#LetThemServe – Gender Variance and Military Service

As you may know, I serve many transgender and gender variant persons, and find it to be very fulfilling for me to see the transformations these people make when they are affirmed, supported, and able to create their lives the way they believe were intended. This does not come without fear, anxiety, and sacrifice, but a very high majority would not regret their decision to transition. I will go into the why I treat this population in a later post, but time is of the essence.


On 3/23/2018 (yesterday, as I type this), President Trump again reinforced his ill-conceived decision made via policy decree that a majority of “transgender persons with a history or diagnosis of gender dysphoria — individuals who the policies state may require substantial medical treatment, including medications and surgery — are disqualified from military service except under certain limited circumstances.” (CNN.com). This position is ill-conceived for a variety of reasons.


The first is that persons who have been diagnosed with gender dysphoria, a significant medical condition treated by mental health and medical providers to better align the person with their identified gender and expressed characteristics, are a risk to colleagues, combat readiness, and not fulfilling their duties expressed in their oath to serve and defend their country. Gender dysphoria is the distinct set of symptoms that result from distress felt by the person in seeing their bodies not aligning with the gender they believe themselves to be, feeling as though they are not able to be aligned in their gender, and being mislabeled (misgendered) in society because their physical characteristics may not 100% put them in the correct gender category. This can result in depressive symptoms, anxiety symptoms, suicidal ideation, and death. In the most recent US Trans Survey (2015), it was reported that 40% of trans-identified people have attempted suicide in their lifetimes. 40%!!!!! That is unacceptable, especially as around 0.5% of the adult American population have attempted suicide (AFSP.org). It is the 10th leading cause of death in America, and costs the American economy $69 BILLION a year. What transpeople have reported helped them not contemplate or attempt suicide were: affirming their gender identities, treating them with respect and acceptance, having access to affirming mental health and medical care, and recognizing their need to express their gender identities.


Let’s shift to military statistics, shall we? To volunteer to serve in the military is an admirable feat, in that you pledge to protect our country, fellow servicemembers, and even those who disagree with you. This could be within our country’s boundaries, or on foreign soil. We have lost so many servicemembers due to the various conflicts we have found ourselves in, and even more are lost because of the trauma they have experienced while engaging in conflict. Many of them do come back invisibly wounded, and many require significant resources to get the treatment they need in order to live. Many still are discharged due to disability, with mental health reasons qualifying them for discharge and disability payments. These payments are not enough to keep them off the streets, or to fully pay for the treatments they need, in addition to providing for themselves and the family members left to pick up the pieces.


Statistics for veteran suicide rates with domicile listed in Virginia (where I reside) are 32.9 per 100,000 people. Data is current as of 2014. Non-veteran suicide rates in Virginia are 17.0 per 100,000 people. For those of you with a statistics background, this is a significant difference at the p=<0.0001 level. Data collected as of 2013 and presented in 2014 report that veterans discharged with a PTSD diagnosis account for 177, 149 servicemembers discharged and eligible for disability, which was a severe underestimation for VA hospital/services utilization. For persons exhibiting possible mental health disorders, the VA estimated around 20% would require services, and around 27% were utilizing VA disability services and payments, costing anywhere between $355-534 BILLION over the next 40 years (including all those receiving non-medical discharge payments). Billion. Just for VA Disability payments and service utilization, not including medically discharged personnel or those using Social Security Disability payments. These numbers may be including folks who also identify as transgender, but I’m going out on a limb to say that the numbers would be extremely insignificant.


The earlier argument from the President was that having transgender servicemembers serve and be allowed to transition/continue using transition-related healthcare treatments would be too costly. The figure referenced is $8.4 million out of a $50 billion budget that would be allocated for various forms of treatment, counseling, medications, surgery, time out of work recovering from possible medical procedures, etc. If a grossly overestimated 7,000 servicemembers decided to seek medical treatment to include all forms of medication and top and bottom surgery (gender confirmation surgery to transform chest/breasts and lower genitalia to match their gender identity), that figure would still only be $280 million, or 0.56% of the total defense budget. Another fun fact which I’m sure you’ve heard, the DoD spends roughly $41.6 million on Viagra specifically, and $84.24 million on erectile dysfunction prescriptions. Does anyone else hear a slow clap? Anyone?


Okay, so back to things that mean more than money. I have counseled several persons who identify as transgender and served in the military, anywhere from the late 1970s to the early 2010s. Many were stealth and did not share their gender identity until long after separating from the military, and some were discharged because of it. Others also lost their sense of purpose upon retirement or discharge, and if that was forced upon them due to their gender identity, their prognosis was worse. If the stats show that improving a person’s support to demonstrate affirming use of their appropriate gender pronouns (he/she/ze/they, etc) and getting affirming medical and mental health support to be so inexpensive relative to loss of life or 40 years of disability payments, then why can’t we as the “greatest nation in the world” care enough to allow trans persons to volunteer to die for the country? It’s just like the conditional love that many get from their parents and caregivers growing up…you’re good, but just not good enough. We are saying these people are not good enough in that they are “mentally ill” or unfit to serve, when those who were stealth in the service were. It boggles the mind.


Why would a trans person desire to serve in the military, you ask? Well, it’s simple. Many come from military families, and have been taught that it is the most admirable career to have to serve your country, and they would not be wrong in thinking that. Many others see it as security and stability, while getting amazing training and education that they can take with them to careers outside of the military. Many prefer a trade versus a college degree because they work better with their hands than behind a desk, intelligence being irrelevant. Many need structure, and what better place to find it than in the military. So the same reasons a trans person would want to join the military are the exact same as those who are cisgender (someone whose gender identity matches gender expression and anatomy).


Now, let’s return to the current argument that people with gender dysphoria are mentally ill and unfit to serve because of their gender identities. President Trump is saying that those with gender dysphoria are unfit to serve because of the diagnosis rendered to describe how they are coping with the difficult reality of their gender identity in their minds not matching those of their physical body. Many servicemembers have a diagnosis of depression, anxiety, combination of the two. Yet, they are provided medication, counseling, and still deemed fit to serve. Their diagnosis may be biologically gained, meaning that it’s due to genetics and not circumstances. Now, not all who have these diagnoses remain in the military, and are of the above-referenced statistics for discharge and disability payments. There are others still who are accepted into the military who have previous trauma and abuse histories. These are now fewer and farther between with more data to suggest that those who have these histories are very likely to develop additional mental health issues like PTSD, which the military would be smart in screening out, as able, to reduce the future expenditures to those who develop PTSD after a history of Adverse Childhood Experiences.


“But Angela, what about Bradley/Chelsea Manning? Are you saying that she’s justified in what she did that compromised national security?”


Not justified at all. However, her mental health might have been just a tad better to use logic and reason to determine whether or not her intended actions were appropriate, a threat to national security, or otherwise if she was able to get her gender affirmed and not get to a point of desperation. Kristen Beck, formerly a Seal Team 6 member and decorated veteran, did not feel the need to rise to this type of occasion, but she did destroy herself with alcohol and in relationships prior to being able to transition. Her story is fascinating; find her book Warrior Princess to learn more.


Bottom line, if we are saying trans servicemembers are too much of a financial risk, then we are lying. If we are saying they are too much of a mental health risk, then we are also lying, and if we are saying they are potentially vulnerable to security threats, then one servicemember’s actions do not lead to a ban. And we shouldn’t trust someone to listen to people (the generals, you know, the ones he knows more than) who continue to prove that they will back whatever he says, especially someone who was deemed unfit to serve for medical reasons during the draft related to the Vietnam War. These statements harken back to racist rhetoric when black men were not able to serve with white men, despite them volunteering for the same cause. We can do better than this, America, and we need to show our trans brothers/sisters/siblings that they matter more than what one person deems them to be.

Prove to us that they are a danger; that they aren’t fit to serve. A medical diagnosis like gender dysphoria should not immediately exclude people from enlisting or assuming an officer position within the military, and we cannot take it from the Commander in Chief to speak on these issues without several mental health and medical professionals weighing in. Ones that are unbiased in their understanding, or allowing civil discourse with data to come to a conclusion. There simply isn’t data here yet to decide. Let them serve bravely.

Thanks for reading!