Air Force releases guidance on transgender airmen

The Air Force this week publicly released its guidance for how the service will incorporate transgender airmen into its ranks.

"Transgender airmen serve alongside us with integrity, service and excellence," Air Force Secretary Deborah Lee James said in a news release announcing the guidance. "This is another step in allowing transgender airmen to serve openly, receive medical care relating to gender transition and allow transgender individuals to join the Air Force. Our strengths as a military are the quality and character of our people, and those things that make us unique are the same things that make us strong."

The guidance, which was included in a memo dated Oct. 6, spells out how the Air Force will handle questions of which lodging, bathroom and shower facilities transgender airmen will use while they are transitioning. It also outlines plans for handling their fitness assessments and uniforms during the transition process.

And while it warns airmen and commanders that discrimination and bias against transgender airmen will not be tolerated, the guidance also said that handling such transitions could be tricky.

"Gender transition while serving in the military presents unique challenges associated with addressing the needs of the airman in a manner consistent with military mission and readiness," the guidance said. "A commander may employ reasonable accommodations to respect the privacy interests of airmen."
The Air Force stopped involuntarily separating, discharging, or denying reenlistment or continuation of service to airmen solely due to their gender identity as of June 30. But even before that, some trans airmen were openly serving. For example, Staff Sergeant Logan Ireland, a security forces airman who deployed to Kandahar, Afghanistan, shared his story in 2015, three years after he began his transition to a man. Ireland told Air Force Times last year that his unit leadership was supportive and assigned him to the male barracks.

In an interview Friday, Ireland -- who consulted with the Air Force as it drafted the new policy -- said he was very happy with how it turned out.

"This will bring a lot of relief to a lot of airmen," Ireland said. "It's just a matter of time before each troop across the board will get the help that they need in their transition process."

For the most part, the guidance said, transgender airmen typically will have to use the lodging, bathroom and shower facilities of their current gender while they are transitioning, as well as wearing the uniform and maintaining appearance standards of their pre-transition gender. After the airmen's transition process is officially deemed to be complete, their gender marker will be changed in the Military Personnel Data System (MilPDS) and the military will allow them to use their preferred gender's facilities. Airmen will then be required to meet all uniform, grooming, medical and physical fitness, deployability, Military Drug Demand Reduction Program participation, retention, and other standards for their preferred gender.

A Medical Multidisciplinary Team -- made up of a case manager, a mental health provider, an endocrinologist, and/or a surgeon that handles transgender medical care -- or an approved civilian provider must tell an airman's commander when that airman's gender transition is complete, and the airman must show either a certified copy of a birth certificate, a court order, or a U.S. passport that reflects their post-transition gender.

Ireland said that he was happiest to see that there won't be a "gray area" for airmen who have finished transitioning, and that the Air Force will fully consider them members of their preferred gender.

"There won't be any exceptions to certain policies once that gender marker is changed," Ireland said. "We don't want this gray area. We don't want a third gender."

However, the new guidance says airmen may request an exception to policy that allows them to use the facilities or wear the uniform of their preferred gender before they have finished the transition process.
When an airman decides to request gender transition, he or she first must receive a diagnosis by a military medical provider, or a civilian provider validated by the military, which is then confirmed by the Medical Multidisciplinary Team. That airman's unit commander will then be notified and a gender transition plan will then be drawn up, including a plan for the timing of medical treatment and exceptions-to-policy that may be required.

For example, transgender airmen who are receiving cross-sex hormone treatment may request an exemption from taking their fitness assessments during the transition period. To get that exemption, transitioning airmen must show they failed a documented fitness assessment, and their commanders must certify they made a full and clear effort to meet their original gender's standards. Those commanders must then decide whether they think the request should be approved or not, and then send it up through their chain of command for their input. The request will finally be sent to a Service Central Coordination Cell at Air Force headquarters, which was created to provide medical, legal and other advice and assistance to commanders on transgender issues, and the Air Force's personnel office will make the final decision.

But even if a transitioning airman receives a fitness exemption, he or she will have to stay healthy, take part in unit physical fitness activities, and work with his or her unit commander to make sure they are keeping up an active fitness regimen.

The guidance also says that when commanders are completing the required assessment for an exception to the uniform rule, they should include information about the transitioning airman's "professional military image in current and preferred gender's dress and appearance standards, fit and/or function of the uniforms, and potential impact on unit cohesion, good order and discipline (if any)."

And transitioning airmen who receive permission to wear the uniform of their preferred gender before their official gender marker is changed must carry a copy of their approval memorandum until their transition is complete and their gender marker is changed.

Ireland said having transgender airmen in the process of transitioning carry a uniform approval memo won't be a big deal. Airmen already carry their Common Access Cards everywhere, he said, and due to an acne condition, he carries a shaving waiver.
The official change in a transgender airman's gender marker does not necessarily mean the end of his or her care or treatment, the guidance said. For example, the airman could continue to receive cross-sex hormone therapy even after the transition is deemed to be complete.

And when a unit commander is trying to accommodate a transitioning airman's request to use alternate facilities, the guidance said the commander should take into account the privacy of the other airmen using those facilities. And units should explore "no-cost facility options," such as allowing transgender airmen to use family-style restrooms or shower areas, or providing additional time for transgender airmen to change or shower in the privacy of their own residences.

"The unit commander should consider and balance the needs of the transgender individual and the needs of the command," the guidance said.

And transgender airmen who are selected for deployment will still be able to deploy, as long as they are medically qualified.
The guidance also spells out the conditions under which transgender people can join the Air Force. A history of gender dysphoria, medical treatment associated with gender transition, or sex reassignment or genital reconstruction surgery is disqualifying, the guidance said -- except if 18 months have passed since gender transition or the surgery, or if the applicant who experienced gender dysphoria has been stable and without social, occupational or other important impairment for 18 months. The guidance also allows the Air Force secretary to waive that 18-month requirement if necessary.

Ireland said one of the biggest challenges going forward for the Air Force will be educating other airmen on what it means to be transgender, and he feels the release of this guidance is a good first step toward beginning that conversation.

The need for education is even greater than when the ban on gay people in the military was repealed, he said -- and it's going to take some time.

"When DADT [Don't Ask Don't Tell] was repealed, people got what gay and lesbian meant, but as far as being transgender, I think there is some more education that needs to be facilitated," Ireland said. "Especially when that troop does come out as being transgender, there is going to be that [lengthy] time period before they get their gender marker changed. This troop might look like, for all intents and purposes, a female, but they are transitioning to be a male, and we need to give those troops the same dignity and respect that we would anybody else in the unit or squadron."