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Posted on Apr 7, 2019 Print this Article

The Trump/Mattis Transgender Policy – What Are the Facts?

On March 28, 2019, members of the House of Representatives staged an unserious “debate” about the issue of transgenders in the military.  Ultimately, the members approved HR 124, a non-binding “Military Mutiny Resolution” urging members of the military to disregard lawful directives from the Commander-in-Chief. [1]  The following responses to ten typically false arguments should be considered any time the issue comes up for discussion in Congress, the Senate, or anywhere else:

1.   The Trump/Mattis policy is a “ban” that punishes transgenders for who they are. 

The policy is not a “ban” on transgenders as a class, and it does not “punish” or “stigmatize” anyone. The Trump/Mattis policy focuses on a serious psychological condition called gender dysphoria -- one of many physical and psychological conditions that require special medical treatment and are therefore disqualifying for military service.  The policy’s nuanced approach:

a)     Allows persons identifying as “transgender” but without gender dysphoria to serve in their biological gender, if they have been “stable” for 36 months and meet requirements for deployability;

b)     Disqualifies persons with gender dysphoria from military service; and

c)     Retains “grandfathered” personnel identifying as transgender and receiving treatment under previous administration policies. [2]

Military service is not a “right,” and nothing in the policy “forces” anyone to serve in any way.  Persons diagnosed with gender dysphoria are to be treated the same as others who have disqualifying medical conditions.

2.   Trump acted out of “animus” when he announced his military transgender policy on Twitter.

Contrary to political legend, "tweets" on the transgender issue that President Donald Trump issued in July 2017 occurred almost a full month after Defense Secretary James Mattis responded to the concerns of military leaders by calling for a pause and a Pentagon study of the issue.

On August 25, 2017, President Trump signed a formal memorandum stating his views on the transgender issue and directing Secretary Mattis to do a comprehensive study. [3]  Mattis convened a panel of experts to review all costs and consequences of the issue over six months.  The panel’s February 2018 44-page report supported Secretary Mattis’ recommendations to President Trump.

On February 22, 2018, Secretary Mattis exercised his option to recommend a new policy different from President Trump’s original directive. [4] The President revoked his own previous directives and approved the new policy on March 23, 2018. [5]

During congressional testimony on April 26, 2018, Secretary Mattis shed light on the previous administration’s mandates for unprecedented social change, which his predecessor Ashton Carter imposed in June 2016.

A few months into the Trump Administration, Secretary Mattis learned that the military service chiefs serving under President Barack Obama were not consulted before Secretary Carter revoked the long-standing medical disqualification for persons with gender dysphoria.

When the service chiefs told Secretary Mattis that they were concerned about the previous administration’s orders to begin recruiting new transgender personnel on July 1, 2017, Secretary Mattis suspended that deadline and initiated his own study.  The ensuing six-month process was conducted more carefully than the top-down, politically-motivated mandates imposed under President Obama.

Secretary Mattis also learned that the previous administration’s policy precluded reporting of any problems with the Obama/Carter policy up the chain of command.  As he told Sen. Kirsten Gillibrand in April 2018:

“The reason is that under the Carter policy the reporting is opaque. We cannot report that problems emanated from a transgender.  So, the questions you’ve asked the service chiefs and the chairman are ones that right now the Carter policy prohibited that very information from coming up because it is private information.” [6]

Lawsuits filed with four different U.S. District courts delayed implementation of the new Trump/Mattis policy.  However, on January 4, 2019, the Court of Appeals for the District of Columbia vacated a lower court preliminary injunction.

On January 22, the U.S. Supreme Court ruled 5-4 that the Trump/Mattis policy could proceed while ongoing litigation continues.  On March 12, the Department of Defense released a Memorandum announcing that implementation would begin on April 12. [7]

The higher courts’ actions indicate that the Trump/Mattis policy has a good chance of prevailing on the merits when it reaches the Supreme Court, and further underscores the unprecedented and dangerous nature of HR 124’s call for mutiny against the Commander-in-Chief.

3.   All four military service chiefs have said that transgender servicemembers have served openly since 2016, with “zero” negative consequences for unit cohesion.

This claim is overstated and misleading.  During April 2018 budget hearings, Sen. Kirsten Gillibrand asked members of the Joint Chiefs of Staff whether they were aware of any problems with transgenders in the ranks. [8]  She did not ask them to comment on the many negative consequences associated with the Obama/Carter transgender policy, which the February 2018 DoD panel of experts had reported in detail.

Instead, Sen. Gillibrand’s question and the chiefs’ answers focused on the well-being of transgender personnel who, they said, had been treated with “dignity and respect.”  This is a credit to military discipline, but the chiefs’ answers have been deceitfully misconstrued as comments about “unit cohesion” which Sen. Gillibrand subtly redefined to get the responses she wanted.

"Unit cohesion" is properly defined as mutual trust for survival in battle. [9]  A review of the true definition makes it easy to understand why persons who do not meet standards under the Trump/Mattis policy would have a negative impact on unit cohesion.   

There is no way to determine the impact of Obama/Carter policies on unit cohesion because, as Secretary Mattis told Sen. Gillibrand, military leaders have been precluded from reporting problems up the chain of command.  (See #2, above)

4.   The 2016 RAND Report found that allowing transgender Americans to serve openly in the Armed Forces would have minimal impact on costs and readiness.

RAND is a largely-civilian Pentagon contractor paid to write a deeply-flawed 2016 report supporting the previous administration’s social agenda for the military.  In his February 2018 recommendations to President Trump, Secretary Mattis criticized “significant shortcomings” in the RAND report, which used questionable methods to calculate costs and “erroneously relied on the selective experiences of foreign militaries with different operational requirements than our own.” [10]

The RAND report was written in consultation with LGBT activist groups.  Unlike the 2018 Defense Department report, it did not have actual Military Health System (MHS) data showing disproportionate mental health care costs for persons serving with gender dysphoria under the 2016 Obama/Carter policy.

RAND recommended controversial policies and the administration implemented them as President Obama was leaving office.  Neither RAND nor previous administration officials have to live with the consequences of their ill-advised policies.  The people who do have to live and possibly die under unworkable mandates are combat troops and their colleagues in uniform who have had no say.

The Defense Department panel of experts’ report noted significant costs during the previous administration, from October 1, 2015, to October 3, 2017.  (The dates cover the time period between announcement of the Obama/Carter policy and President Trump’s call for a return to Defense Department policies in place long before Obama took office.)

  • During this time, 994 active-duty service members diagnosed with gender dysphoria accounted for 30,000 mental health visits.  Medical care costs for these personnel increased three times, or 300%. [11]
  • Available data showed that cumulatively, transitioning service members in the Army and Air Force averaged 167 and 159 days of limited duty, respectively, over a one-year period. [12]
  • Some commanders reported that it was necessary to divert operational and maintenance funds to pay for active-duty transgender servicemembers’ extensive travel throughout the United States to obtain specialized medical care. [13]

Elevated medical costs and lost time affect mission readiness and deployability.  Treating gender dysphoria as different from all other disqualifying physical and psychological conditions that affect deployability constitutes special treatment, not equality.

5.   Thousands of transgender Americans currently serve in the Armed Forces and in the Reserves throughout all branches and military occupational specialties.

References to somewhere between 2,150 to 10,790 transgenders in the military, sometimes claimed to be 8,980, do not reflect actual data.  Such numbers are based on a self-reporting online survey, from which RAND extrapolated speculative estimates. [14]

Accomplishments of individuals identifying as transgender are laudable but not relevant when making policy for force composition.  When exceptions determine policy and the experiences of others do not rise to the same level, the system breaks down, mission readiness is weakened, and people can die on the battlefield.

6.   The American Medical Association, the American Psychological Association, the American Psychiatric Association, and three former military Surgeons General are part of a “global consensus” that transition-related care is effective.

In litigation filed against the Trump/Mattis policy, LGBT lawyers erroneously stated that opinions favoring transgender ideology constitute a “settled, medical and scientific consensus.”  This is simply not true.

One of the authorities cited in support of this notion was the unnamed Chair of a so-called “blue-ribbon” commission, Joycelyn Elders – a controversial former U.S Surgeon General who created controversy by advocating for unusual forms of sexual expression.  The lawyers also referred to “peer-reviewed” studies done by what appears to be the also-unnamed Michael D. Palm Center, an academic LGBT activist group based in San Francisco.

Left out of these discussions are a growing number of men who have experienced gender dysphoria and LGBT-approved treatments, with disastrous results.  Compelling personal stories have described painful, unsuccessful “transitions” that have been difficult to reverse. [15]

7.  The effectiveness of current treatments for gender dysphoria are well-established. 

Supporters of HR 124 ignored the findings of many independent studies cited in the February 2018 Defense Department report, which have called into question the notion that a biological man can be transformed into a woman, and vice versa.  As stated in the DoD report:

  • "Transgender persons with gender dysphoria suffer from high rates of mental health conditions such as anxiety, depression, and substance disorders."
  • "High rates of suicide ideation, attempts, and completion among people who are transgender are also well documented in the medical literature, with lifetime rates of suicide attempts reported to be as high as 41% (compared to 4.6%for the general population).”
  • "A review of the administrative data indicates that Service members with gender dysphoria are eight times more likely to attempt suicide than Service members as a whole.”  (12% versus 1.5%)
  • "Service members with gender dysphoria are also nine times more likely to have mental health encounters than the Service member population as a whole.” (28.l average encounters versus 2.7 average encounters per service member) [16]

None of the prevailing remedies for gender dysphoria “account for the added stress of military life, deployments, and combat.”  [17]

8.   The claims attempting to justify President Trump’s policy are based on flawed scientific and medical assertions of ‘‘considerable scientific uncertainty’’ regarding the efficacy of transition-related care.

According to the DoD panel of experts who conducted a comprehensive review of the medical literature on treatment of gender dysphoria, the effectiveness of current treatments for gender dysphoria has not been established.

  • The Centers for Medicare and Medicaid Services (CMS) conducted a review of over 500 articles, studies, and reports to determine if there was “sufficient evidence to conclude that gender reassignment surgery improves health outcomes for Medicare beneficiaries with gender dysphoria.”  The CMS, quoted in the Mattis report, concluded, “Overall, the quality and strength of evidence were low due to mostly observational study designs with no comparison groups [and other controls.]
  • The Mattis report also quoted a credible study, done in Sweden over a period of ten years, which compared persons undergoing gender reassignment surgery.  Citing the CMS Report, the DoD noted, “[M]ortality was primarily due to completed suicides (19.1-fold greater than in the control group. . . We note, mortality from this patient population did not become apparent until after 10 years.”  [18]

Even RAND admitted that 6% to 20% of those receiving [male to female] genital surgeries experience complications and long-term disability, and as many as 25% (one in four) of those receiving [female to male] surgeries will have complications.  [19]

The Pentagon report stated, “Given the scientific uncertainty surrounding the efficacy of transition-related treatments for gender dysphoria, it is imperative that the Department proceed cautiously in setting accession and retention standards for persons with a diagnosis or history of gender dysphoria.” [20]

The medical opinions of civilian professionals whose livelihood depends upon the unquestioned acceptance of their recommended treatments for gender dysphoria should not be deemed more credible than data and findings supporting the Mattis/DoD Report.

9.   The Department of Defense has failed to provide evidence the existing policy has impaired morale, unit readiness, or unit cohesion.

The burden is not on the military to prove that service by those with gender dysphoria will not impair morale, unit readiness, or unit cohesion.  The burden is on those who wish to use the military as a social laboratory for the transgender movement to prove that permitting those with gender dysphoria to serve justifies the impact on the armed forces as a whole.

No one has explained how reinstatement of the Obama/Carter transgender policy -- imposed with more than fifteen convoluted directives, instructions, training manuals and handbooks forcing military personnel to accept and act on unscientific theories of gender “transition” -- would improve morale and combat lethality.

10.   At least 18 nations allow transgender people to serve openly and effectively in their armed forces.

As Secretary Mattis stated in his February 2018 memo taking issue with RAND report claims such as this, none of those nations has the responsibility and safety of the United States as their primary reason for being.  Furthermore, those nations, like many others, rely upon the American military to deter and defeat hostile forces so that they won’t have to.

Conclusion:  Members of Congress should understand, respect, and defer to the carefully-considered policies formulated in consultation with experts convened by the Department of Defense.  The Trump/Mattis policy, which has a good chance (but no guarantees) of being upheld as constitutional by the U.S. Supreme Court, should be implemented as planned on April 12, 2019.

* * * * * *

The Center for Military Readiness is an independent public policy organization, founded in 1993, which reports on and analyzes military/social issues.  More information is available on the CMR website, www.cmrlink.org.

Endnotes:

[1] See CMR: Pelosi to Troops: Defy Commander-in-Chief on Transgender Policy

[2] DoD Implementation Briefing, 5 Things to Know about DoD’s New Policy on Military Service by Transgender Persons & Persons with Gender Dysphoria (Mar. 13, 2019)

[3] Whitehouse.gov: Presidential Memorandum to the Secretary of Defense and Secretary of Homeland Security, Subject: Military Service by Transgender Individuals, August 25, 2017.

[4] Memorandum to the President, Military Service by Transgender Individuals, Feb. 22, 2018.  Excerpt: “[T]he Department of Defense concludes that there are substantial risks associated with allowing the accession and retention of individuals with a history or diagnosis of gender dysphoria and require, or have already undertaken, a course of treatment to change their gender. Furthermore, the Department also finds that exempting such persons from well-established mental health, physical health, and sex-based standards, which apply to all Service members, including transgender Service members without gender dysphoria, could undermine readiness, disrupt unit cohesion, and impose an unreasonable burden on the military that is not conducive to military effectiveness and lethality.”  Also see Department of Defense "Panel of Experts” Report, analyzed in the April 2018 CMR Special Report: Trump Transgender Policy Promotes Military Readiness, Not Political Correctness (34 pages)

[5] Presidential Memorandum to Secretary of Defense, “Military Service by Transgenders,” March 23, 2018.  

[6] Travis Tritten, Washington Examiner Jim Mattis, Kristen Gillibrand Butt Heads Over Transgender Policy, Apr. 26, 2018.  Also see Excerpts of testimony, SASC hearing, April 26, 2018, time mark 1:16, emphasis added.

[7] DoD Directive-Type Memorandum (DTM-19-004) Military Service by Transgender Persons and Persons with Gender Dysphoria, March 12, 2019.

[8] Tara Copp, Military Times, All Four Service Chiefs on Record – No Harm to Units from Transgender Service, Apr. 24, 2018.

[9] Report of the Presidential Commission on the Assignment of Women in the Armed Forces, Nov. 15, 1992, Finding #2.5.1, p. C-80.  “Cohesion is the relationship that develops in a unit or group where (1) members share common values and experiences; (2) individuals in the group conform to group norms and behavior in order to ensure group survival and goals; (3) members lose their personal identity in favor of a group identity; (4) members focus on group activities and goals; (5) unit members become totally dependent on each other for the completion of their mission or survival, and (6) group members must meet all standards of performance and behavior in order not to threaten group survival.”

[10] Mattis Memorandum to the President, February 22, 2018, p. 2.

[11] DoD Report, Footnote #4 supre, p. 22 and p. 41.

[12] DoD Report, Footnote #4 supra, p. 33.

[13] DoD Report, Footnote #4 supra, p. 41.

[14] DoD Report, Footnote #4 supra, p. 7, Footnote #10.

[15] Jamie Shupe, The Daily Signal: I was America’s First Binary Person: It was All a Sham.

[16] DoD Report, Footnote #4 supra, pp. 21-22.

[17] DoD Report, Footnote #4 supra, p. 24.

[18] DoD Report, Footnote #4, supra, pp. 24-25.

[19] DoD Report, Footnote #4, supra, pp. 23-24.

[20] DoD Report, Footnote #4 supra, p. 27.

 

Posted on Apr 7, 2019 Print this Article