Defense Bill Targets Transgender Medical Care for Military Kids

House Democrats are bracing for a challenging vote this week regarding the final compromise of the annual defense bill, which incorporates pay raises for troops while also implementing a ban on transgender care coverage for U.S. service members’ children.

The preliminary procedural vote on Tuesday ended with all present Democrats opposing the advancement of the historically bipartisan legislation, resulting in a 211-207 tally. As Congress proceeds, a final vote could take place as soon as Wednesday. This marks the 64th consecutive year Congress has convened to pass the annual package.

Rep. Adam Smith, ranking Democrat on the House Armed Services Committee, publicly stated his intent to vote against the comprehensive defense policy bill. He criticized the bill for “blanketly denying health care to people who need it — just because of a biased notion against transgender people.” Smith emphasized that this harmful provision endangers the lives of vulnerable children, potentially forcing thousands of service members to choose between their military careers and securing crucial healthcare for their children.

As the nearly $900 billion National Defense Authorization Act for fiscal year 2025 progresses, it proposes a significant raise for military personnel—a 4.5% across-the-board pay increase, along with a 10% increase for the lowest-ranking soldiers starting in April. The bill also aims to enhance military housing and establish new protocols for addressing traumatic brain injuries resulting from blast exposure.

Included in the bill’s final version are several provisions aligned with right-wing priorities, such as restrictions on diversity, equity, and inclusion (DEI) hiring, and a ban on federal funding for “critical race theory” education in the military, while still accommodating academic freedom for instructors.

The most contentious element of the legislation is a provision that explicitly prohibits coverage for minors seeking treatment for gender dysphoria under the military’s TRICARE health program. This includes medically necessary interventions that could lead to sterilization, although the bill does not specify which interventions would be barred.

Gender dysphoria, as acknowledged by medical professionals, refers to a disconnect between an individual’s expressed gender and their sex assigned at birth, often leading to significant mental distress. Rep. Mark Pocan, chair of the Congressional Equality Caucus, urged Democrats to reject the final package, highlighting the hypocrisy in overriding soldiers’ medical decisions on behalf of their children.

Rep. Teresa Leger Fernández echoed these sentiments on the House floor, condemning the provision as potentially lethal. She accused House Republicans of assuming authority over parental and medical decisions concerning the care of service members’ children, calling it an offense to those serving in the military.

House Speaker Mike Johnson praised the bill during his weekly press briefing, citing “landmark investments” and the essential pay increase for military families. He framed the bill as a means to enhance housing for military families and remarked on the prohibition of certain treatments under TRICARE, emphasizing the need to eliminate the DEI bureaucracy.

The attempt to eliminate the transgender coverage restriction was unsuccessful in a prior vote by the House Committee on Rules. Rep. Smith articulated his belief that denying necessary treatments related to gender dysphoria—such as puberty blockers and hormone therapy—contradicted widely accepted medical practices aimed at assisting minors grappling with suicidal thoughts and mental health challenges.

Treatment options remain focused on holistic care, including mental health therapy, hormone treatment, and, in select cases, surgery. However, the World Professional Association for Transgender Health has strict criteria for recommending adolescent surgery, advocating for counseling and fertility preservation discussions for younger individuals considering irreversible options.

Smith indicated that approximately 6,000 to 7,000 children of service members are currently receiving care for gender dysphoria, although the House Armed Services Committee has yet to clarify this figure. It’s important to note that coverage for gender-affirming care was not extended to service members’ children until September 2016, leading to increased access in recent years.