Pentagon proposes medical benefits for transgender troops

The military healthcare system may soon cover the cost of hormone therapy and other non-surgical treatments sought by transgender service members.

The proposed medical benefits for transgender troops are tucked into a notice published Monday in the Federal Register that lists a number of proposed changes to treatments covered by Tricare related to mental health and substance abuse.

“It is no longer justifiable to categorically exclude and not cover currently accepted medically and psychologically necessary treatments for gender dysphoria (such as psychotherapy, pharmacotherapy and hormone replacement therapy) that are not otherwise excluded by statute,” the notice reads.

{mosads}In July, Defense Secretary Ash Carter announced he intends to lift a ban on transgender troops serving openly after a working group studies the implications of lifting the ban. A final decision is expected in the spring.

In the meantime, Carter made it more difficult to discharge transgender troops by requiring high-level approval for the discharge.

Under Monday’s proposal, gender reassignment surgery would still be barred from being covered by Tricare.

Rep. Mac Thornberry (R-Texas), chairman of the House Armed Services Committee, told reporters Monday he hadn’t seen the proposed changes and so couldn’t comment directly on them.

“As somebody transitions, what’s the government’s responsibility in that medical process, and I don’t the answers to that,” he said.

In terms of allowing transgender troops to serve openly, he said mission readiness should guide all personnel decisions.

“My focus, and I think the appropriate focus of Congress, is on capability to get the mission done, and that’s what counts,” he said. “I do not believe the military should be an experimental laboratory for social issues. But I also believe that you focus on capability, getting the job done, protecting the country and don’t worry so much about a person’s color or gender or whatever it is, religious affiliation, on and on, as long as they can do the job.”

The fact that the Defense Department has made or proposed multiple changes over the last few months creates new challenges for Congress’s oversight role, he added. Last week, Carter announced changes to benefits for military mothers and families, and in December, he announced the opening of all combat jobs to women.

Regarding the changes Carter announced last week, Thornberry said his main concern is cost.

The reforms announced last week are expected to cost about $380 million over five years.

In addition to the medical benefits for transgender troops, the proposal published Monday would eliminate all inpatient mental health day limits, the 60-day partial hospitalization limit for substances abuse, annual and lifetime limits on substance abuse treatment, limits on outpatient therapy and limits on face-to-face counseling to quit smoking.