The Pentagon will resume sex change treatments for transgender servicemembers or their trans-identifying dependents. Services to resume include gender dysphoria diagnosis, hormone therapy, surgical procedures, and mental health care and counseling.
In a new memo dated April 21 seen by Politico, the Pentagon’s acting assistant secretary of Defense for health affairs, Dr. Stephen Ferrara, announced the return of the radical policy.
“Service members and all other covered beneficiaries 19 years of age or older may receive appropriate care for their diagnosis of [gender dysphoria], including mental health care and counseling and newly initiated or ongoing cross-sex hormone therapy,” it reads.
So-called “Gender affirming” procedures and care halted after Trump signed the “Prioritizing Military Excellence and Readiness” Executive Order 14183. It required the Secretary of Defense Pete Hegseth to update the Medical Standards for Military Service within sixty days.
Among other things, it required the Secretary of Defense to “promptly issue directives for DoD to end invented and identification-based pronoun usage” in the military.
It also declared “medical, surgical, and mental health constraints on individuals with gender dysphoria” as “inconsistent” with the “high standards for troop readiness, lethality, cohesion, honesty, humility, uniformity, and integrity.”
On February 7, 2025, Hegseth issued a memo directing the Pentagon to halt the recruitment of servicemembers suffering from gender dysphoria and pause gender affirming care in line with Trump’s executive orders.
“Effective immediately, all new accessions for individuals with a history of gender dysphoria are paused, and all unscheduled, scheduled, or planned medical procedures associated with affirming or facilitating a gender transition for Service members are paused,” the memo stated.
However, on March 18, 2025, the first openly gay, Uruguayan-born U.S. district judge of the United States District Court for the District of Columbia, Ana Reyes, blocked Hegseth’s decision, terming it unconstitutional. The Biden appointee also issued an order for the Pentagon to “take all steps necessary to effectuate” her order, including restoring gender-affirming care for transgender servicemembers.
Similarly, U.S. District Judge Benjamin Settle also issued a nationwide injunction lifting the ban on transgender service members joining the military and restored gender-affirming care, essentially reinstating the Biden-era policy across the military.
Settle argued that Trump’s executive order likely violates the U.S. Constitution’s Fifth Amendment right to equal protection under the law. He also ruled that the Trump administration failed to prove that gender dysphoria affects cohesion within the military.
“The government falls well short of its burden to show that banning transgender service is substantially related to achieving unit cohesion, good order, or discipline,” Judge Settle wrote.
Meanwhile, the Trump administration has appealed the rulings and asked the Supreme Court to enforce its transgender policy. Trump argues that the nationwide injunction oversteps the issuing court’s judicial authority.
Subsequently, the resumption of gender-affirming care for transgender servicemembers will likely be temporary, as the Supreme Court could uphold Trump’s ban given its long-established deference to the military.
“Nevertheless, so long as the Court follows its long history of showing extreme deference to the military, it seems exceedingly likely that the Trump administration will prevail in this case,” wrote Vox’s senior legal correspondent Ian Millhiser.
