I guess no HPSP of USUHS if you're transgendered?

[aaronrodgers]

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Trump's Twitter, if anyone is out of the loop, reveals an imminently implemented ban on transgendered service members from joining in any capacity

 

[Onefellswoop87]

Let the political dust settle and wait for the official memo from SecDef or the individual branches to elaborate and detail the policy.

 

[DD214_DOC]

People need to relax and just wait for more official word. He announced this on Twitter for Christ's sake, and he tends to ramble on it quite often.

 

[aaronrodgers]

What is the culture of disagreeing and politically voicing against what the US administration is doing while one is in the military? I reckon it can only harm your reputation and that seems to explain why only retired senior officers are criticizing Trump.

Perhaps the best advice to say is that if one disagrees with the govt then he/she shouldn't have signed up to work for it

 

[pgg]

The Uniform Code Of Military Justice (UCMJ) Article 88 states: "Any commissioned officer who uses contemptuous words against the President, the Vice President, Congress, the Secretary of Defense, the Secretary of a military department, the Secretary of Transportation, or the Governor or legislature of any State, Territory, Commonwealth, or possession in which he is on duty or present shall be punished as a court-martial may direct."

Enlisted members may be covered by Article 134, though it's quite a bit less specific: "Though not specifically mentioned in this chapter, all disorders and neglects to the prejudice of good order and discipline in the armed forces, all conduct of a nature to bring discredit upon the armed forces, and crimes and offenses not capital, of which persons subject to this chapter may be guilty, shall be taken cognizance of by a general, special, or summary court-martial, according to the nature and degree of the offense, and shall be punished at the discretion of that court."

Perhaps the best advice to say is that if one disagrees with the govt then he/she shouldn't have signed up to work for it

No, this is stupid and unreasonable.

Over the course of any career, the government is sure to do a number of things any individual disagrees with. You don't forfeit your right to vote when you sign up. You do have to abide by some regulations aimed at
1) avoiding any confusion that an individual opinion is an official position of the government
2) preserving good order and discipline

Specifically, partisan activity is prohibited and defined as "activity directed toward the success or failure of a [particular] political party or candidate for a partisan political office or partisan political group." That's pretty broad and covers a lot of things, whether you're doing those things in or out of uniform.

Participation in social media is explicitly allowed and even encouraged by the military. For example this is the Navy's guidance for online conduct. Note that the very first bullet point on the very first list is "Be yourself and share authentically about unclassified Navy and Navy-related topics to your service."

Rules Restrict Political Activity by DOD Personnel: "In fact, DOD has a longstanding policy of encouraging members to carry out the obligations of citizenship, officials said. DOD encourages its military and civilian members to register to vote and vote as they choose, they said. Both groups can sign nominating petitions for candidates and express their personal opinions about candidates and issues. However, officials emphasized, they can do so only if they don't act as - or aren't perceived as -- representatives of the Armed Forces in carrying out these activities."


A commissioned officer can say "I think transgender people should be allowed to serve in the military" even though there may be an order forthcoming from President Trump that prohibits this ... provided this opinion was spoken (or written) in a context that makes it absolutely clear that this is a personal opinion. It's important to avoid even the appearance of official endorsement of a policy, and it can't be part of campaigning, partisan activities to promote a candidate, etc. (I include the disclaimer in the .sig at the end of my posts to ensure that nothing I ever write can ever be misconstrued as an official communication.)

A commissioned officer may not say "The President is a jerk" or anything that would be broadly interpreted as "contemptuous words" ... even if it's clear this is a personal opinion.

This is not a bad thing. The military would risk becoming a political entity unto itself if its members, who in general may lean in one direction more than another, were completely free to influence and participate in the political process. Far better that we keep clear lines, and that the military remain completely under civilian control. We're here to kill people and break things when the elected civilian government tells us to.

If that is something you disagree with, then no, you shouldn't sign up.

 

[Cooperd0g]

I'm not voicing an opinion either way, but transgender is considered a medical diagnosis. There are many medical diagnoses that are considered unfit for military service. It is not discrimination and has been upheld in court as such. The duties and requirements of the military make it impossible or seriously dangerous for some medical conditions to serve. Just some food for thought for those that look at this issue strictly through a political lens instead of a logistical one.

 

[BlackFrancis33]

I'm not voicing an opinion either way, but transgender is considered a medical diagnosis. There are many medical diagnoses that are considered unfit for military service. It is not discrimination and has been upheld in court as such. The duties and requirements of the military make it impossible or seriously dangerous for some medical conditions to serve. Just some food for thought for those that look at this issue strictly through a political lens instead of a logistical one.

No, gender identity if not congruent with one's born gender, is not a medical diagnosis. There is no gender identity disorder anymore in DSM V. There is gender dysphoria only if one is distressed over their gender identity. I would be careful with the medical diagnosis argument, as it is not supported by the psychiatry community based on the DSM V.

 

[Shikima]

No, gender identity if not congruent with one's born gender, is not a medical diagnosis. There is no gender identity disorder anymore in DSM V. There is gender dysphoria only if one is distressed over their gender identity. I would be careful with the medical diagnosis argument, as it is not supported by the psychiatry community based on the DSM V.

Not supported by some. Remember, DSM criteria is very politically motivated.

 

[aaronrodgers]

What's the suicide rate for these people again? They are an incredible liability for any Commander and a terrible investment for the .Mil. They also usually have all sorts of psych comorbidities which are disqualifying. Remember they DQ people at MEPS for mild eczema.

These folks can play act all they want in civ land but absolutely should be banned from active service.

ex 61N

The reason someone is transgendered is possibly not the same reason to why they are suicidal. If anything, the higher suicide rate could be due to how poorly people treat them.

The logic provided means that hypothetically the military should also disqualify ethnic Japanese because of the suicide stereotype, would it not?

That being said, I'm supportive if there is convincing evidence that there is truly something unfit for service associated with being transgendered in and of itself

 

[BlackFrancis33]

What is the suicide rate for AD transgendered? It is a terrible investment is your own opinion, and I have not seen convincing evidence to support your opinion. I am not a psychiatrist, but I am sure the authors of the diagnostic and statistical manual vol 5 might point to the lack of evidence supporting gender identity as a psychiatric disorder. 'Very politically motivated' is also an opinion about the DSM V, which is not shared by many psychiatrists who use it to classify and treat psychiatric disease. I would like to believe we can do better than making blanket, unsubstantiated assertions about an entire group of people. Is it possible that an individual who happens to be transgender may excel in a military career?

 

[aaronrodgers]

I don't think Japanese adults commit suicide at a rate 22 times higher than the average person. Time to go back to logic school, kid. In fact, I recall recently reading an article that talked about how content most Japanese were. Stunning, and shocking to me, because Japan is one of the least diverse and most ethnocentric places on earth. How could they be happy without diversity? Apparently there is so little crime that the police are having to find other ways to occupy themselves. I fervently hope that Uncle George Soros will set things right and the Japanese will get with the open borders program!

- ex 61N

Your argument's logic is valid but I am questioning the soundness of the premise within that argument which assumes being transgendered = being suicidal. The sweeping ban disregards the otherwise mentally/physically sound transgendered individual such as the ~6000 service members that the DoD deemed fit for duty already. Please don't call me kid, I'm not fighting you, just discussing while using my free time on the forum.

Edit: Adding this in for anyone interested and want to draw their own conclusion. Note that this is not military specific, just general population.

https://williamsinstitute.law.ucla.edu/wp-content/uploads/AFSP-Williams-Suicide-Report-Final.pdf
"Overall, the most striking finding of our analysis was the exceptionally high prevalence of lifetime suicide attempts reported by NTDS respondents across all demographics and experiences. Based on prior research and the findings of this report, we find that mental health factors and experiences of harassment, discrimination, violence and rejection may interact to produce a marked vulnerability to suicidal behavior in transgender and gender non-conforming individuals. More research on suicidal behavior among transgender and gender non-conforming people is needed."

 

[Cooperd0g]

I believe Hopkins was the first place that did the surgery. They also shut down due to excessive suicide rates AFTER surgery. It was years before they started up again.

 

[aaronrodgers]

Listen- you can blame their suicide rates on whatever you like. White supremacy is probably the real culprit. But the fact remains that-whatever the cause- their suicide rates are unacceptably high and THAT is what makes them a terrible risk/investment to an organization that deploys to austere locations, fights endless, pointless wars and already has a mental health/suicide epidemic in its non trans-gendered ranks. Nowhere in any of my posts did I comment on what I though makes them so likely to off themselves, although I have a supposition. You are just trying to run interference and re frame the argument. I'm talking about odds, probabilities and good sense.

Come talk to me when you have to go pronounce one of your guys who steals an M4 and suck starts it while sitting in a Hilux on a deserted corner of the FOB. On "suicide watch" no less.

- ex 61N

I agree with you that it all comes down to the numbers in the end. Taking causation out of the equation, my concern still stands that preventing all transgendered individuals from TRYING to enlist because they have a higher % of being suicidal is akin to preventing all white americans from enlisting because they as a group have a higher % of developing lou gehrig's disease. It is essentially stereotyping. I support perhaps letting transgendered individuals TRY to enlist & qualify according to the set military mental/physical standards instead of outright banning them.

 

[Cooperd0g]

I agree with you that it all comes down to the numbers in the end. Taking causation out of the equation, my concern still stands that preventing all transgendered individuals from TRYING to enlist because they have a higher % of being suicidal is akin to preventing all white americans from enlisting because they as a group have a higher % of developing lou gehrig's disease. It is essentially stereotyping. I support perhaps letting transgendered individuals TRY to enlist & qualify according to the set military mental/physical standards instead of outright banning them.

This is an extremely weak comparison as they are orders of magnitude off. ALS has an incidence rate of 1.5-2.7 per 100,000. Suicide from transgendered people has an incidence rate of 32,000-50,000 per 100,000. The rate difference is ~20,000x!

 

[Shikima]

So why have any rules for military entrance? Very high BMI - no biggie, we'll put you into the fat camp for the first 6 months and then you go to boot camp for your service obligation. Low IQ, we'll have tutors to teach the basics prior to boot camp. Felony? We'll put you into certain jobs with 24/7 monitoring.

Any deficiency can be rationalized away.

 

[Homunculus]

I'm still on the fence on this one. anyone who has deployed has seen people who have no business being in the military, let alone deploying. people sneak through with disqualifying medical conditions all the time-- just in this deployment I've seen a soldier with FAP, another with hematuria since adolescence, another with recurrent uveitis since age 8- the list goes on. if you're going to target the transgender population you should be just as adamant about these people getting chaptered out as well.

to me the silence from the medical side of the house is deafening. everything seems to be conjecture and estimates. how many transgender servicemembers are there? how much does their medical care really cost? what is the suicide risk of *military* transgendered vs civilian? it very well may be that those who are motivated and functional enough to join the military and have a peer group, steady income, a "career" if they want it, etc may be a lesser risk, maybe even the same as the average recruit. what if being in the military is actually protective? The problem is no one knows. I assume this was all to be in the fact finding mission that was underway when POTUS decided to unilaterally act.

being non-deployable for what some deem to be an elective procedure I can understand. my solution (since the recovery period is so long) would be to extend the commitments of those people by however long the non-deployable time lasts. this removes the "but they can't deploy!" argument from the equation. as far as the "cost"-- this is more complex since the .mil also does cosmetic and elective procedures for others. our ENT clinic at MAMC was actively recruiting these cases when I deployed back in Feb.

regardless of your stance on if they should be allowed to serve, you have to agree the way in which this came about was poorly thought out- by both Obama and Trump. At the end of the day, just like when DADT was around, this will not rid the services of transgenders. they'll just go back to doing what they were doing when they were forced to keep it a secret. and in my opinion, just like when DADT was repealed and the military didn't implode, it also won't implode if transgenders are allowed to serve openly.

--your friendly neighborhood don't care who I share a shower with as long as they don't pee in it caveman

 

[HighPriest]

Ok, I suppose I'll weigh in.

I honestly don't care if transgendered people serve. I think you're going to run in to issues if they're in an infantry unit with regards to cohesion, but otherwise so long as they're fit for service physically, I'm sure there's a job that can be found for them.

I'm not ok with covering their surgeries. I don't like the idea of Tricare/Medcom deciding what they'll cover based solely upon political sensation.

If you're a woman, and you have a poor body image, and you feel that you would be happier and feel more complete with breast enhancement, that's an out of pocket expense. But if you're a man who wants the same thing because you aren't happy with your body and you feel like you should be a woman, they'll foot the bill? WTF is that? What if you're a couple struggling with infertility? The military doesn't cover your expenses. But if you're a woman who wants to go on hormone therapy to grow a beard and get a deeper voice, that we'll pay for?

I can't support it. I already have an issue with how they pick and choose what elective surgeries are covered and which are not, but in my opinion this is clearly crossing a line. Either cover everything, or don't. But if you don't, make it a clear, non-political decision. I'm ok with offering discounted out-of-pocket pricing like we do for other cosmetic procedures.

 

[DeadCactus]

Black men are 20x more likely to go to prison than white women. Clearly, the military should not allow black men to join.

I certainly hope the military is less lazy with their statistical analysis when deciding who to allow in...

 

[Cooperd0g]

I feel exactly as @HighPriest does. You want to join and serve, fine. But the way it was rolled out initially with "hey, we'll cover your sex change operations too!" was not great.

Why do most young, enlisted people join the military? Many are trying to escape something and/or have few other options. Sure there are the ones doing it for college funds or family reasons or patriotism, but my anecdotal experiences of 23 years in the military (18 in the line) is that the vast majority of young, enlisted folks join to escape their current civilian situation. They want out of the inner city or off the farm or away from the abusive family. Telling transgendered people we will "fix" them would encourage people, who otherwise may not want to join, to sign up. Meanwhile they will want those services right away and they won't know that it is a long process that has to be signed off by your command. It wouldn't have been easy. They would have been frustrated. They would have regretted their decision to join. They likely would have been very problematic because they joined for the wrong reasons and weren't getting what they thought they were going to get right away.

Feel free to disagree, but honestly consider if you have the experience with which to disagree other than your own pre-conceived or conceptual notions. Remember, you don't know what you don't know.

 

[BlackFrancis33]

https://www.rand.org/news/press/2016/06/30.htmlThe estimated number and cost of transgender individuals in the military per the RAND corporation. The previous policy indicated you had to be in your identified gender for 18 months before joining the military, limiting the medical care these individuals would need if transgender upon joining. The numbers do not support a large number of people joining for transition specifically, and the estimates also don’t indicate that the majority of the thousands of transgender service members are requiring additional, expensive medical care. The cost is 0.00001% of the DOD budget, or some inanely small number. 61N you use words like ‘incredible liability’ and then ‘self mutilation’ to describe transition surgery both of which are strongly in the opinion category. Again, being transgender is not considered by many, including the DSM-V, to be a medical diagnosis or psychiatric disorder. I acknowledge the suicide risk, but is that a reason to exclude every transgender person and moreover to kick out transgender americans currently serving in good standing in their respective military professions? Perhaps, the military with emphasis on discipline, honor etc is a place where transgender americans will be at lower risk of suicide. We all end up ****ting in the same slit trench, and I am not sure gender identity matters in the field if you can do your job. That is what I believe, and I will re-examine this belief with evidence. Before I exclude an entire group of people from the military, and remove thousands of americans currently serving, I would ask for evidence of sub-standard performance, risk to mission, risk to the person, excessive cost to the detriment of the mission etc. I believe that is what our SECDEF asked for before this decision was made for him via social media. You clearly have an opinion but you ‘believe’ is the important part of what you said. I don’t share your opinion, but I would be willing to re-examine my opinion with evidence.

 

[Shikima]

Can't suck the same crap in the trench if you need ongoing medication therapy. Same argument could be used for those with type 1 DM.

 

[deleted480308]

Queue all the dudes transitioning for the easier PT scores and the right to shower with actual women

 

[DD214_DOC]

Just to add my two cents, suicide rates don't actually change much post transition. Sex reassignment surgery isn't actually curative and can lead to many of its own problems.


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[pgg]

Can't suck the same crap in the trench if you need ongoing medication therapy. Same argument could be used for those with type 1 DM.

If a type 1 diabetic has their must-be-refrigerated medication supply interrupted during a deployment, they die. Can't really say the same thing about transgender people and their meds.

 

[dr zaius]

What if you're a couple struggling with infertility? The military doesn't cover your expenses. But if you're a woman who wants to go on hormone therapy to grow a beard and get a deeper voice, that we'll pay for?

Actually tricare covers sperm harvest (100% of the procedure), vasectomy reversals (100%), infertility work ups including HSG for women (100%), the medication for both men and women for assisted reproduction (clomid, etc 100%). There is out of pocket cost for lab fees for the actual procedures, but they are greatly reduced compared to civilian costs. IUI costs around $170/session, IVF is about $7k/cycle. Sperm banking you pay a little bit out of pocket as well.

I'm not upset about it being covered. The male factor infertility aspect of it generates cases for me, and it's very gratifying to help a couple who has been struggling to conceive actually conceive. It always just struck me as odd that it's covered.

 

[Gastrapathy]

So we shouldn't pay for their care but we should pay for HMC's cheeto induced OSA? Why allow women to serve when they are at risk for pregnancy any minute? This isn't about cost or suicide (I could just as easily argue that they are less likely to die in the .mil). The money involved here is trivial and keeping people from serving is not the same as keeping them from being TRICARE beneficiaries.

This is about the same response that made homosexuality such a controversy. Call that what you will.

My standard is simple. Worldwide deployable most of the time.

It's pretty interesting that Mattis' basically said he'd figure it out and then go back to the Orange. If the military had responded that way to prior presidents, it would have been a major story.

On a lighter note, I heard about a hemophiliac who made it into theater. He'd supposedly been getting factor injections through his parents insurance for the time he'd been in and came in to confess when he started bleeding. The story was he medevac'd thru LRMC a couple years before I was there.

 

[HighPriest]

Actually tricare covers sperm harvest (100% of the procedure), vasectomy reversals (100%), infertility work ups including HSG for women (100%), the medication for both men and women for assisted reproduction (clomid, etc 100%). There is out of pocket cost for lab fees for the actual procedures, but they are greatly reduced compared to civilian costs. IUI costs around $170/session, IVF is about $7k/cycle. Sperm banking you pay a little bit out of pocket as well.

I'm not upset about it being covered. The male factor infertility aspect of it generates cases for me, and it's very gratifying to help a couple who has been struggling to conceive actually conceive. It always just struck me as odd that it's covered.

and so, just as I said, it isn't covered. At least, most of it is not. Having been through everything you mentioned (except sperm harvest, which cost me nothing...though I might have paid for a little help), we spent more using Tricare than not. We spend less avoiding Tricare entirely, and going with a civilian program that offered a refund. IVF was $8,000/cycle with Tricare, $10,000/cycle without and I got a refund for ineffective cycles with the civilian option. Plus, it was far far more painful dealing with the military system while going through all of that hardship than it was the civilian system. I thought about it every time they asked me to consider going ishiki procedures for transgendered patients for free.

And just like IVF, I'd be ok offering ishikis at a discounted rate, like we do other cosmetic procedures. I did say that earlier.

 

[HighPriest]

So we shouldn't pay for their care but we should pay for HMC's cheeto induced OSA? Why allow women to serve when they are at risk for pregnancy any minute? This isn't about cost or suicide (I could just as easily argue that they are less likely to die in the .mil). The money involved here is trivial and keeping people from serving is not the same as keeping them from being TRICARE beneficiaries.

This is about the same response that made homosexuality such a controversy. Call that what you will.

My standard is simple. Worldwide deployable most of the time.

It's pretty interesting that Mattis' basically said he'd figure it out and then go back to the Orange. If the military had responded that way to prior presidents, it would have been a major story.

On a lighter note, I heard about a hemophiliac who made it into theater. He'd supposedly been getting factor injections through his parents insurance for the time he'd been in and came in to confess when he started bleeding. The story was he medevac'd thru LRMC a couple years before I was there.

No, we shouldn't pay for OSA if you got it by getting fat. That being said, I've treated OSA in patients who got it due to facial reconstruction after an IED blast. That's s different story. But again, the point is that we've drawn an arbitrary line with regards to what's covered and what isn't.

If you want to serve and you're transgender, great. But until we've decided to cover all cosmetic procedures, you should have to pay for your sex change. Even if at a discounted rate, like rhinoplasty or IVF.

It isn't about cost at all. It's about where you draw the line with regards to what is covered.

 

[HighPriest]

If a type 1 diabetic has their must-be-refrigerated medication supply interrupted during a deployment, they die. Can't really say the same thing about transgender people and their meds.

See, and I agree here. So long as they pay their own medical bills (specific to their gender reassignment), game on.

 

[Gastrapathy]

My point is that the line is being drawn here for reasons other than cost. There's no one clamoring to make people pay $100k for HCV treatment despite most of that epidemic being due to high risk behaviors. If it was free to the govt, they would just move on to the other tropes (its remarkable the .mil survived what blacks, women and gays were each going to do to good order and discipline).

 

[pgg]

So we shouldn't pay for their care but we should pay for HMC's cheeto induced OSA?

Hah, if we started denying coverage for self-inflicted disease, there'd be nothing for us to do for anyone over the age of about 6, ever. It's (almost) ALL self inflicted. 🙂

But just think of how much time that would free up for computer-based training on fire extinguisher use and human trafficking!

(its remarkable the .mil survived what blacks, women and gays were each going to do to good order and discipline).

Yes.

Equally remarkable were the women and minority service members who opposed letting teh gays serve openly. It kind of hurt my brain to hear them make the same arguments that were once made to exclude them.

 

[ArmyTiger]

If a type 1 diabetic has their must-be-refrigerated medication supply interrupted during a deployment, they die. Can't really say the same thing about transgender people and their meds.

If a transgendered person goes off their hormones in a high stress deployment environment, how long until they're psychologically unable to perform? 4 hour patrols can turn into 48 hour wait for EOD patrols quickly.

The reason someone is transgendered is possibly not the same reason to why they are suicidal. If anything, the higher suicide rate could be due to how poorly people treat them.

The logic provided means that hypothetically the military should also disqualify ethnic Japanese because of the suicide stereotype, would it not?

That being said, I'm supportive if there is convincing evidence that there is truly something unfit for service associated with being transgendered in and of itself

Sent from my Pixel XL using SDN mobile

 

[HighPriest]

My point is that the line is being drawn here for reasons other than cost. There's no one clamoring to make people pay $100k for HCV treatment despite most of that epidemic being due to high risk behaviors. If it was free to the govt, they would just move on to the other tropes (its remarkable the .mil survived what blacks, women and gays were each going to do to good order and discipline).

I agree. Cost isn't a valid argument. We wasted more money in a week than I would cost to provide those services for the same amount of time.

 

[Homunculus]

I heard about a hemophiliac who made it into theater. He'd supposedly been getting factor injections through his parents insurance for the time he'd been in and came in to confess when he started bleeding. The story was he medevac'd thru LRMC a couple years before I was there.

this deployment (not my unit) there was a soldier who developed DKA. was a pre-existing type 1 whose wife was mailing him his insulin. can't make this stuff up.

(its remarkable the .mil survived what blacks, women and gays were each going to do to good order and discipline).

+1

If a transgendered person goes off their hormones in a high stress deployment environment, how long until they're psychologically unable to perform? 4 hour patrols can turn into 48 hour wait for EOD patrols quickly.

acute estrogen withdrawal? acute testosterone withdrawal? what are you arguing? last I checked withdrawing from hormones (unless you have CAH) is probably better than the guy with HTN who goes off his 3 meds, the one with depression/PTSD on SSRI who goes off his, the one with BPH who goes off his, etc. those are case ive seen this go around. I'm sure there are others. also, news flash, there are people who are "psychologically unable to perform" their duties who have no medical issues and whose jobs are working in a DFAC or filing papers. the inability to cope with stress is not transgender specific.

I agree. Cost isn't a valid argument. We wasted more money in a week than I would cost to provide those services for the same amount of time.

if they simply killed off USFHP they'd have their money right there, lol.

--your friendly neighborhood 70 days or so to go caveman

 

[ArmyTiger]

this deployment (not my unit) there was a soldier who developed DKA. was a pre-existing type 1 whose wife was mailing him his insulin. can't make this stuff up.



+1



acute estrogen withdrawal? acute testosterone withdrawal? what are you arguing? last I checked withdrawing from hormones (unless you have CAH) is probably better than the guy with HTN who goes off his 3 meds, the one with depression/PTSD on SSRI who goes off his, the one with BPH who goes off his, etc. those are case ive seen this go around. I'm sure there are others. also, news flash, there are people who are "psychologically unable to perform" their duties who have no medical issues and whose jobs are working in a DFAC or filing papers. the inability to cope with stress is not transgender specific.



if they simply killed off USFHP they'd have their money right there, lol.

--your friendly neighborhood 70 days or so to go caveman

If a FtM transgendered soldier stops hormones, how long until they can't lift their 180lb battle buddy with full kit? If a MtF soldier stops hormones, how long until they have to shave? And for both categories, how long until their gender dysphoria comes back? It's hardly unreasonable to consider. Every team is a LRP team with counter-insurgency ops. I wouldn't send an asthmatic with them, or a T1DM, or even an OSA patient. And all of those examples should go through an MEB.

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[Homunculus]

If a FtM transgendered soldier stops hormones, how long until they can't lift their 180lb battle buddy with full kit? If a MtF soldier stops hormones, how long until they have to shave? And for both categories, how long until their gender dysphoria comes back? It's hardly unreasonable to consider. Every team is a LRP team with counter-insurgency ops. I wouldn't send an asthmatic with them, or a T1DM, or even an OSA patient. And all of those examples should go through an MEB.

Sent from my Pixel XL using Tapatalk

so you are worried about an acute loss of strength from missing a dose of testosterone? and using the scenario you described I don't think shaving will be at the top of anyone's priority list on a 48 hr EOD operation-- so I would say the same as the other males?

your hypothetical arguments for excluding transgender servicemembers can be countered with any one of many chronic medical conditions people deploy with, many of which are worse than taking hormones. what about the post-ablation graves' patient who misses their thyroid?

yes, you can MOD13 a lot of ****. you can also come up with hypotheticals all you want-- the fact of the matter is taking hormones isn't that big of a deal. females are on OCPs, and they manage, yes? the "burden" on the medical system while deployed would be less than the malingering weenies who come in for every ache, pain, ouchie and boo-boo wanting meds and profiles.

--your friendly neighborhood I don't care what gender you are if you can do your job caveman

 

[pgg]

If a transgendered person goes off their hormones in a high stress deployment environment, how long until they're psychologically unable to perform? 4 hour patrols can turn into 48 hour wait for EOD patrols quickly.

LOL, that's your argument?!?

That's like arguing that black people shouldn't be allowed to serve because there's no reliable supply of fried chicken and watermelon out in the field. Both arguments are specious, founded in ignorance, and well over the line of gratuitous offensiveness to both groups.

 

[ArmyTiger]

LOL, that's your argument?!?

That's like arguing that black people shouldn't be allowed to serve because there's no reliable supply of fried chicken and watermelon out in the field. Both arguments are specious, founded in ignorance, and well over the line of gratuitous offensiveness to both groups.

One of many, honestly. They're an incredibly small minority that will consume medical resources faster even then the malingerer trying to get out of PT. The military requires they get a surgery to change gender, and that alone will make them non-deployable for at least 6 months for what's essentially a cosmetic change. Even after said surgery, their suicide rate is higher than 11Bs returning from combat. And they're adding what to our capabilities? They're just another guy or girl? Doesn't justify the costs at all.

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[pgg]

One of many, honestly.

But it's the one you chose to make first. You realize that hormone therapy for these people is akin to women taking birth control pills, in terms of cost and complexity? And that the consequence of missing a dose is essentially nothing vs getting pregnant and becoming non-deployable for the next year and a half?

And they're adding what to our capabilities?

The same thing black people and women and gay people do: whatever they're trained to do.

Doesn't justify the costs at all.

Your arguments are ridiculous! The cost is negligible. A woman getting pregnant costs far, far more than any one of these people. Or maybe you think we shouldn't let women serve?

FWIW, the last time we won a war was when the .Mil wasn't integrated and women were in a separate corps, so maybe we should go back to that setup, if the function of the .Mil is even to win wars these days.

Or maybe you do?

You really think maybe we should re-segregate the military because blacks in the Navy could only be cooks and ditch diggers the last time we won a war?

 

[Onefellswoop87]

One of many, honestly. They're an incredibly small minority that will consume medical resources faster even then the malingerer trying to get out of PT. The military requires they get a surgery to change gender, and that alone will make them non-deployable for at least 6 months for what's essentially a cosmetic change. Even after said surgery, their suicide rate is higher than 11Bs returning from combat. And they're adding what to our capabilities? They're just another guy or girl? Doesn't justify the costs at all.

Sent from my Pixel XL using Tapatalk

No.

No.

The USN (and I assume the whole DoD) wasn't planning on requiring any surgery on and service member transitioning. We do have a concept of autonomy in medicine. I was at a flag command for many briefs about this time last year when the instruction came out - I heard those talking points and heard them debunked.

FWIW, the last time we won a war was when the .Mil wasn't integrated and women were in a separate corps, so maybe we should go back to that setup, if the function of the .Mil is even to win wars these days.

- ex 61N

We also won the revolutionary war with muskets and armies engaging across a field to exchange cannon fire. Oh, and we had slaves. I'm not sure your argument does anything to advance your position.

 

[Onefellswoop87]

He's not talking about mandating surgery on these people.

- ex 61N

He's not? He said, "The military requires they get a surgery to change gender". That's just not true.

 

[Homunculus]

here, I will attempt to give a real life HIPAA compliant illustration. I know of 2 female to male transgenders who have fallen under my umbrella for care during my current deployment. I know this because when the **** hit the fan we had to figure out what to tell them in regards to their future service since they had "outed themselves" under the old policy. how many times have they been seen at the aid station? only for their routine anthrax boosters. neither one is at risk of failing a PT test. no EBH visits. nothing.

counter that with a DFAC enlisted straight soldier we've seen 16 times during the deployment for miscellaneous complaints. or the soldiers we've had to evac for SI who have never deployed but are so distraught over their significant other/spouses at home and their shenanigans they want to kill themselves (or at least say they do). or the females I've sent back who have gotten pregnant in theater. argue all you want about the covering elective surgical procedures and deployability, but operationally I've not seen these "they're gonna kill themselves and suck up all the medical resources" concerns.

I hate anecdotal evidence as much as the next person, but until we have actual data on costs in dollars and readiness this is all just another political cause de jour. I also think like most of these kinds of things actually meeting someone it impacts also changes your math.

--your friendly neighborhood didn't we win desert storm? so we haven't been shut out caveman

 

[TheEarDoc]

And here I thought my astigmatism being over 3.0 was a horrible thing..... 🤔

 

[notdeadyet]

Given how little formal psychiatric training is found in literally any residency other than psychiatry,* the mental health stereotyping and misunderstanding doesn't surprise me.

But for a forum with a bunch of doctors on it, I'm a little taken aback by the loose grip on the facts of some of the medical stuff (e.g.: A few of us might be overestimating the power of a hormone pill, no?)

* = I've read stats that somewhere around 20% of primary care visits are primarily for mental health reasons, yet to my knowledge, family practice residencies don't require even a month of psych. Head scratcher...

 

[HighPriest]

Given how little formal psychiatric training is found in literally any residency other than psychiatry,* the mental health stereotyping and misunderstanding doesn't surprise me.

B...

You crazy.

 

[HighPriest]

* = I've read stats that somewhere around 20% of primary care visits are primarily for mental health reasons, yet to my knowledge, family practice residencies don't require even a month of psych. Head scratcher...

Well, they spend essentially no time in ENT, and that's an even larger percentage. Which explains the insane crap I see done for people. It's a conundrum. This is why primary care is being overrun by mid-levels. People just want a referral.

 

[notdeadyet]

Well, they spend essentially no time in ENT, and that's an even larger percentage. Which explains the insane crap I see done for people. It's a conundrum. This is why primary care is being overrun by mid-levels. People just want a referral.

Interesting. Had no idea ENT was such a big component of primary care.

Interestingly, I actually just saw an ENT guy and he mentioned how much of HIS patient-base is psych as well. Surprised me too.

 

[HighPriest]

Interesting. Had no idea ENT was such a big component of primary care.

Interestingly, I actually just saw an ENT guy and he mentioned how much of HIS patient-base is psych as well.

Yeah, a goodly amount.
A need for otolaryngology education among primary care providers

And I certainly see some psych issues. I wouldn't say a ton. Anxiety, somatization of anxiety and depression. They're certainly a common comorbid disease. I think a lot of Ent guys think vertigo patients are all crazy. Some are, but usually there's some kind of actual problem. Maybe plus a psych issue. But fortunately if there aren't any physical problems, I can refer them. I don't even try to treat psych issues beyond reassurance and taking time to hear people out. Because I'm an otolaryngologist. It's not in my job description.

Anyway, I'm hijacking the crazy, illogical thread here...

 

[dr zaius]

Given how little formal psychiatric training is found in literally any residency other than psychiatry,* the mental health stereotyping and misunderstanding doesn't surprise me.

But for a forum with a bunch of doctors on it, I'm a little taken aback by the loose grip on the facts of some of the medical stuff (e.g.: A few of us might be overestimating the power of a hormone pill, no?)

Definitely wrong. When I do a testopel implant guys immediately feel completely jacked and up their max bench press by 70% on average. Within seconds of the date/time for placement of another one they turn into wimpy 12 year olds. That's totally how hormones work.

 

[astrostellar]

What I find the most amusing about the "but if they're in the trenches" argument is the idea that joining the military puts you in a foxhole in Vietnam. I couldn't get a deployment if I wanted one. The one time I was going to deploy, I was on antidepressants, and nobody cared. They were going to send me with them.
My entire unit and career field is basically nondeployable, and when we do deploy, it's to a fenced-in Burger King in the desert. There are many, many jobs where this would never be a problem.
Where is this assumption that everyone is infantry in 2003 Iraq? Granted, those jobs exist, but they are not the majority of the military's forces right now.

"Oh, no! I'm outside the wire, there's Charlie everywhere, bullets flying over my head, and for some reason, I can't reach into my pocket and take the hormone pill prescribed to me that I brought!"

In reality, transgendered people deployed will probably be more like,

"Oh man, I forgot my SIPR token in my laptop while I was watching bootleg anime. Now I'll have to go back to my dorm to get it during lunch instead of going with the guys to Chipotle."