Transgender Military Service: Legal Or Not?

The inclusion of transgender people in the military has been a highly contested issue in the United States, with policies varying across different presidential administrations. While former President Trump sought to implement a ban on transgender individuals serving in the military, citing concerns over substantial medical treatment requirements and costs, President Biden has since reversed this policy, allowing most transgender people to serve openly. This change has sparked controversy, with critics arguing that it prioritises radical gender ideology over military readiness and could result in the discharge of experienced personnel. However, supporters of the inclusion of transgender individuals in the military highlight the unfair discrimination and injustice faced by this demographic, as well as the potential loss of talented and critical personnel. The exact number of transgender service members is unknown, with estimates ranging from 2,200 to 15,500, further fuelling the debate surrounding the impact of such policies.

• Diversity is critical for militaries to survive in the 21st century.
• The current medical understanding of gender identity contradicts the argument that transgender individuals have a mental illness.
• There is no empirical evidence that transgender individuals are unfit for service. | | Arguments against inclusion | - Transgender individuals have a high incidence of depression and suicide, and hormone therapy can affect mood and well-being.
• The cost of treating transgender military personnel.
• Transgender individuals would negatively impact unit cohesion and morale. |

The history of transgender people in the military

From 1775 to 1949, there were no formal policies explicitly addressing the inclusion of transgender individuals in the U.S. military. However, societal norms and a lack of understanding of transgender identities during this period likely led to the informal exclusion or rejection of individuals who challenged traditional gender roles. Starting in 1949, explicit bans on transgender individuals serving in the military were enacted, citing concerns about gender non-conformity and compatibility with military service. These bans remained in place, with some variations, until the early 2000s.

In the late 1990s, transgender military advocacy gained visibility through grassroots organisations and individual activists. This led to the formation of groups like the Transgender American Veterans Association and the Palm Center, which advanced the cause through research and advocacy efforts. As a result of their work, the first openly transgender individuals began serving in the U.S. military in 2013, with Sage Fox becoming the first openly transgender service member.

During the Obama administration, there was a push for greater inclusion of transgender individuals in the military. In 2016, the ban on transgender service members was lifted, allowing them to serve openly and access medical care related to gender transition. However, this progress was short-lived as the Trump administration reversed these policies during its first term, citing concerns about medical costs and military readiness. The Biden administration has since reinstated policies allowing transgender individuals to serve openly in the military.

The inclusion of transgender individuals in the military remains a contentious issue globally, with varying policies across different countries. As of 2022, more than 30 countries allow transgender military personnel to serve openly, while others have limited or no inclusion. The arguments for and against the inclusion of transgender individuals in the military centre around issues of unit cohesion, medical costs, and equality.

Arguments for and against inclusion

Arguments for inclusion:

• Excluding transgender people from military service overtly intensifies the stigma of that group's civic inferiority. The notion that all citizens are obligated to serve their nations if the need arises supports the inclusion of transgender military personnel to serve openly without fear of exclusion.
• The inclusion of all LGBT personnel in the military is more than a mere human rights issue. For militaries to survive in the twenty-first century, diversity is critical.
• The current understanding of human experience has advanced, and sexual identity is now better understood. Where being transgender was once considered a paraphilic disorder, the current Diagnostic and Statistical Manual of Mental Disorders places being transgender in a separate chapter, terming the condition gender dysphoria.
• There is no empirical evidence that transgender people are unfit for service. Factors such as a supposed predisposition of transgender individuals to problems such as depression, anxiety, and suicidal thoughts are countered by the prevalence of these same issues in the LGBT community, yet in many countries, their service is not excluded.
• The high medical cost of transgender people is often cited by militaries, but they fail to reconcile this argument with current standards for other service members. For example, militaries often allow hormone treatments for reasons besides gender dysphoria, such as conception.
• Research on the impacts of allowing LGBT individuals to serve openly in the Israeli Defense Forces, British Armed Forces, and Canadian Armed Forces found no necessary negative impacts on performance, unit cohesion, or morality.
• Transgender people are significantly more likely to serve in the US military than the general US population. According to 2014 estimates, about 21.4% of the total transgender population in the US is estimated to have served in the military, making transgender people approximately twice as likely as others to serve.

Arguments against inclusion:

• Being transgender is considered a mental illness, and as such, transgender individuals are unfit for service. This argument is supported by the high incidence of depression and suicide manifest in transgender individuals, especially those who have had sex-reassignment surgery and are unsatisfied with the results.
• Hormone therapy can affect mood and a sense of well-being, a factor that counts against inclusion and its effect on service capability.
• Complications may arise due to hormone treatments, including an increased risk of thromboembolic disease, myocardial infarction, breast cancer, fertility problems, stroke, abnormal liver function, renal disease, endometrial cancer, and osteoporosis. Any of these could cause significant issues for effective military service, especially when deployed in remote areas or in field training settings.
• The cost of treating transgender members in the military is a concern. A small portion of transgender soldiers seek medical intervention, with 30 to 140 pursuing hormone treatment and 25 to 100 having surgical reassignment surgery annually.
• To have an effective, smooth-running military, there must be cohesion within the unit. It is argued that transgender individuals would negatively impact unit cohesion and morale.
• Military service forces members into very intimate living quarters. Requiring members to live in situations that make them feel disconcerted and uncomfortable may result in their performance being undermined.

The cost of gender-affirming surgeries

Chest Reconstruction Surgery:

This procedure typically ranges in cost from $6,900 to $45,080. It involves the removal of breast tissue to create a more masculine appearance or the shaping of breast tissue for a more feminine appearance.

Body Masculinization or Feminization:

These procedures aim to contour the body to align with the individual's gender identity. Costs can vary depending on the specific areas treated, but prices generally range from $7,000 to $50,000.

Facial Feminization or Masculinization Surgery:

These procedures involve altering the bones and soft tissue of the face to create a more traditionally masculine or feminine appearance. The cost can range from $6,900 to $63,400, depending on the specific area of the face being treated.

Phalloplasty or Metoidioplasty:

These procedures are typically considered masculinizing bottom surgeries. The cost of metoidioplasty can vary depending on whether the patient chooses to undergo a simultaneous primary urethral lengthening procedure, which facilitates urinating while standing. Phalloplasty is a more complex procedure and can cost significantly more.

Vaginoplasty:

Vaginoplasty is a feminizing bottom surgery that typically costs around $45,000. This procedure involves the construction or reconstruction of vaginal anatomy.

Orchiectomy:

Orchiectomy, or the surgical removal of the testes, can cost around $6,900. This procedure may be performed as part of a gender-affirming surgery or for other medical reasons.

Mastectomy:

Mastectomy, or the surgical removal of breast tissue, typically costs around $6,900. This procedure is often sought by transgender men as part of their gender-affirming journey.

Mammoplasty:

Mammoplasty, or breast augmentation surgery, typically costs around $7,000. This procedure may be sought by transgender women to create a more feminine appearance.

It is important to note that these cost estimates may not include additional expenses such as anesthesia fees, facility fees, pathology fees, post-surgery expenses, and travel costs. Insurance coverage can also significantly impact the out-of-pocket costs for individuals undergoing gender-affirming surgeries.

The impact on unit cohesion

Unit cohesion refers to the "bonds of trust among individual service members". It is a vital aspect of military service, as it ensures that morale remains high and that members can work together effectively.

There are arguments that the inclusion of transgender people in the military would negatively impact unit cohesion. One argument is that military service forces members into very intimate living quarters, and requiring members to live in situations that make them feel uncomfortable may result in their performance being undermined. However, this argument fails to address the question of what kinds of structural accommodations could be put in place to maintain morale and unit cohesion.

There is also a concern that if transgender personnel were allowed to serve openly, morale would be detrimentally affected. However, this argument has been disproven in practice in the US and in other countries that allow transgender people to serve openly in the military. A RAND study commissioned by the Pentagon during its policy review found that there was no effect on unit cohesion or effectiveness in the militaries of 18 other countries that allow transgender personnel to serve. These countries include Australia, Austria, Belgium, Bolivia, Canada, the Czech Republic, Denmark, Estonia, Finland, France, Germany, Israel, the Netherlands, New Zealand, Norway, Spain, Sweden, and the United Kingdom.

Furthermore, the US military's experience of having thousands of transgender personnel serving across the force without significant issues since transgender individuals were allowed to serve openly indicates that the argument based on disruption to the force is a pretext. The claim that allowing transgender military personnel to serve reduces military effectiveness is not a novel one and has been disproven when applied to the integration of African American, female, and lesbian, gay, and bisexual service members.

In fact, allowing transgender people to serve openly in the military may even improve unit cohesion by creating a more accepting environment and mitigating the distress that transgender personnel feel. This is supported by research on the impacts of allowing LGBT individuals to serve openly in the Israeli Defense Forces, British Armed Forces, and Canadian Armed Forces, which found no negative impacts on performance, unit cohesion, or morale.

Moreover, by excluding a demographic from equal service, militaries are overtly intensifying the stigma of that group's civic inferiority. Allowing transgender military personnel to serve openly without fear of exclusion would be a huge step toward equality and is critical for militaries to survive in the twenty-first century.

The legal status of the ban

In 2016, the Obama administration lifted the ban, allowing transgender individuals to serve openly and access medical care related to gender transition. However, this policy was short-lived, as the Trump administration reinstated the ban in 2017, citing concerns about military readiness and costs. This decision was challenged in court, and several lawsuits were filed, resulting in injunctions against the ban.

The Biden administration reversed the ban again in 2021, allowing transgender individuals to serve openly and access gender-affirming medical care. However, in 2024, the National Defense Authorization Act, a defence spending package, included a provision banning coverage of gender-affirming care for transgender minors who are dependents of military service members. This provision was criticised by Democrats and human rights groups as discriminatory and harmful to military families.

Frequently asked questions