The Honorable James N. Mattis Secretary
Department of Defense
1000 Defense Pentagon
Washington, DC 20301-1000
Dear Secretary Mattis:
On behalf of the physician and medical student members of the American Medical Association ( AMA ), I am writing to express our concern about the new policy recently approved by President Trump imposing limits on transgender individuals serving in the military.
This new policy, based on recommendations you made in February to President Trump, states that "transgender persons with a history or diagnosis of gender dysphoriaindividuals who the policies state may require substantial medical treatment, including medications and surgeryare disqualified from military service except under certain limited circumstances" ( Presidential Memorandum for the Secretary of Defense and the Secretary of Homeland Security Regarding Military Service by Transgender Individuals, May 23, 2018 ).
We believe there is no medically valid reasonincluding a diagnosis of gender dysphoriato exclude transgender individuals from military service. Transgender individuals have served, and continue to serve, our country with honor, and we believe they should be allowed to continue doing so. We share the concerns recently expressed by former Surgeons General M. Joycelyn Elders and David Satcher that the Defense Department's Feb. 22, 2018, memorandum for the President mischaracterized and rejected the wide body of peer-reviewed research on the effectiveness of transgender medical care. This research, demonstrating that medical care for gender dysphoria is effective, was the rationale for the AMA's adoption of policy by our House of Delegates in 2015, that there is no medically valid reason to exclude transgender individuals from military service.
The AMA also supports public and private health insurance coverage for treatment of gender dysphoria as recommended by the patient's physician. We support the finding of the RAND study conducted for the Department of Defense on the impact of transgender individuals in the military that the financial cost is negligible and a rounding error in the defense budget. It should not be used as a reason to deny patriotic Americans an opportunity to serve their country. We should be honoring their service.
James L. Madara, MD