Last year, transgender people in the U.S. acquired the legal right to openly fight for their country. But that doesn't mean the military is fully equipped to accommodate them.
Most U.S. military doctors feel unprepared to address trans people's needs, according to a study published in JAMA Internal Medicine. Though the majority of the 204 doctors surveyed said they wouldn't judge people for their gender identity, 90% felt they would need more training in order to properly prescribe hormones.
74% hadn't gotten any training on trans people's healthcare needs whatsoever, and 95% had gotten three hours or fewer. Only 37% had experience treating gender dysphoria. Those who had received training were more likely to say they'd prescribe hormone therapy, but over half said that in the event that they got the necessary education, they still wouldn't.
The military is currently working on a new curriculum so that doctors can better address such health concerns. "I think it shows the military is leading the way in this aspect," study author Dr. David Klein told Reuters. "I’m not sure civilian physicians are receiving as much."
This is especially important given that the proportion of trans people in the military is higher than in the civilian population, lead author Dr. Natasha Schvey added. 13,000 are currently serving, and 200 per year request medical treatment. And trans people's healthcare needs go beyond the physical process of a transition. Due to the societal stigma they face, trans people are at a greater risk for mental health issues.
Jamie L. Henry, MD, a transgender internist working in the military, wrote a personal response to the findings in a JAMA Internal Medicine paper. She described going through medical school without learning about gender dysphoria — a gap in knowledge that can lead to many misdiagnoses.
"Up until 2016, transgender individuals in the military were not given appropriate medical or psychological assistance. They were forced to seek help in secret, outside the military health care system, or await discharge proceedings," she wrote. "We need better protocols for individuals who wish to transition while active duty, for retirees, and their family members. We need to aid them in preserving their fertility, and we need to foster an environment of openness where no soldier feels like he or she is isolated from fellow service members owing to gender identity."