Life for the estimated 15,450 transgender Americans serving in the U.S. military is more than a fight to survive a combat deployment or endure the impact of post-traumatic stress. It’s a daily struggle to keep their identity tightly under wraps.

Despite the 2011 repeal of the “don’t ask, don’t tell” policy, which ended the official persecution of gays in the military, transgender troops who identify themselves as such to a superior officer can still be kicked out of the service. Even if they’ve earned a spotless record of brave service, transgender warriors can lose their job and benefits and get cut off from a career and community that may be central to their lives.

They don’t even have to “tell” to face that punishment. Technically, a commanding officer need only designate a service member as transgender to trigger disciplinary action that could end with removal from military service, says Aaron Belkin, director of the Palm Center, a research initiative based at San Francisco State University’s Department of Political Science.

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The Palm Center has just released a study conducted by a nonpartisan team of respected medical and psychological experts led by former surgeon general Dr. Joycelyn Elders and the now-retired Coast Guard director of health and safety, Admiral Alan Steinman.

Their goal? To determine whether U.S. military policies that ban transgender service members are based on medically sound reasoning.

The commission found “no compelling medical rationale for banning transgender military service, and that eliminating the ban would advance a number of military interests.”

They went even further: “We determined…that the ban itself is an expensive, damaging and unfair barrier to health care access for the approximately 15,450 transgender personnel who serve currently in the active, Guard and reserve components.” (The figure was estimated by UCLA’s Williams Institute, which extrapolated it from numerous data points, including the percentage of transgender veterans.)

One misconception the report dispels is that some medical procedures or treatments transgender people choose would impede their service. “The prohibition on medically necessary cross-sex hormone treatment is inconsistent with the fact that many non-transgender military personnel rely on prescribed medications, including anabolic steroids, even while deployed in combat zones,” the report explains.

In addition, the report calls the regulations that keep transgender service members from obtaining gender-confirming surgery “inconsistent with policy concerning other reconstructive surgeries that service members are allowed to have.” In fact, the study finds that some of the elective cosmetic procedures that troops receive actually “risk post-operative complications that can be more serious than those of medically necessary gender-confirming surgeries.”

Meanwhile, many people who identify as transgender choose not to have any medical procedures. Gene Silvestri, a transgender veteran who does outreach work on behalf of LGBT veterans and service members, says many transgender warriors are seeking simply to do their jobs and serve the nation. “People are keeping their business to themselves,” he says. “We’ve always been there. LGBT-plus has always served…. It’s just a matter of being able to do it openly.”

Silvestri served as a female and vividly remembers the stress he felt when a superior officer would mistakenly identify him as male. Like many LGBT rights advocates, he sees the data in this report as a useful tool for lobbying to change the lives of the thousands of transgender service members living under the threat of detection.

In the coming months the Palm Center, the National Center for Transgender Equality, Human Rights Campaign, and other organizations will be pressing the subject with the White House and the Department of Defense. “The conversation is just beginning,” says Belkin.

Will the Obama administration choose to remove the ban? Thus far, there’s been little indication: Asked about the report during a press briefing earlier this week, White House spokesman Jay Carney referred reporters to the Pentagon.

The Pentagon was more blunt: According to The Guardian, defense spokesman Lt. Commander Nate Christensen said there were currently “no plans to change the department’s policy and regulations which do not allow transgender individuals to serve in the U.S. military.”

DOD’s research shows that service members have little concern about the sexual preferences of those who serve alongside them, suggesting that some may feel the same way regarding gender designation. A 2010 study on the potential impact of a repeal of DADT found "a widespread attitude among a solid majority of servicemembers that [it would] not have a negative impact on their ability to conduct their mission.”

History is bearing that out: More than two years after DADT was lifted, a 2013 survey of more than 5,000 military families by the nonprofit Blue Star Families found that “a majority of respondents felt the repeal…had no impact on a variety of issues.” Seventy-five percent of respondents, most of whom were military spouses, said the repeal had “no impact on their service member’s ability to do his/her job and 72 percent said it had no impact on their service member’s desire to re-enlist.”

When DADT was repealed, President Obama called the Department of Defense’s acceptance of openly gay troops “a tribute to all the patriots who fought and marched for change.” That day, then–Secretary of Defense Leon Panetta said he was “committed to removing all of the barriers that would prevent Americans from serving their country and from rising to the highest level of responsibility that their talents and capabilities warrant.”

Transgender service members are still waiting for that commitment to be fulfilled.