What exactly does the US Military transgender ban actually mean?

Recently, President Donald Trump announced via Twitter that transgender individuals would no longer be permitted to serve in the United States Armed Forces.

The response to Mr Trump’s announcement was decidedly mixed, with expressions of support, dismay, but above all, confusion, circulating on social media. Rights for this group remain a controversial and often-misunderstood topic, and this article seeks to explain the subject as it relates to military service, and the implications of President Trump’s announcement.

What does it mean to be transgender?

A transgender person is one whose gender identity does not match their biological sex: they may, for example, possess male sex characteristics, but identify as female (and vice versa). Transgender people are called transsexual if they seek medical assistance to transition from one sex to another. Being transgender is independent of one’s sexual orientation, but like sexual orientation, the scientific community is united in accepting that being transgender is not a choice.

Much attention has been paid recently to the healthcare demands and whether being transgender is a mental disorder. However as noted above, transgender people do not necessarily seek medical attention and some simply live as the gender they identify as. If a transgender person is significantly distressed by the disparity between their biological sex and gender identity, then they may be diagnosed with gender dysphoria, or gender identity disorder. This is classed as a mental disorder and the overwhelming consensus among the medical community is that it is best treated with psychotherapy, hormone replacement therapy, and sex reassignment surgery (a ‘sex change’).

All this has implications for the ban on transgender people serving in the U.S. Military. Some commentators supporting the ban have tried to cast being transgender as a disreputable modern lifestyle choice or an act of attention-seeking that a disciplined military has no business supporting. This is emphatically not true: a transgender person no more chooses their gender identity than they do their eye colour. Indeed, given the degree of vitriol direct at transgender people, and the potential complications of medical treatment, it is difficult to see why anyone would want to make that choice.

Can transgender people currently serve in the U.S. Military?

Openly transgender people were formally banned from serving in the U.S. Military in the early 1960s. This ban was independent of the ‘Don’t Ask, Don’t Tell’ policy enacted in the 1990s that prevented gays and lesbians from serving openly. In 2014, President Barack Obama’s Secretary of Defense, Chuck Hagel, announced that the ban was under continual review.

His successor, Ash Carter, said in 2015; “That’s the important criteria: are they going to be excellent service members? And I don’t think anything but their suitability for service should preclude them.”

Thereafter the individual armed services began easing their bans on transgender people: the Army, Navy and Marine Corps required any requests to dismiss transgender personnel to be forwarded to the services’ most senior civilian personnel, and the Air Force announced that there were only grounds for dismissing a transgender airman were if their condition interfered with their potential deployment or performance on active duty.

The RAND Corporation was requested to conduct a study on the implications of transgender service members and reported in June 2016. The report cited transgender personnel serving in the Australian, Canadian, Israeli and British armed forces and concluded that; “in no case was there any evidence of an effect on the operational effectiveness, operational readiness, or cohesion of the force.” It further concluded that transgender healthcare cost only 0.13% of the military health system’s annual budget of $6 billion.

In response, on June 30th the Department of Defense completely lifted the ban on transgender personnel serving openly, however non-transitioned civilians were still barred from recruitment. By November 10th, it was reported that over a hundred soldiers, sailors and airmen were seeking transgender healthcare.

Between 2,000 and 10,000 transgender people may currently serve in the US Military, with some studies citing 6,630 serving actively and 4,130 serving in the reserves.

The ban on non-transitioned civilians entering the U.S. Military was to be lifted on July 1st 2017, however Secretary of Defense James Mattis ordered a six-month delay to conduct a policy review “to evaluate more carefully the impact of such accessions on readiness and lethality.”

At time of writing, no policy change outside of President Trump’s Tweets has been announced and senior officers have declared that the existing policy is as-yet unchanged.

What about the British Armed Forces?

 Transgender people have been permitted to serve openly in the British Armed Forces since 2000. Discrimination against transgender personnel is grounds for disciplinary action. In response to President Trump’s announcement, at least three senior officers Tweeted their opposition to the ban, declaring their support for transgender soldiers and relief that no similar policy had been enacted in the United Kingdom.

Caroline Paige was the first transgender officer to serve openly in the British Armed Forces and served in Bosnia, Iraq and Afghanistan.

Captain Hannah Winterbourne of the Royal Electrical and Mechanical Engineers served in Afghanistan and attracted national media attention when she came out as transgender in 2016.

Guardsman Chloe Allen of the Scots Guards came out as transgender at the end of 2016 and is therefore the first female to serve in an infantry unit. However, the BBC reports that the total number of transgender people serving in the British Armed Forces is likely to be fewer than 10.  

What does transgender healthcare cost the U.S. Military?

In his announcement of the ban, President Trump said that the U.S. Military “cannot be burdened with the tremendous medical costs and disruption that transgender in the military would entail”. However, the 2016 RAND Corporation study found that, among active service personnel, no more than 140 new hormone treatments would be initiated a year and no more 130 sex reassignment surgeries would be conducted a year.

This would come to a cost of between $2.4 million and $8.4 million, representing an approximate 0.13% increase in the U.S. Military’s healthcare budget. An increase of slightly over one-tenth of a percent in healthcare costs cannot be described as a “tremendous medical cost”.

Various news outlets have reported rather gleefully that the U.S. Military spends nearly $84 million on Viagra and other erectile dysfunction treatments.

It must be said that the majority of this was prescribed to older retired veterans whose healthcare is still handled by the Department of Defense, and some to younger personnel who suffered erectile dysfunction owing to psychological problems caused by deployment to Iraq and Afghanistan. Nevertheless, the point still stands: if the Pentagon can afford to spend nearly ten times the cost of transgender healthcare on erectile dysfunction drugs, then it makes a mockery of President Trump’s claim that those healthcare costs are unaffordable. 

Who does the ban target? 

Quite simply, we don’t know. President Trump’s Tweets are no more than that: Tweets. They do not constitute a formal announcement of policy. The previous policy remains in effect. We do not know whether Mr Trump means to maintain the current ban on non-transitioned civilians entering the military, or whether the Department of Defense will cease to provide healthcare to transgender personnel, or whether he intends to dismiss all openly transgender people from service.

Far from an act of decisive policymaking, all Mr Trump’s announcement has done is put in doubt the careers of thousands American servicemen and women, possibly for months until his intent is clearly discerned. 

What does the US Military think about the ban?

 President Trump’s Tweets were met with surprise and dismay by senior American military officers and politicians. The Secretary of Defense, retired Marine General James Mattis, is said to have been given only a day’s notice of the announcement and was “appalled” by the ban.

Within hours of Mr Trump’s announcement, it became clear that his claim that he had made the decision “after consultation with my generals and military experts” was not entirely true. The Chief of Staff of the United States Army, General Mark Milley, said that he found out about the ban “the same way everybody else did – on the news.” 

The remarks of General Joseph Dunford, the Chairman of the Joint Chiefs of Staff and America’s most senior military officer, were perhaps the most pointed. He said in a memo to the rest of the Joint Chiefs that a Tweet did not constitute policy and that the policy would remain unchanged until they received a formal guidance document from the White House. His final remark is perhaps most indicative of what General Dunford thinks about the ban: “In the meantime, we will continue to treat all of our personnel with respect”.