Marginalizing health care for trans people is nonsense. It’s also unnecessary and needlessly hurtful

On Tuesday, a rash of extremely misleading headlines, from the New York Times to the Washington Post to ABC News, reported that Defense Secretary Jim Mattis had “frozen” Donald Trump’s ban on transgender people serving in the military. This was misleading to the point of being a flat-out lie. As Mark Joseph Stern of Slate wrote:

This framing is an extreme mischaracterization of the facts. Mattis did not “freeze” the trans ban, and he is not “buy[ing] time” in some potentially insubordinate effort to buck Trump. In reality, the secretary is doing exactly what Trump directed him to do in a recent memo.

Mattis’ claim that the issue needs more study is a lie designed to make a decision based in raw bigotry look more thoughtful than it is. The reason we know this is that the military has already studied this issue extensively, releasing a 2016 report that found “allowing transgender personnel to serve openly” would have “little or no impact on unit cohesion, operational effectiveness, or readiness.”

The excuse that Trump used when he first announced this ban on Twitter, and the excuse he will almost certainly continue to use, is that medical care for trans people, such as hormone therapy or gender confirmation surgery, is too expensive. Not only is this another lie — it was widely reported that the military spends five times as much on Viagra as it expects to spend on gender confirmation treatments — but this excuse is in itself a form of bigotry, a way to demonize transgender people by stigmatizing the health care they need.

“The only reason we’re even having this conversation is because the president and others don’t actually consider health care for trans people to be real health care,” Chase Strangio, a staff attorney with the ACLU’s LGBT & AIDS Project, explained to Salon. “It’s only because we stigmatize this care and we don’t understand trans people that part of the conversation even comes up, because all of the evidence shows that the costs are negligible in a budget that’s billions and billions of dollars.”

Strangio, who helped Chelsea Manning with legal issues during her time in a military prison, is working on a suit that the ACLU filed against Trump and the Department of Defense on behalf of five active service members. The ban would not only bar trans people from enlisting and threaten the status of those currently serving, it would also forbid them from having equal access to health care.

“From a medical aspect, transgender care is regular health care,” explained Dr. Jenn Conti, an ob-gyn who has helped trans men with their gender confirmation care and who is an advocate for Physicians for Reproductive Health. Trump’s “statements and his tweets are truly not founded in medical science,” she continued. “It’s a political issue, and it’s something that’s happening at the expense of an already stigmatized and underserved population.”

What Conti and Strangio both emphasized repeatedly is that there is no reason, morally or medically, to single out trans health care as any different from any other kind of medically necessary care.

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