support for overturning the transgender ban at his nomination hearing and quickly acted to implement Biden’s two executive orders.
“If you’re fit and you’re qualified to serve, and you can maintain the standards, you should be allowed to serve,” he said Jan. 19. “You can expect that I will support that throughout.”
Spoehr noted he had no firsthand knowledge of transgender service members, but he worried the new policies would pressure commanders to approve procedures within the required 90-day window.
In comparing the Clinton-era debate about gay people in the military to the current debate about transgender individuals, the former Army commander with three decades of experience admitted that, ultimately, concerns about unit cohesion were unfounded for gay and lesbian service members.
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“They just wanted to make sure that people could do their job, that they could be counted upon, that they would pull their fair share,” he said.
“That’s my concern with this is,” he said. “With these people being gone frequently, for treatment and counseling or whatever, that there’s going to be this perception that there’s two kinds of people, that these folks aren’t pulling their full fair share.”
