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Military Health System

Transgender Health Care Services

TRICARE covers hormone therapy and psychological counseling for gender dysphoria. This condition is when a person is born one gender, but feels they are the opposite. TRICARE generally doesn’t cover surgery for gender dysphoria. However, active duty service members may request a waiver if their provider deems surgery medically necessary. 

Transgender Education References & Training Resources

VHA TRAIN offers several training opportunities for health care providers to learn more about transgender care.

View VHA TRAIN Resources

  • These education references and training resources are built on evidence-based practice guidelines and standards of care. 
  • These resources apply to both Direct CareDirect care refers to military hospitals and clinics, also known as “military treatment facilities” and “MTFs.”direct care and purchased care network and non-network TRICARE-authorized providers.

Policies

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Treatment Guidelines

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Archived Documentation

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Transgender Health Care Services

Army Directive 2021-22 (Army Service by Transgender Persons and Persons With Gender Dysphoria)

Policy

This directive implements Army and Department of Defense (DOD) policy changes to the standards for retention, separation, in-service transition, and medical care of transgender personnel, as well as the accession of individuals with gender dysphoria. This directive supersedes all previous guidance regarding transgender service, including Army Directive 2016-30.

Interim Guidance For Service Of Transgender Navy Personnel

Policy

This NAVADMIN provides interim guidance in line with reference (c) for policy, regulations and procedures related to the service of transgender Navy personnel, in anticipation of an update to reference (e). This policy applies to Navy military personnel, including those serving in the Reserve Component (RC)

DODI 1300.28 In-Service Transition for Transgender Service Members

Policy

This issuance establishes policy, assigns responsibilities, and prescribes procedures: • Regarding the process by which Service members may transition gender while serving. • For changing a Service member’s gender marker in the Defense Enrollment Eligibility Reporting System (DEERS). • For medical care for Active Component (AC) and Reserve Component (RC) transgender Service members.

Military Service by Transgender Persons and Persons with Gender Dysphoria 2021

Policy

On January 25, 2021, the President signed an Executive Order entitled, "Enabling All Qualified Americans to Serve Their Country in Uniform," allowing all transgender individuals who wish to serve in the U.S. military and can meet the appropriate standards be able to do so openly and free from discrimination. The Military Health System will continue to provide MEDICALLY NECESSARY care for active-duty transgender Service members.

Military Service by Transgender Persons and Persons with Gender Dysphoria

Policy

In accordance with the authority in DOD Directive 5124.02, this issuance establishes policy, assigns responsibilities, and prescribes procedures regarding the standards for military service accession, retention, separation, in-service transition, and medical care for Service members and applicants for accession to the Military Services with gender dysphoria or who are transgender, as applicable.

(DTM)-19-004 -Military Service by Transgender Persons and Persons with Gender Dysphoria (Change 1)

Policy

Implements the policy in the Feb. 22, 2018 Secretary of Defense Memorandum and the February 2018 DOD Report and Recommendations on Military Service by Transgender Persons, assigns responsibilities, and prescribes procedures regarding the standards for accession, retention, separation, in-service transition, and medical care for Service members and applicants with gender dysphoria, as applicable. This DTM is effective April 12, 2019. This DTM will be incorporated into DODIs1300.28, 1332.14, 1332.30, and 6130.03, and supersedes any contradictory guidance in those publications. This DTM will expire effective Sept. 12, 2020.

Air Force Policy Memorandum Military Service by Transgender Persons and Persons with Gender Dysphoria

Policy

This Air Force Policy Memorandum immediately establishes specific Air Force policy and provides guidance associated with the accession and in-service transition of exempt Airmen identifying as transgender with a diagnosis of gender dysphoria. Compliance with this memorandum is mandatory.

Guidance for Medical Care in Military Treatment Facilities for Service Members Diagnosed with Gender Dysphoria

Policy

Military Service by Transgender Persons and Persons with Gender Dysphoria

Policy

This Fact Sheet for Service Members discusses the Department of Defense policy with respect to Military Service by Transgender Persons and Persons with Gender Dysphoria, and answers frequently asked questions about the policy

Air Force In-Service Transition of Airmen Identifying as Transgender

Policy

This memorandum extends the policy and guidance associated with in-service transition of Airmen identifying as transgender established in Air Force Policy Memorandum 2016-36-01 (AFPM2016-36-01), dated 6 October 2016. To the extent the memorandum's directions are consistent with other Air Force publications, this information herein prevails, in accordance with Air Force Instruction 33-360, Publications and Forms Management.

CORRIGENDUM FOR “Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline”

Policy

This describes errors made in the original document, and summarizes the corrections made to the recommendations.

Interim Defense Health Agency Procedures for Reviewing Requests for Waivers to Allow Supplemental Health Care Program Coverage of Sex Reassignment Surgical Procedures

Policy

The purpose of this memorandum is to share with you the procedures the Defense Health Agency (DHA) will follow to consider requests for a Supplemental Health Care Program (SHCP) waiver to allow coverage of sex reassignment surgical procedures.

Military Service by Transgender Individuals -Interim Guidance

Policy

Consistent with military effectiveness and lethality, budgetary constraints, and applicable law, this memo describes the DoD's plan to implement the policy and directives in the Presidential Memorandum, "Military Service by Transgender Individuals," dated August 25, 2017. The plan will establish the policy, standards and procedures for transgender individuals serving in the military.

Endocrine Treatment of Gender-Dysphoric/ Gender-Incongruent Persons: An Endocrine Society* Clinical Practice Guideline

Policy

This Guideline updates the “Endocrine Treatment of Transsexual Persons: An Endocrine Society Clinical Practice Guideline,” published by the Endocrine Society in 2009.

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Last Updated: September 01, 2022
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