2 Transgender Cadets To Graduate But Will Not Serve

Some of the FAQs:


Q: Does being transgender mean an individual is psychologically unstable?


A: It does not. In May 2013, the most recent (fifth) edition of Diagnostic and Statistical

Manual of the American Psychiatric Association (DSM-5) was released, which depathologized

gender nonconforming behavior and identities, removed the earlier

Gender Identity Disorder (GID) diagnosis, and placed gender dysphoria in its own

distinct category. The APA states in this document, “It is important to note that gender

nonconformity is not in itself a mental disorder.”7 In the past few years, most major


medical and psychological organizations have adopted positions opposing

discrimination against transgender individuals, including the withholding of medically

necessary care.8

Q: What types of medical care do transgender service members require?

A: Courses of treatment vary from person to person. As with many conditions, the

individual selects treatment options based on the recommendations of his or her doctor

and other consulting specialists.

Treatment typically begins with counseling or psychotherapy to confirm a diagnosis of

gender dysphoria. Counseling also provides the individual with the opportunity to better


understand his or her gender identity, address the negative impact of gender dysphoria


and stigma on mental wellness, enhance social and peer support, and build resilience in

preparation for transition. As part of this process, internationally recognized standards of

care recommend in most cases that the individual begin living part-time or full-time in

the gender role more consistent with their gender identity. This shift is typically made

prior to any further medical intervention and, often, as an eligibility requirement for

receiving such intervention.9

Medical interventions often associated with transition include the following:

• Hormone Replacement Therapy (HRT) administered via pills, intramuscular


injections, or transdermal patches or gels;

• Surgery to change primary and/or secondary sex characteristics (e.g.,

breasts/chest, external and/or internal genitalia, facial features).10

Standards of Care and Ethical Guidelines for treatment are published and maintained

by the World Professional Organization for Transgender Health (WPATH), an

international professional organization established in 1979.11

Q: What are the projected costs of providing appropriate medical care for

transgender service members?

A: A recent study by the Williams Institute of UCLA showed that in civilian contexts, the

cost to employers of providing transgender individuals with appropriate health care

raised gross premium costs by no more than a four tenths of a percent for large

companies, and as little as four one-hundredths for smaller organizations.12 Applied to


the military context, providing appropriate health care is significantly more cost effective

than discharging transgender service members without cause. For example, it cost over

half a million dollars to train CT3 Landon Wilson13, a U.S. Navy Cryptologic Technician


discharged in 2014 for being transgender, yet the average total lifetime costs of

transition-related claims per individual is less than $30,000.14

Q: Will the DoD be able to provide the medical expertise necessary to care for

transgender service members?

A: Most of the care transgender service members require can be handled by a general

practitioner.15 DoD doctors already perform some of the surgical procedures


transgender service members may need, such as breast reconstruction, augmentation,

reduction, and hysterectomy.16 In those few cases where DoD medical professionals


lack proper expertise or DoD medical facilities are not properly equipped, there are

already administrative systems in place, such as TriCare, to allow service members to

obtain access to appropriate specialists outside DoD.17

Q: Don’t transgender individuals require a lot of extra, specialized medical care

after transition?

A: No. Post-transition, most transgender individuals who are otherwise healthy see a

general practitioner once or twice a year for routine blood work and prescription

renewal.18, 19

Q: Are transgender people deployable to forward locations and other austere

environments?

A: Yes. In fact, DoD has been deploying transgender individuals for over a decade as

civilians and contractors to Afghanistan, Iraq, and the Persian Gulf and embedding them

with US forces there.20, 21, 22 In this capacity, transgender Americans have served openly


in forward locations such as Camp Anaconda and Balad Air Base in Iraq, New Kabul

Compound and Kandahar Air Base in Afghanistan, and aboard US Navy ships

operating in the Persian Gulf. Additionally, our allies have successfully deployed

transgender service members for more than 20 years and into every theater of the war

on terror.23 There are no special medical requirements that would prevent a transgender

service member from deploying to any location where US troops serve today.24

Q: Will providing transgender service members access to necessary medications

place an additional burden on the military health care system?

A: No. The military health care system already provides the medications commonly

used for HRT to non-transgender service members as treatment for other conditions.

HRT for transgender service members would not require new pharmaceuticals,

logistics, or significant cost.25

Q: What if a transgender service member is prevented from accessing their

medications due to logistical or tactical circumstances?

A: Such a situation is highly unlikely. Allied militaries in which transgender individuals

serve openly have found the rate of such occurrences to be extremely low. In those

circumstances where temporary loss of access to HRT medications is truly unavoidable,

the effects are neither debilitating nor life threatening.26, 27

I was on oral HRT from day one as this was prescribed by my NHS

endocrinologist, and simply stocked up from my medical center before

deployment. When I suddenly found myself extended for 2 months in the

Falklands in 2011, I ordered more through the medical center there.
28

– Flight Lieutenant Ayla Holdom, RAF



Q: Will transgender service members spend a lot of time in a non-deployable


status?

A: No. Transgender service members in other countries report spending less than six

months total in a medically non-deployable status. Typically, the medical elements of

transition that might affect readiness are scheduled so as not to impact unit readiness

(i.e. while the unit is on a home cycle).

I was kept at G1 A1 Z1 [physically fit for flying and ground deployment

without any restriction] and retained my flying category throughout, with


the exceptions of having a month off flying duties when I began my HRT

(which is the standard time-period for any long-term medication) and 6

months off flying in total, following my Gender Reassignment Surgery

(GRS), during which time I was medically downgraded to P7 (nondeployable)…

Shortly after I began HRT though, before my public

transition, I was deployed for 7 weeks to the Falkland Islands in a flying

role and again for 9 weeks towards the end of my transition, a few months

before my GRS.

I am now A1 P2, which means there’s no restriction to my flying or my

deploying and is simply a marker to show I am on long-term medication.29

– Flight Lieutenant Ayla Holdom, RAF


Does the website lay out any of the drawbacks or negative aspects?
I to would like to know this answer. Everything can't be all that good. Yes?
 
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