America's Doctors: Transgender Military Ban Is Pointless

The American Medical Association weighs in — against the ban on military service by out transgender Americans.

In the most sweeping statement yet in favor of overturning the ban on out trans troops, the American Medical Association has concluded there is “no medically valid reason to exclude transgender individuals from service in the U.S. military."

The AMA, the latest voice to oppose the prohibition on military service by out trans Americans, approved a resolution today against the ban at an annual policy-making meeting, according to the Washington Blade.

Just last week, the U.S. Air Force broke ranks with the other military branches by announcing that transgender identity or a diagnosis of gender dysphoria alone would no longer be a reason for an Airman or Airwoman to be “separated” from duty — in other words, kicked out.

The American Military Partner Association cited a 2014 study the Williams Institute that estimated there are 15,500 transgender service members currently serving in silence. AMPA President Ashley Broadway-Mack issued this statement:

"With the American Medical Association weighing in, the pressure continues to build for Secretary Carter to take action and implement a fair and uniform standard across the branches — one that lifts the ban on open and honest service by transgender troops. We urge Secretary Carter to order a comprehensive review and implementation of the important and necessary changes to the outdated regulations that continue to harm our brave transgender service members and their families. The time for this unjust ban to end is now."

In March, AMPA and the Transgender American Veterans Association issued a joint report that highlighted the tremendous harm the transgender ban causes an entire military family unit. The joint report notes:

“As long as the military continues to enforce antiquated medical regulations, the entire family is subject to the ban’s harmful impact. They are exposed to the same levels of risk, discrimination, and humiliation that transgender service members face, left with no choice but to serve in silence along with their service member. The entire family unit shares in the burden of having to live a double life, forced to keep their loved one’s true gender identity concealed. Often times, they remain helpless, witnessing the pain and torment their loved one experiences as a result of overwhelming pressure from the ban.”

The Human Rights Campaign weighed in on AMA's resolution, which comes after a series of large studies arrived at the same conclusion, that there is "no compelling medical reason" to keep openly transgender Americans from serving in the military.

"This important resolution from the nation’s largest association of physicians should be a catalyst for Secretary Carter to take action and update the outdated regulations preventing transgender troops from serving openly and honestly," said HRC's Government Affairs Director David Stacy in a statement. "Not only is there no valid medical reason for this ban to continue, but there is no valid reason, period."

According to the announcement by an Air Force spokesperson last week, "Neither gender dysphoria nor self-identification as transgender is an automatic circumstance that generates involuntary separation. ... Identification as transgender, absent a record of poor duty performance, misconduct, or a medically disqualifying condition, is not a basis for involuntary separation.”

Additionally, the Air Force elevated discharge decisions from an airman's chain of command to the Director of the Air Force Review Boards Agency, in a move similar to one the Army made earlier this year.

The USAF's reference to "medically disqualifying condition" can still apply to "gender dysphoria," a form of mental and emotional distress over a mismatch in body and gender identity experienced by many trans people — but such a diagnosis alone does not require separation, under the Air Force's new guidelines.

What's most significant, as Army helicopter crew chief Sgt. Shane Ortega revealed to The Advocate last month, military doctors may not consider every trans person as automatically suffering from gender dysphoria — a commonly-held position outside of the military. This creates room for some trans Air Force members to remain on active duty.

"Though the Air Force policy regarding involuntary separation of gender dysphoric Airmen has not changed," explained top Air Force personnel official Daniel Sitterly, "the elevation of the decision authority to the Director, Air Force Review Boards Agency, ensures the ability to consistently apply to existing policy."

However, it's still possible the Air Force may review its stance on gender dysphoria at a later date. "From my point of view, anyone who is capable of accomplishing this job should be able to serve," Air Force secretary Deborah James said in December. "And so I wouldn't be surprised if this doesn't come under review."

The Air Force's decision is still a cause for relief and celebration for the likely thousands of trans servicemembers who had kept their identities hidden out of fear of losing their Air Force jobs, although many others may choose to remain silent if they experience gender dysphoric symptoms.

Meanwhile, trans military advocates urge continued pressure on the Pentagon to lift the transgender military ban that remains intact in all other branches of the U.S. military. As the policy is a regulation and not a law, it can be changed without Congressional action, at the discretion of the Pentagon, the Secretary of Defense, or President Obama, as commander in chief.

"This is a significant step forward for a portion of roughly 15,000 current transgender service members across all branches," said SPARTA director of policy and transgender Army veteran Allyson Robison in a statement. "However, we need a consistent solution across all the services." She added that the current "patchwork of solutions out there [find] local commanders struggling to reconcile unclear guidance with their responsibility to retain good people."

This reality has resulted in only a handful of transgender servicemembers serving openly over the past several years after their commanders decided not to follow the non-binding Department of Defense Instruction 6130.03. That rule dictates that any type of gender-confirming clinical, medical, or surgical treatment is evidence of "disqualifying physical and mental conditions."

Secretary of Defense Ashton Carter, who took office in February, has said he is “open-minded” about reviewing the policy, which has not been updated since it was written in the 1970s. But despite pressure from activists within the ranks and in Washington, the Pentagon has confirmed that no specific review of the transgender-specific ban is currently under way.

“However, the Department of Defense began a routine, periodic review of the‎ Department's medical accession policy, DoDI 6130.03 in February 2015,” a Pentagon spokesman, Cmdr. Nate Christiansen, told The Advocate via email. “The‎ review will cover 26 systems of the human body (e.g., neurologic, vision, learning, psychological and behavioral). We routinely review our policies to make sure they are accurate, up-to-date and reflect any necessary changes since the Department's last policy review... The current periodic review is expected to take between 12-18 months; it is not a specific review of the Department’s transgender policy.”

Just hours before the Air Force announced its decision, the creator of the TransMilitary documentary on the U.S. transgender military ban, Fiona Dawson, debuted a short documentary in The New York Times that shows how these policies affect individual trans Air Force members.

The film, Transgender, at War and in Love, features fiancees Logan Ireland, a trans Senior Airman serving openly, and Laila Villanueva, a trans Corporal whose identity is not supported by her command.