Palm Center study calls for lifting of ban on transgender military service

The Palm Center released the Report of the Transgender Military Commission yesterday, funded by transgender billionaire Jennifer Pritzker, who is also a military veteran, to the tune of $1.35 million, about the suitability of transgender people for service in the military.

Although Don’t Ask, Don’t Tell was repealed in 2010, transgender people have remained banned from the military on the basis of the Department of Defense medical regulation DODI 6130.03 which considers any type of gender-confirming clinical, medical or surgical treatments as “disqualifying physical and mental conditions.”

The new report asserts:

Removal of the military’s blanket ban on transgender service members would improve health outcomes, enable commanders to better care for their troops, and reflect the federal government’s commitment to reducing disparities in health care access for transgender people.

The commission was co-chaired by former US Surgeon General Joycelyn Elders and Rear Admiral Alan M. Steinman, MD (Ret.) and included former military officers and top scholars on gender and health.

The Executive Summary is broken into 8 statements.

(1)  There is no compelling medical rationale to exclude transgender people from military service and eliminating the ban would enable commanders to better care for their troops.

(2)  Medical regulations requiring discharge of transgender people to be discharged are inconsistent with how the military regulates all other medical and psychological conditions.  Medical conditions related to transgender identity are the only gender-related conditions requiring discharge irreapective of fitness for duty.

(3)  Military regulations are updated to reflect revisions of the American Psychiatric Society’s Diagnostic and Statistical Manual of Mental Disorders (currently DSM-5), but regulations have not been amended to reflect the fact that gender non-conformity is no longer classified as a mental illness.

(4)  The prohibition on medically necessary hormone treatment for transgender people is inconsistent with the fact that non-transgender military personnel often rely on prescribed medications, including anabolic steroids, even when deployed in combat zones. The prohibition is simply based on inaccurate understandings of the complexity, risks, and efficacy of such treatments.

(5) Regulations that prohibit transgender service members from obtaining medically necessary gender-confirming surgery are harmful to the service members and inconsistent with policy concerning other reconstructive surgeries that service members are allowed to have.

(6) The ban on transgender military service compromises continuity of care between the Military Health Service and the Veterans Health Administration, a goal endorsed by officials from both systems.

(7)  Military regulations should be stripped of enlistment disqualifications for transgender conditions, whether defined physically or mentally, as well as retention provisions that specify gender identity disorder as grounds for administrative separation.  Transgender personnel should be treated in accordance with established medical standards of care, as is done with all other medical conditions.

(8)  Senior leaders should rely on the experiences and standards of other militaries ( and US federal agencies in formulating administrative policy to address fitness testing, records and identification, uniforms, housing, and privacy.

At least 13 countries allow open military service by transgender personnel: Australia, Canada, England, Israel, Belgium, the Czech Republic, the Netherlands, Spain, Sweden, Thailand, Denmark, New Zealand, and Norway.  

The commission’s investigation of the rationale for excluding service by transgender personnel made two important discoveries:  (1) the restrictions are vastly out of date and (2) there is no documented history of why it was instituted in the first place.

Slate’s original title for their article about the report was:  

The military’s ban on transgender service members is prejudice, pure and simple.

They’ve backed off of that title.

It’s been 20 years since the American Psychiatric Association’s DSM-IV removed “transsexualism” as a diagnosis.  When it did so, in 1994, it replaced the term with “gender identity disorder.”  But in the DSM-5, the latest version of the psychiatric manual published last year, gender identity disorder has been replaced with “gender dysphoria.”  The changes are not just semantics but carry real significance.  Unlike either transsexualism or gender identity disorder, gender dysphoria is not a mental disorder, and it is not something that all transgender people suffer from.  Instead, it refers to clinically significant distress that someone feels in conjunction with a deep cross-gender identification.  And even those who do get the diagnosis are regarded as having a treatable condition, not an identity disorder.

–Nathaniel Frank, Slate

The military does not currently offer a reason for the ban.  

At this time there are no plans to change the department’s policy and regulations which do not allow transgender individuals to serve in the U.S. military.

Navy Lt. Cmdr. Nate Christensen, Defense Department spokeman

I hope their takeaway will be we should evaluate every one of our people on the basis of their ability and what they can do, and if they have a condition we can treat we would treat it like we would treat anyone else.


When you closet someone, you create a security risk, and we don’t need another Chelsea Manning.  If I were a commander, I certainly wouldn’t want people in my unit in a position to be blackmailed.

–Brigadier General Thomas Kolditz (Ret.), commission member

Of course Center for Military Readiness President Elaine Donnelly predicts disaster, opining that putting transpeople in the barracks will result in an increase in sexual assaults (she doesn’t indicate if she believes that the transpeople will be the victims or the perpetrators, but we can imagine) and will infringe on the privacy of non-transgender personnel.

This is putting an extra burden on men and women in the military that they certainly don’t need and they don’t deserve.


The commission made three recommendations:

#1:  Lift the ban on transgender military service.

With respect to medical regulations, the Commander in Chief should order the Defense Department to eliminate bars to transgender military service by updating enlistment regulations that disqualify conditions that are defined physically (“abnormalities or defects of the genitalia such as change of sex”) and mentally (“psychosexual conditions, including but not limited to transsexualism”).  These blanket enlistment bars should be deleted, along with other disqualifications that may arise from medically appropriate treatment of transgender-related conditions, such as amenorrhea or hypogonadism.  The Commander in Chief should order the Defense Department to eliminate retention regulations that specify gender identity disorder as a condition justifying administrative separation as well.

#2:  Do not write new medical regulations.

Aside from these minor revisions, the Defense Department should not write new medical regulations or policies to address health care needs of transgender personnel, and should treat transgender service members in accordance with established medical practices and standards, as it does with the provision of all medical care.  As we have documented throughout this report, transgender service members should be presumed to be fit.  Any medical issue that interferes with an individual’s performance of duty is already subject to evaluation under existing medical standards, which are sufficient for enabling doctors to make determinations of fitness and deployability for transgender personnel.  Transgender service members should not be held to different standards of self-sufficiency or fitness than any other service members.

#3:  Base new administrative guidance on the experiences of foreign military and US governmental precedent.

[F]oreign military regulations that apply to transgender military service are straightforward and sensible, offering a sound model for US military policy.

Personally, as a transgender veteran and based upon my experience in the military during the Vietnam Era, I would not counsel a transgender person to join the military, but the fact is that transgender people do serve in the military at astoundingly high levels as compared with cisgender people.  And military service that is available to part of the population should be available to all of the population, especially when there are financial and educational benefits stemming from that service.

 photo SageFox_zps5ae89011.jpg

In this photo taken Wednesday, March 12, 2014, Army Reserve Capt. Sage Fox poses in El Dorado Hills, Calif. Following a deployment to Kuwait as a man, Fox began taking female hormones and began living as a woman. After notifying her battalion commander, whom she says expressed support, Fox received a set of orders informing her she had been placed on inactive status, a step from discharge.

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