SAN FRANCISCO (AP) — An independent commission led by a former U.S. surgeon general has concluded there “is no compelling medical reason” for the U.S. armed forces to prohibit transgender Americans from serving and that President Obama could lift the decades-old ban without approval from Congress, according to a report being released Thursday.

The report said Department of Defense regulations designed to keep transgender people from joining or remaining in the military on the grounds of psychological and physical unfitness are based on outdated beliefs that require thousands of current service members either to leave the service or to forego the medical procedures and other changes that could align their bodies and gender identities.