These are active-duty service members. Although the VA is currently looking into covering these surgeries for veterans, as it stands, they aren’t happening. There is a lot to unpack here, but I would like to take you through the most recent guidance on “healthcare” for active-duty military with “gender dysphoria.” What you read below will detail everything, and I suggest you take the time. However, understand this: with increasing frequency, the US Military is performing gender reassignment surgery—up to and including the removal of genitals and the creation of fake ones- on active duty military, and you are paying for it. Not only that, but they are also covering what would be considered "elective" cosmetic procedures for all Active Duty with gender dysphoria whose doctors say they are "medically necessary." Further, I was told by my source that most of the transitions they have seen are Female to Male. The military requires (in most cases) that you change your gender in their records to match whatever the gender you "transition" to is. Those individuals are then held to the readiness standards of their new "gender." So if a large majority of females enlisted are having this surgery, what are the chances they will be able to keep up to male readiness standards when the time comes, years from now, after they've been cleared back? Likely slim.
This almost seems like a business to me; the language designed to stress keeping procedures in-house, the loose way they approve them, the streamlined process for waivers—something any current Active Duty will tell you isn't always the easiest - it seems like the US Military and DoD are making money off of mental illness. It also seems that many folks who couldn't afford this care on their own would enlist to get it. All of this being said, please read the below. Share with your friends. Awareness is key. There will be more to come in the days and weeks ahead.
The military would like to perform these surgeries in a military healthcare facility. In circumstances where the service member is stationed somewhere that doesn’t have the capability, they have an entire process to grant waivers for surgery and treatment. Of course, the surgery must be “medically necessary,” defined as “healthcare services…that qualified medical professionals accept to be appropriate, reasonable, and adequate…”
The military uses acronyms. A lot. SCHP: Supplemental Health Care Program TGD ADSM: Transgender Active Duty Service Member DHA: Defense Health Agency MTF: Military Medical Treatment Facility
So, without further delay, let's take a gander through the policy, how they use "exclusions" to get procedures covered, what the process is, and the amount of time and money they've dedicated. A separate thread on Veterans will be coming.
The Director has a lot of responsibility in this area. They want to "standardize" the "medically necessary" healthcare for trans-ADSM (Active-Duty Service Member.) They also want to streamline the process for granting waivers so ADSM can get surgery/treatment elsewhere if they can't do it at a military facility. SHCP= Supplemental Healthcare Program
MHS= Military Health System. In the Definitions section, the military explains the difference between GI and GD. GI=Gender Incongruence GD= Gender Dysphoria - "clinically significant distress" seems important. You also need to be enlisted for at least 180 days before you can get services.
You get an entire interdisciplinary TEAM at your disposal here, and notice they do carve out for docs to refuse to conduct this treatment in "2."
Here is how a typical pathway works for an ADSM experiencing "GD." They get a diagnosis on-site or at a PCP. Then, they try to find a treatment doctor "in-market" (inside the military somewhere). Those new people review and evaluate the ADSM. It then goes to the "TGHC," who "validates" the diagnosis.
Can anyone explain to me a world in which this diagnosis would *not* be validated?? I can't imagine one. I have heard from some sources I spoke to for this story that even mentioning non-affirmation will get you sacked in more ways than one.
"Primary care, BH, dermatology, endocrinology, gynecology, general and plastic surgery, urology, oral maxillofacial surgery, otolaryngology, speech pathology (e.g., gender-affirming voice training), case management, and other specialties)." They've started a whole care division for this: Even voice training! Imagine how wonderful it must be to have ALL that covered for you...For "free."
I highlighted one of the keys here that allows this treatment to be fully funded. Validating medical necessity...
Does point 1 mean that they consider GD a "mental disorder?" Because I was under the impression that WE were the crazy ones for saying that. Again, note the words "medical necessity."
Before they remove your ability to conceive a child, they want to make sure you have met the "real life experience" metric for the surgeries.
Here, they specify that these procedures can be performed at a military treatment center (where my source came from) OR with a waiver for treatment outside of one.
Here is the "pre-surgical checklist," for lack of a better word. Focus on #2. They are making it much easier to obtain this. Worst case? Ask for a waiver. It'll be granted, and the procedure will take place off-site. I have so many more questions.
"To get around TRICARE and coverage issues, we will say all procedures are medically necessary so they can return to full duty."
Non-Binary and "gender diverse" people need extra care, it seems, because people don't really know what to do to treat them. A very gray area.
Wait! Here are some ideas—I feel like they never tell the 13-14-year-olds this. ALWAYS affirm (very important): offer surgery even if they haven't taken the typically required course of hormones, and make sure to try to warn them they may be causing themselves fertility issues.
As the ADSM gets ready for their surgery, the timing of it all needs to be approved—AND—they need to change their gender to the *new* gender in DEERS. This also requires them to meet THE SAME STANDARDS for fitness, etc., as the gender they "became." I am told a lot of these procedures are F-M. It would be interesting to see what the rate of retention is afterward.
Before we get to what is covered and what you need to do to qualify for it, look at the training requirements for personnel on JUST this issue. Unbelievable.
So, what this means is, if you are going to have Gender Affirming Surgery that impacts your ability to conceive a child, they want you to be on hormones for a year (if you want) and also to have lived as your "desired" gender for at least a year.
If it's just something cosmetic, you don't need anything but that diagnosis. And that means vocal training, or Adam's apple shaving, or breast implants, or a mastectomy.
And here we go, folks. Here is the list of "medically necessary" procedures for GD and their requirements. Hysterectomy and salpingo-oophorectomy (removal of uterus and ovaries), Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s) Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s) Vaginal hysterectomy, with total or partial vaginectomy. Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with the removal of tube(s) and/or ovary(s) Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with the removal of tube(s) and/or ovary(s) Salpingo oophorectomy, complete or partial, unilateral.
The taxpayer will pay to remove your testicles, release your cli**ris, make you a new one from muscle grafts, get you fake testicles, rearrange your female parts to look like male ones, create a fake urethra so you can pee standing, and, in this last line, cut off your junk.
And more...
Now, all of those were surgeries that affect your reproductive system and make it so you can not conceive. These are just the cosmetic surgeries tax-payers will pay for, while our soldiers can't get good care for PTSD...
For everyone else, these procedures below are considered "elective." You can't get these if you aren't looking to transition. However, if you are? The DoD is wrong. These procedures are medically necessary and approved (for the most part) with a waiver.
And, you can get your breasts done if you are a male transitioning to a female and on hormones for at least 24 months.
Again, they want to do these on-site; it seems like big business, honestly.
This is really just the skin on the onion. I have been researching this topic for quite a while now. Back in 2016, Trump banned all of this from happening, and as soon as Biden took office, they ramped it back up again. Trump didn't ban "trans people" from the military; he said none of our tax dollars would be used for what we just detailed above.
The gov website directs you here for all kinds of "training" on trans-related "healthcare."
It's bad enough that our tax dollars are funding this for active duty, but the Vets want in on it, too. Another piece forthcoming will discuss how the military handles the FAMILIES and minor children of AD.
Trans-Veterans groups like TAVA are mobilizing and have sued the VA—here is an appeal at the 5th. The number of states and major corporations that have signed on to this and other suits like this would really surprise you.
They state here that over 20% of transgender people in the US have served in the military—more than 134 THOUSAND veterans are transgender. They want the care that AD are receiving. 10k of them get it now.
I have a veteran friend who needed a specialized heart operation to SURVIVE. They wouldn't allow him to have it. The only way he could was because we raised the money for him. He even went to CONGRESS. But this? Dole it out.
