AMA House of Delegates Backs End to Ban on Transgender Individuals Serving in Military

There is no medically valid reason to exclude transgender individuals from service in the U.S. military, and transgender service members should be provided care according to the same medical standards that apply to non-transgender personnel.

So declared the AMA House of Delegates during its 2015 annual policymaking meeting in Chicago last month by approving a resolution introduced by the Section Council on Psychiatry in coordination with several other groups.

The resolution was widely supported during reference committee hearings and passed without debate during the meeting of the House.

Mark Moran

“This resolution is about ending the blanket ban that prohibits transgender people from military service and transgender military service members from equal access to care,” said Brian Hurley, M.D., a psychiatrist speaking for the section council. “There is a difference between having a transgender identity and having gender dysphoria, and there is no reason that transgender status alone should exclude anyone from military service or equal access to care.

“This resolution asks the AMA to state that there is no medical justification for this blanket ban and, in doing so, empower military physicians and commanders to assess readiness to serve on a case-by-case basis.”

Hurley is a delegate to the Section Council on Psychiatry from the Gay and Lesbian Medical Association: Health Professionals Advancing LGBT Equality (formerly known as the Gay and Lesbian Medical Association).

“We don’t exclude gay people from military service or treat gay people and straight people according to different standards of care, so there is no justification for a continuing ban that treats transgender people different from cisgender people,” Hurley said. “There are over 15,000 transgender service members who remain closeted as a matter of policy, so it is urgent that the AMA weigh in now to affirm that there is no medical justification for this discriminatory policy.”

Carl Streed, M.D., an internist at Johns Hopkins Bayview Medical Center, speaking in support of the resolution, reminded House members that at least 18 other countries have allowed transgender individuals to serve in the military. Streed is a member of the Resident Fellow Section (RFS) and is the RFS representative to the Board of Trustees Advisory Committee on LGBT issues.

During his remarks to the House, Streed read the written testimony of an anonymous AMA member and member of the armed forces who is transgender. The anonymous written testimony included the following comments: “Delaying adoption of this policy … will only serve to further harm those of us who actively serve our country in silence every day. We simply cannot wait. … The AMA’s mission is to promote the art and science of medicine and the betterment of public health. The science on this issue is clear. There is no medical basis for the current ban.”

Also speaking in support of the resolution was retired Rear Admiral Alan M. Steinman, who was the director of health and safety for the U. S. Coast Guard from 1993 to 1997. He was coauthor of a 2014 report in the journal Armed Forces and Society, which analyzed Defense Department regulations and other medical data to determine whether U.S. military policies that ban transgender service members are based on medically sound rationales.

Steinman and his fellow authors concluded that that there is no compelling medical reason for the ban on service by transgender personnel, that the ban is an unnecessary barrier to health care access for transgender personnel, and that medical care for transgender individuals should be managed using the same standards that apply to all others.

“Simply treating transgender service members in accordance with established medical practices and standards, as it does with the provision of all medical care, is all that’s needed to end the unnecessary and harmful policy of discrimination against transgender service,” Steinman and colleagues said.

“While no new medical rules are needed, the Defense Department could look to foreign military experiences as it formulates administrative guidance to address fitness testing, records and identification, uniforms, housing, and privacy. … Foreign military regulations that apply to transgender military service are straightforward, sensible, and fair, offering a sound model for U.S. military policy. … [T]aking these steps to reform current military policy governing transgender service would improve care for U.S. service members without burdening the military’s pursuit of its vital missions,” the authors stated. ■