The Pentagon ordered a stop to all medical procedures associated with “affirming or facilitating a gender transition” and banned bringing in new recruits who have sought similar treatment in the past, according to a memo posted to X by Secretary of Defense Pete Hegseth.
However, the likely impact of the rules laid out in the memo is unclear since military medical services, including both on-base hospitals and TRICARE, are barred under current law from providing gender-affirming surgeries. The Pentagon did not provide numbers on how many service members have sought non-surgical gender-affirming care in recent years.
Research from 2016 to 2021 found that on average, less than 400 active-duty military members sought non-surgical treatment every year.
The memo also did not specify if dependents or retirees would also lose access to gender-affirming care. Officials at the Pentagon did not respond with details on eligibility Monday afternoon.
The memo orders that “all new accessions for individuals with a history of gender dysphoria are paused, and all unscheduled, scheduled, or planned medical procedures associated with affirming or facilitating a gender transition for Service members are paused.”
The American Medical Association defines gender dysphoria as “psychological distress” over gender identity.
The memo is addressed to “senior Pentagon leadership, commanders of combatant commands” and defense agency and “field activity directors,” which likely includes the Assistant Secretary of Defense for Health Affairs, who oversees DoD’s sprawling healthcare systems. Dr. Stephen Ferrara currently holds that position as the acting secretary, according to the agency’s website.
A January report by the Congressional Research Service found that under the current TRICARE operating manual, “medically or psychologically necessary and appropriate medical care, including nonsurgical treatments for [gender dysphoria], are covered [for all beneficiaries] when provided by a TRICARE-authorized provider.”
Hormone therapy, the report said, is a “covered service” for adults and adolescents with a medical diagnosis of gender dysphoria.
However “TRICARE is explicitly prohibited from covering gender-affirming surgical care for beneficiaries” outside of exceptional cases of those with pre-existing physical conditions, according to the report.
Unclear was whether the memo is intended as a direct order to individual troops to refrain from pursuing gender-related therapies, or whether its intent is just to halt those treatments at Defense Department facilities or those under DoD sponsorship.
Though official numbers are hard to come by, gender-affirming care appears to be fairly rare in the military. The Pentagon spent about $3 million annually on gender-affirming care for close to 1,900 active duty members between 2016 and 2021, the CRS report found.
Among dependents, the Congressional Research Service found, a 2019 study found that in the previous decade, 2,533 “youth” received gender-affirming care through military health services, including 834 who received pubertal suppression or hormone therapy.
Advocates for transgender servicemembers said the order unfairly targeted military members who have served proudly.
“Transgender Americans have served openly and honorably in the U.S. Armed Forces for nearly a decade. Thousands of transgender troops are currently serving, and are fully qualified for the positions in which they serve. Anyone who meets the standards should be able to serve. The transgender service members currently in the military have met the standards and have more than proven themselves,” said a spokesperson for Sparta Pride, an advocacy group for trans military members. “There’s no reason to deny transgender Americans the opportunity to serve or limit access to medically necessary care that all service members are entitled to.”
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