What Chuck Hagel Needs to Understand

Defense Secretary Chuck Hagel speaks to reporters about the Defense Department's sexual assault prevention and response progr
Defense Secretary Chuck Hagel speaks to reporters about the Defense Department's sexual assault prevention and response program, Thursday, May 1, 2014, at the Pentagon. Hagel said sexual assaults are a threat to both women and men in uniform. And he says the Pentagon must do more to fight a culture that discourages victims from reporting assault. (AP Photo/Manuel Balce Ceneta)

U.S. Secretary of Defense Chuck Hagel recently said the ban on transgender persons serving openly in the U.S. military "continually should be reviewed." He hasn't stated that the ban should be lifted. However, he has stated his belief that "every qualified American who wants to serve our country should have the opportunity if they fit the qualifications and can do it."

So far, so good, right? Well, it is, except when you consider what he said about the repeal of "don't ask, don't tell" (DADT). Letting gays, lesbians and bisexuals serve openly in the military is all well and good, he opined, but he added that the issue of transgender persons serving is "more complicated" because sometimes we "require medical attention" that can't always be provided in the remote (or "austere," as he put it) locations in which service members often find themselves.

Now, some of you might say, "He has a point," and you'd be right. What if I were in some desolate area of, say, Afghanistan and ran out of my prescribed hormones? Or, more importantly, what if the medical supervision needed to ensure safe transitioning or post-operative care weren't available? Then, of course, there is the question of what to do if someone in such a setting were to develop complications related to surgery or other aspects of transitioning.

I would like to say that it should be possible to overcome such difficulties. It probably is, but I couldn't tell you how, nor could most health care providers, for that matter -- at least, most in this country couldn't. I'm guessing that someone in Australia, the United Kingdom, Canada or Israel has answers to those questions, because those nations allow trans people to serve openly in their armed forces.

But having to consider that question leads to another: Is transgenderism primarily a medical condition, or should it be classified as such, at any rate? Almost all current definitions used by health care and insurance providers, as well as by researchers and policy makers, are based on medical and physiological criteria, and the "treatments" are pharmacological and surgical ones.

While some trans people exhibit physical traits and mannerisms of the sex that's "opposite" the sex they were assigned at birth, being trans is as much a state of mind and spirit. Some would argue, as I would, that a trans person doesn't become trans by putting on the clothes of the "opposite" gender, taking hormones or getting surgery. Doing such things merely allows trans people to live more easily as their true selves. (At least, it does for some: There are trans people who don't do any of those things but still live as the gender with which they identify, whether or not their physical characteristics and behaviors conform to their culture's ideas about that gender and how it should be expressed.)

Thus, some trans activists like Pauline Park denounce the "medicalization" of transgenderism. She and her fellow activists (including yours truly) believe that people should be allowed to live as the gender with which they identify whether or not they choose, or are able, to take hormones or undergo gender-reassignment surgery. Some cannot afford the surgeries or even lack medical insurance altogether; others are unable to avail themselves of those options because of other medical conditions. Still others simply do not want to risk the possible complications of hormones and surgeries. Ms. Park thinks, as I do, that no one should feel forced to undergo these procedures simply to have the right to live and work as his or her true self.

But the ability to get coverage for hormones and surgeries (from those employers and insurers who offer it) and the struggle for transgender equality have been predicated on the notion that transgenderism is mainly if not entirely a medical condition. While that may have helped decriminalize wearing the clothes of the "opposite" gender and remove a little bit (though certainly not much) of the stigma attached to being a trans person, it also limits us. And it will limit the military, which will deny itself some talented, intelligent individuals who want to live as the women or men they actually are rather than by the "M" or "F" that was checked off on their birth records. That is what Chuck Hagel and the military brass need to understand in "reviewing" the ban against transgender persons serving openly in the military.