I am so glad to hear that the VA is providing such great care for everyone above! Luckily, the VA has more flexibility to refer people out of the military network, and I hope those on active duty can also get referrals to experienced providers outside a military facility.
Cimara, the policy was officially changed last year, but it wasn't until the last couple of months that they pushed out the additional guidance and training. I'll try to summarize how it works:
1. The Service Member (SM) gets diagnosed with "gender dysphoria" by a military provider.
2. The SM informs their Commander (the officer in charge of the SM) of the intent to transition.
3. The SM and medical providers come up with a treatment plan, which is then presented to the Commander for "approval".
4. The treatment plan is carried out.
5. Once the medical providers determine the SM is "stable in the preferred gender", the SM is administratively classified as "transition complete", and the official gender in their military records is changed.
That's the process in a nutshell. A few important things are:
a. The distinction between being diagnosed as "transgender", which does not meet the standard to start the transition process, and being diagnosed with "gender dysphoria", which does meet this new standard.
b. The SM needs to be either diagnosed by a military medical provider or have a civilian diagnoses confirmed, so just having an outside provider say someone has dysphoria doesn't mean it will meet the military criteria...and I'm not sure what exactly those criteria are.
c. The Commander has a very big role in this...they don't have a say in the treatment or plan, but they have final approval. Since the SM is still a military member, the military mission comes before the individual SM. That being said, I do not see very many (if any) issues with Commanders not approving treatment unless the SM is getting ready to deploy or some similar critical event. Treatment for diagnosed dysphoria is considered "medically necessary", but does not necessarily require immediate treatment.
d. The SM is required to meet all standards in the current gender until the determination of "transition complete" and the Commander approves the official gender change in the military records. This means if someone is transitioning from male to female, they are required to maintain male grooming standards (short hair, no ear piercings, etc.), male physical fitness standards (physical fitness tests and height/weight standards), male uniforms, male barracks, male restroom, male showers...everything male literally until the day of the change in the military records. I can see this causing problems in some instances. As far as RLE, it will need to be done only off-post and will require a special exception to policy signed by the Commander.
e. The determination of "transition complete" is an administrative term only. It is not dependent on anything other than the SM being comfortable and "stable" as they are in the preferred gender...so gender confirmation surgery is not required. However, many, many people who at least pretend to be OK with this are absolutely losing their sh*t about the idea of of a "guy" using a "girls" bathroom or shower, especially if they have not had the "surgery". Unfortunately, there is no real surprise there.
All of this is for people already in the military. For right now, gender dysphoria is a disqualifying condition to entering the military. This policy is also being revised, but it looks like it will be fairly strict. Essentially, they will require people trying to join to be able to prove they have been "stable" for 18 months...either being transgender without issues for 18 months, diagnosed dysphoric but without issues for 18 months, or post-transition and stable for 18 months. I am sure they are trying to avoid having people join exclusively to have their surgery paid for and then get out, so there are going to be a lot of restrictions and hoops to jump through.
Hope this helps everyone understand the current situation!
