The Pentagon detailed rules for service members undergoing a sex change transition including a prohibition on personnel from living their “preferred gender” lifestyle on base.

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The commander of the service member going through the gender transition has to approve government-funded medical treatment for the sex change and then oversee the service member’s return to service.

The Department of Defense laid out the details for the 18 page comprehensive manual in a process that starts with a service member having to first get a medical diagnosis from a military medical provider. The service member then has to tell their commander that says a diagnosis for gender transition is “medically necessary.”

The manual tries to explain the difficulties the military has with sex changes and how the needs of a service member are “consistent with military mission and readiness.”

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The manual explains that the service members are prohibited from living their “preferred gender” lifestyle on the base and can’t live their “Real Life Experience,” or RLE, until the military and the service member’s transition is complete.

RLE is described as

“The phase in the gender transition process during which the individual commences living socially in the gender role consistent with their preferred gender. RLE may or may not be preceded by the commencement of cross-sex hormone therapy, depending on the medical treatment associated with the individual Service member’s gender transition. The RLE phase is also a necessary precursor to certain medical procedures, including gender transition surgery. RLE generally encompasses dressing in the new gender, as well as using preferred gender berthing, bathroom, and shower facilities.”

According to a study by Rand Group, there are currently between 1,300 and 1,600 active transgender service members.

Last month, Defense Secretary Ash Carter announced that transgender individuals will be able to openly serve in the military after previously calling the Pentagon’s regulations “outdated.”