The U.S. Military Spends More on Erectile Dysfunction Meds Than Trans People's Healthcare
On Tuesday, the Supreme Court allowed, by a vote of 5-4, for the Trump administration's transgender military ban to be reinstated, preventing most transgender people from serving in the military until a final decision on the legality of the ban can be reached. The injunctions put in place against the policy when it was first recommended by former Secretary of Defense James Mattis in 2017 have been lifted, and the Department of Defense can begin barring transgender men and women from the military at any time. This action alone will affect the more than 15,000 transgender men and women estimated to be currently serving and has the potential to affect hundreds of thousands more Americans.
The ban, according to transgender U.S. Army Captain Jennifer Peace, also opens the floodgates for discrimination against other marginalized groups like gay, lesbian, and bisexual men and women, African Americans, women in general, and more. "It's essentially 'don't ask, don't tell' for trans people," Peace says, referencing a law that prohibited gay and lesbian Americans from serving openly in the armed forces from 1993 to 2011. (Its name meant that those who didn't "tell" anyone about their sexuality were okay, and leaders weren't to "ask" about it.) "There is this conversation that's gone around that this isn't really barring trans people from serving, and that's incorrect."
We spoke to Peace, whose story launched InStyle's Badass Women series back in 2017, about her reaction to the news and what this means for her and her peers. Below, she debunks the current administration's concerns related to transgender military personnel and speaks to the larger implications of this policy.
What does the transgender military ban mean for you and for your peers?
The most immediate and negative effects are going to be among people who want to join the military. The idea is, you can join the military if you're trans only if you've never been diagnosed as having something like gender dysphoria, you haven't begun transitioning at all, and you don't come out as trans while in the military. So you can't receive any medication, therapy, anything like that, and you don't transition. Essentially, you could be trans as long as you don't ever say anything or do anything about it.
Also, it [impacts] retention, which means you can stay in the army, but if you're enlisted and you want to become an officer, you can't. If you're enlisted and you want to become a warrant officer, you can't. If you want to go and do a different MOS or job skill, you can't. Essentially, wherever you're at in your military career, you can't move [if you're out as trans].
What are some of the far-reaching implications?
The thing that isn't as clearly written, that I think will be more insidious, is that the former Secretary of Defense, the President, the Vice President, and I believe even the Secretary of State have all come out and said that trans people are not qualified to serve in the military. Now, if the President and the Vice President and the Secretary of Defense have told me that trans people are not qualified and capable to serve, that they shouldn't be in the military, then when a trans person's packet comes across my desk to be promoted or to go into a nominative position at an agency, why would I give them that opportunity? Why would I promote them? Why would I recommend them for an award when my boss has already said they shouldn't even be in the military? I think that level of discrimination, while it's not explicitly stated, is what's going to do the most harm to actively serving trans members.
How many people will be affected by the ban?
Across our entire US armed forces, there are around 15,000 actively serving trans members. Only about 900 have come out as trans. For the rest, if they don't come out before the policy is implemented, they will no longer be allowed to come out or receive treatment. For those who want to join the military, which often trans people join for an inclusive environment where we take care of each other, where you have health care, jobs, friends, and a community, will no longer be able to join.
Also, [considering the estimated 134,000 veterans that identify as trans], the United States military and the Department of Defense is the largest employer of transgender people in the world. For a class that's already being disenfranchised from employment, housing, medical care, and numerous other things, you're now going to remove this vulnerable population's largest employer.
How could the ban affect other marginalized groups in the military?
It's historically important to look at how the military has evolved. There was a time black people couldn't serve in the military, and we changed that. Then we had the Women's Army Corps, which was segregated, and then we allowed women to join the military. Gays, lesbians and bisexuals joined the military openly only a decade ago. Now trans people have been able to serve openly for about two years. This would be the first time in our military's history that we have taken a step backwards in the wrong direction, and I think that limits inclusion in the future and it also puts every other group at risk if they are perceived as not being as capable of serving, regardless of evidence.
Can you explain the primary concerns the transgender military ban policy cites?
The policy published by Secretary Mattis outlined three primary concerns that were being looked at as reasons that trans people could no longer serve. They were: the cost of health care, the impact on readiness, and the impact on morale and cohesion. As far as the impact on medical cost goes, the average expected cost per year of transgender people serving in the military is between $2.4 and $8 million. That sounds like a lot until you realize that last year, the U.S. government spent just around $80 million on erectile dysfunction medications for service members, and almost $40 million of that was on Viagra alone. Also, to put this into context, trans-related healthcare costs are less than one thousandth of one percent or .0001 percent of the the overall defense budget. Based on those numbers, I think we could say that the cost is negligible for the investment that we have in a talented group of individuals.
As far as readiness, there's a concern that medications and potential surgeries would have a long-term non-deployable impact on trans service members. But we have found that for most trans service members the overall time that they are non-deployable, throughout their transition until they consider it complete and are 100 percent on duty, is actually less time than it is for a single pregnancy.
And I think the morale and cohesion argument is really the same argument that we've heard about African-Americans serving, about women serving, about gays and lesbians serving. It has never panned out. When gays and lesbians were allowed to serve in the military, there were all these concerns that there would be violence and rioting in units or masses of people leaving the army. We didn't see any of that happen.
Was Tuesday's news surprising for you?
No. I'm on the Board of Directors for an organization called SPART*A, which represents a significant number of actively serving trans service members. We were aware of where the policy was at, and there was certainly a concern that the Supreme Court would address it. While this is a disappointment, it was not un-anticipated.
How do you personally keep your spirits up?
I come into work every day and I do the best that I can at my mission. I let that speak for itself. The people around me, the people who I work with, my peers and my subordinates and my superiors, I let them judge me based on my job performance. When they find out at a later date that I'm trans, or the discussion comes up, I think that has the biggest impact. They realize that they've been working with a successful officer, an effective officer, who also happens to be trans. I think that helps shift their view.
You have three children and your wife at home. How has this affected your family?
When I first started transitioning, I spoke to the kids. Honestly, the only concern from them was that I would still be there for them, that I would still love them. Once they knew that, it's never been a discussion. Honestly, my kids are unimpressed. I came home yesterday and I said, "Hey, I was on TV yesterday." They're like, "Oh, that's cool." They're 10, 12, 6, now. I don't involve them in the discussion and the worry. With my wife, there is some stress because our lives for 14 years now have been built around military service and the military community.
What bothers you the most?
The idea — if it was something that I did or a way that I was underperforming or unable complete my mission, then I could understand and accept that I was no longer qualified for military service — but the idea that I can come in, do my job to a high standard on one day and then potentially the next day be told, "You're no longer allowed to advance," or, "You're no longer allowed to serve in the military," because of no change in my performance or potential is a jarring reality to have to face.
What can the general public do to help the situation?
It doesn't sound like much, but sharing stories of trans people makes a difference, because so many people's view of trans people is what they get from the media and from pop culture. They've never met a real trans person or heard one speak. Hearing stories is important. If you hear people speaking negatively about trans people, say something. Challenge those ideas. And contact your representatives, regardless of what state they're from, and let them know that you support openly serving trans people in the military and you don't want to see this ban put back into place. Making people realize that this is an important issue is really all any of us can do.