A family recently sought our help on how best to support their child. They described a boy who was buoyant, confident and showered with love and support from family and friends. Their child is also transgender.
When asked about their fears, both parents said they worried for their son’s future. Will the world accept him for who he is? Will he be safe? Will he be happy? We reassured them the world is a different place for a transgender child than even five years ago. While there is still tremendous stigma and bias that transgender people face, a child from a loving and supportive environment that nurtures resilience can thrive being exactly who they are meant to be.
Unfortunately, we may need to revise our reassurances. Last week, President Trump tweeted that the government would reinstate its ban on transgender individuals serving in the U.S. military in any capacity.
In June 2016, when former U.S. Secretary of Defense Ash Carter announced that the U.S. military would lift the ban on transgender service members, he highlighted three main reasons for the decision: the military needs to avail themselves of all talent possible; transgender service members are already serving; and Americans who want to serve and can meet the standards should be able to do so. This policy change was supported by a year-long study by the RAND Corporation, commissioned by the Department of Defense evaluating the impact of transgender individuals on military service (Shaefer, A. et. al., “Assessing the Implications of Allowing Transgender Personnel to Serve Openly,” RAND Corporation, 2016).
President Trump also stated in last week’s tweets that “our military … cannot be burdened with tremendous medical costs.” However, the annual estimate for transgender-related care for military personnel is approximated at $5.6 million out of a $47 billion military health care budget (Belkin, A., “Caring for Our Transgender Troops – The Negligible Cost of Transition-Related Care, New England Journal of Medicine,” 2015; 373: 1089-1092). Indeed, the military would likely spend more on trying to devise a new system to ban eligible service members rather than pay for their health care.
President Trump continued, “… and disruption that transgender in the military would entail.” Again, the RAND study demonstrated that transgender service members openly serving have little to no impact on unit cohesion, operational effectiveness or readiness.
Not only are the effects of the decision to exclude transgender military personnel negligible, but also the impact of such systematic discrimination will certainly exacerbate the existing burdensome health care costs associated with a variety of mental health risks associated with such victimization.
Independent reviews validate that transgender individuals actively serving in the military has no impact on cost or cohesion. Then why is President Trump making this decision, and what message does it send to transgender youth who are trying to find a place for themselves in this world?
This policy change confirms what many transgender youth already think of themselves: that they are “a burden.” This rhetoric is highly dangerous in the context of what we know about stigma and covert and overt aggression against minority groups. The transgender community faces disproportionally higher risk for violence, suicide, homelessness, trauma, substance use and mental health disorders when facing this bias.
It also says that our “government of the people and by the people” is, actually, only for some of the people. It says discrimination is a more cherished value than common sense or the defense of our country. Strength, courage, determination and bravery – the qualities we most often associate with soldiers – are also the qualities displayed by transgender individuals who must continue to fight for equal treatment under the law.
When we consult with our next transgender family, we will have to suggest that while their child still needs love, acceptance and resilience, he or she also needs to learn to fight – maybe not on the field of battle, but almost certainly in defense of their rights as Americans.
The authors all hold positions at the Gender & Sexuality Service in the Child Study Center at NYU Langone Medical Center. Dr. Janssen is a clinical associate professor and service director, Dr. Busa is a post-doctoral fellow, and Dr. Brodzinsky and Mr. Wernick are clinical assistant professors.