Military children and teenagers will no longer have access to gender-affirming health care through the Pentagon's insurance plan under the new military budget just passed by Congress.
A provision banning gender-affirming care foe minors was added to the House version of the annual National Defense Authorization Act (NDAA) by Republicans before the House passed the bill Dec. 11. One week later, the Senate easily passed the bill.
The bill, considered "must-pass" legislation, funds the entire military for the 2025 fiscal year. President Joe Biden is expected to sign it.
Democratic Rep. Sara Jacobs of California sits on the House Armed Services Committee. She says the anti-trans language wasn't part of the bipartisan bill that came out of that committee.
"I'm incredibly disappointed that House speaker Mike Johnson and Republican leadership put in these culture war partisan issues into what has historically been a bipartisan bill," Jacobs said in an interview. "We don't know the exact numbers, but we do think it's at least thousands if not tens of thousands of families who are going to be affected."
But California Republican Rep. Doug LaMalfa spoke in favor of the anti-trans provision from the House floor.
"Children should have the chance to grow up without being subjected to experimental procedures that could cause permanent damage to their bodies and futures," LaMalfa said. "These are minors we’re talking about here. What business is it of the Department of Defense to be engaging in this?"
The provision bans TRICARE from covering gender-affirming care — specifically hormone therapy and puberty blockers — for anyone under 18. TRICARE covers service members, military retirees, and their families.
Hormone therapy and puberty blockers are approved treatments for gender dysphoria in kids, said Kathie Moehlig, the founder and director of TransFamily Support Services, a San Diego-based nonprofit.
"This has been approved care by the medical associations, by the pediatric associations, by the psychological associations as important medical care for gender dysphoria," Moehlig said. "And so when we withhold medical care from anybody, we are creating harm."
Moehlig helps families with trans kids across the country access care. Many of them are military families.
"People are afraid," Moehlig said. Her organization is helping families find alternative care options, which she said isn't always easy.
"Our military families struggle financially," she said.
The language in the Pentagon spending bill echoes that in bills passed in 26 states banning gender-affirming care.
Moehlig said trans kids are weary of being the targets of these laws.
"Remember these are kids — these are some of our most vulnerable population that adults have politicized and decided to attack," she said. "We have youth ... that say things like, 'I don't even know why I should exist — my government hates me.' That is a huge burden for a kid to walk around with."
Zander, 17, lives in a small coastal city near San Diego. His father recently retired from the Navy. Zander has been covered by TRICARE his whole life.
Navy doctors provided his gender-affirming care over the last few years. He’ll now have to find care elsewhere.
Zander spoke on the condition that only his first name be published because he’s concerned for his family’s safety.
He said it’s frustrating when politics interferes with medical care.
"I can kind of believe that some people are genuinely concerned for the kids," Zander said. "But I have a hard time believing that, for politicians specifically, it's actually a concern for the kids. Politicians don't seem to be very empathetic to the people."
Zander said he wished lawmakers would start listening to trans kids and their families.
"A lot of my friends and a lot of the people that I've talked to who are trans — they have felt so much happier after transitioning," Zander said.
His transition, he said, has clarified for him who he really is.
"A lot of people think that it's gender dysphoria that defines being trans," Zander said. "But a lot of times it's like gender euphoria … it's almost like putting on glasses if you have, like, really blurry vision…"
Zander's mother Robyne said their family will be able to absorb the added healthcare costs. But she’s worried that thousands of military families won’t.
"It's going to be hard," she said. "They're going to have a child in distress … my heart breaks. I'm very worried that there are kids that are going to be physically harmed because of this."
She said military kids go through a lot. They have to move, change schools, and make new friends every few years.
"They're called dependents — but I think they're the bravest of all," Robyne said. "They're making a sacrifice that they didn't choose to make. And now their country is turning their back on them. It just it hurts."
Jacobs, who represents thousands of military families in and around San Diego, said she hears from them frequently.
"Our military families are not calling me about drag shows. They're not calling me about these culture war issues," she said. "They're calling me about the housing they need, the child care they need, the health care they need to keep their families safe."
Lawmakers sometimes struggle to see things from the perspectives of those serving, she said.
"A lot of my colleagues are really much more focused on the hardware that is built in their district," Jacobs said. "One of the things I spend a lot of my time doing is actually educating (them) about what it's actually like for service members and their families."
Republicans in the House this summer failed in a border effort to strip insurance coverage for gender-affirming care for everybody covered by TRICARE — including troops and military retirees. But advocates are preparing for more anti-trans proposals to emerge from the Trump Administration.
This story was produced by the American Homefront Project, a public media collaboration that reports on American military life and veterans.
