Memo Shows Extensive Taxpayer-Funded Treatments, Surgeries And Exceptions Offered To Transgender Servicemembers

Memo Shows Extensive Taxpayer-Funded Treatments, Surgeries And Exceptions Offered To Transgender Servicemembers

Micaela Burrow on July 19, 2023

• A newly revealed memo from the Womack Army Medical Center at Fort Liberty describes the breadth of services, including sex-change hormone therapy, counseling and surgeries, offered to transitioning soldiers.
• Soldiers can obtain exceptions to policy for appearance and may be considered non-deployable until their transition is complete, the memo shows.
• “The overarching goal of treatment for Transgender Service Members (TGSMs) is to provide a safe and effective pathway to achieve lasting personal comfort with their gendered selves to maximize their overall health,” the memo states.

Newly revealed policy guidance for the U.S. Army details the extensive medical services and accommodations soldiers seeking gender transition can expect.

The document, dated Feb. 1 and attributed to the Womack Army Medical Center at what is now Fort Liberty, followsDepartment of Defense (DOD) guidance last revised in 2022 and related Army policy implementing changes to standardsfor retention, separation, in-service transition and medical approaches toward transgender services. Services for transgender soldiers and those wishing to transition span behavioral health care, support for so-called real life experiences, cross-sex hormone therapy and surgeries, most of which are performed by the medical facility itself.

“The overarching goal of treatment for Transgender Service Members (TGSMs) is to provide a safe and effective pathway to achieve lasting personal comfort with their gendered selves to maximize their overall health and promote psychological well-being and self-fulfillment, while allowing them to continue to pursue their military service goals,” the memo reads.

Much of the memo is procedural, describing the medical facility’s process to mediate between soldiers, the DOD health system and non-military providers or experts who can provide allegedly “medically necessary” treatments. But it sheds additional light on how the U.S.’ largest Army installation is moving forward with accommodations for transgender servicemembers since President Joe Biden ordered the military to offer gender transition treatments in 2021.

For example, Womack medical providers do not have authority to waive uniform or grooming standards for servicemembers who do not wish to conform to those the Army has set for their birth sex. But they can recommend an exception to the Army’s chief of staff for personnel matters, along with a treatment plan.

Such exceptions are intended to “allow the service member to engage in Real Life Experiences (RLE’s) in the work environment” in their preferred gender while they remain assigned to showers and berths set aside for their original sex.

Primary care physicians have to receive additional training to “provide care for the anatomy that is present regardless of the SM’s self-description,” the memo states. In addition, each servicemember will be assigned a “Transgender Care Team” with additional training in health care and diversity issues to help manage the member’s transition plan.

Commanders can approve treatment plans “with full consideration of impacts to readiness and pending mission requirements,” the memo states. Members undergoing transition will not be able to deploy on initial stages of hormone therapy for up to nine months without complications.

Noting the health risks associated with irreversible cross-sex hormone therapy, the policy calls for exercise and nutrition counseling, metabolic testing and body composition assessments.

Once a transitioning servicemember has been diagnosed with gender dysphoria and “responsibly” completed a regiment of cross-sex hormone therapy for 12 months, the soldier can request to be evaluated for eligibility for various procedures, according to the memo.

Womack does not have the ability to perform more extreme genital construction surgeries, referring servicemembers to civilian providers. However, it does offer facial contouring, “upper” surgery, body contouring, hysterectomy, oophorectomy and orchiectomy.

TRICARE, the military’s medical insurance for members and veterans, still does not pay for sex change surgeries, according to the document.

The goal is to have a soldier’s gender marker in DEERS changed once they have stabilized, establishing the end of the transition plan. At that point, soldiers are expected to meet fitness and appearance standards associated with their new gender.

However, the document did not specify a cutoff timeline by which a soldier must be considered either fully transitioned or referred to a discharge board.

The document acknowledges the situation of self-described “nonbinary” or “gender fluid” soldiers, who are still required to select either “male” or “female” in the Defense Enrollment Eligibility Reporting System.

“This is not meant to misgender or disrespect a [servicemember’s] gender identity, however, the current medical and Army system views gender as a dichotomous variable,” the memo states.

The Defense Health Agency and Womack Medical Center did not respond to the Daily Caller News Foundation’s questions by posting time.