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The huge defense spending bill signed into law by US President Joe Biden in December 2024 includes a provision that prevents military health insurance programs from covering gender reassignment medical care that “could lead to sterilization” for people under 18. clause was included. Despite signing the bill, Biden said he “strongly opposes gender-affirming care restrictions.
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The law does not prohibit service members from receiving gender-affirming treatment for their children elsewhere, but it would be prohibitive to take out private insurance or pay out-of-pocket for gender-affirming treatment. may become expensive.
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It’s unclear how the insurance program Tricare will interpret the law’s vague language, meaning Snopes still can’t say exactly what types of gender-affirming care treatments will be affected. .
In late December 2024, news outlets and advocacy groups reported that U.S. President Joe Biden signed a defense bill restricting gender-affirming care for transgender children in the military.
“President Biden signs defense bill blocking medical care for children of trans military personnel, enacting first anti-LGBTQ+ federal law since Defense of Marriage Act” news release (archived) from the Human Rights Campaign. Some reports like from fox news (archived), CBS News (archived) and NBC News (archived), with a headline stating that the so-called regulation was “prohibited”. Others like it politiko (archived), said the law “restricted” gender-affirming care. Some headings are as follows Reuters‘(archived), only said that gender-affirming care provisions are controversial, but did not attempt to explain what they do.
The defense bill signed by Biden prevents Tricare, the government-backed health insurance program for military personnel, from covering gender-affirming care in certain circumstances. However, because the bill’s language is vague, it is unclear how exactly TRICARE will interpret the new policy. Therefore, Snopes cannot yet definitively assess whether this story is true or false.
Snopes has reached out to TRICARE and will update this article if we hear back.
How did gender-affirming nursing care restrictions become law?
Biden signed HR5009Also known as the “Military Quality of Life Improvement and National Defense Authorization Act for Fiscal Year 2025,” which was enacted on December 23, 2024. A 794-page spending bill was passed each year and provided funding to several federal departments. Including the Department of Defense. The 2025 bill authorized $895 billion in military spending for a variety of programs, including higher pay for military personnel, U.S. aid to Israel, and resources for a more confrontational stance toward China.
But the bill also prohibited Tricare from covering gender-affirming care for minors that “may result in sterilization.” here it is invoice’Complete regulations regarding gender-affirming care for minors:
SEC. 708. Prohibition on application of certain medical procedures to children under the Tricare Program that could result in sterilization.
Section 1079(a) of title 10, United States Code, is amended by adding at the end the following new paragraph: “(20) Medical intervention for the treatment of gender dysphoria that may result in sterilization shall not be provided to children.” Under 18 years of age. ”
House Speaker Mike Johnson, a Republican from Louisiana, reportedly pushed for the restriction to be included, according to reliable news sources such as the Associated Press. There is also a video in C-SPAN Instagram page Johnson credited the provision, saying it “barred Tricare from prescribing treatments that would ultimately result in the sterilization of children.” Snopes has reached out to Johnson’s team to confirm his role in passing the ban and will update this article if we hear back.
Despite signing the bill, Biden said: December 23rd news release He is “strongly opposed” to gender-affirming care restrictions, saying they “target groups based on their gender identity and undermine parents’ role in determining the best care for their children.” It is a hindrance.” Biden’s release said the provision would affect thousands of children. “Military members should not be forced to decide between their families’ access to health care and their mission to serve our nation,” the release continued.
senate passed the bill By a vote of 85-14. In the House, a majority of Democrats voted against the bill, but it passed 281-140. said Rep. Adam Smith, a Democrat from Washington state. in a statement He will oppose final passage of the defense bill because of its gender-affirming care provisions. He said Johnson had “upended” the traditional bipartisan process, adding:We’re putting our children’s lives at risk.” Mr. Smith is the ranking member of the House Armed Services Committee, which usually means he moderates the minority opinion. At the party — at in this case, Democratic Party activities In committee.
tricare beneficiary can The law also does not prohibit military families from seeking other health insurance to pay for gender reassignment treatment, which the bill prohibits from providing.
However, if you enroll in health insurance, Can be prohibitively expensiveand Prices are expected to continue rising At the time of writing this article. Out-of-pocket costs for gender-affirming care are also prohibitive for many families. For example, puberty blockers expensive everywhere $4,000 to $25,000 per year without insurance.
Potential implications for coverage of gender-affirming care
Tricare is covered by insurance. about The 9.5 million beneficiaries include active duty military personnel and their families, veterans and their families, dependents and in-laws, and even former spouses of military personnel who have not remarried. A complete list of TRICARE targets is available on the website.
2019 Survey A paper in the peer-reviewed journal JAMA Pediatrics found that from October 2009 to April 2017, at least 2,000 children sought care for gender dysphoria through TRICARE.
At the time of writing this article, Tricare website (archived) said it targets hormone therapy and psychological counseling for gender dysphoria. This insurance typically does not cover gender reassignment surgery, but active duty military members can request an exemption for medically necessary gender reassignment surgery. However, this page was last updated on September 17, 2024, so it does not reflect how TRICARE will respond to the provisions of the National Defense Bill.
Tricare too memo The list of eligible services is not exhaustive, and the program “covers services that are deemed medically necessary and proven.” of american medical association It asserts that gender-affirming care is often medically necessary and has been linked to “dramatic reductions in suicide attempts,” lower rates of depression, anxiety, and drug use, and other life-saving effects. , argue that trans patients, regardless of gender, often face hurdles in accessing this care. How necessary is that?
It is difficult to determine what falls under the ban on treatments that “may lead to sterilization.” According to Southern Poverty Law Centercivil rights groups, and those opposed to gender-affirming child care often use the term “sterilization” to “create fear and disgust.” The center calls the use of the rhetoric “sterilization” a “medically inaccurate term.”
Gender reassignment surgery – Depending on the surgery, it may cause permanent infertility – Rarely done to minors Such surgeries are performed in the United States, the majority of which are breast reduction surgeries.
Doctors who treat transgender youth say the following about puberty blockers, which are prescribed to both cisgender and transgender youth: Does not cause infertility on its ownHowever, if a patient starts hormone replacement therapy that involves taking either estrogen or testosterone from puberty blockers, it can cause infertility. New research published in peer-reviewed journals suggests that for transgender people, taking one of the following: estrogen or testosterone It does not cause permanent infertility.
Snopes reached out to legal experts to ask how the bill’s language would be interpreted in court. We will update this story when we have more information.
source:
CSPAN. InstagramDecember 10, 2024, www.instagram.com/cspan/reel/DDaOotVxG6d/. Accessed January 2, 2025.
“Gender Dysphoria Services | Tricare”. www.tricare.milwww.tricare.mil/CoveredServices/IsItCovered/GenderDysphoriaServices. Accessed January 2, 2025.
“Gender-affirming surgery is rarely performed on transgender youth | Harvard T.H. Chan School of Public Health.” Harvard University TH Chan School of Public HealthHSPH, July 8, 2024, hsph.harvard.edu/news/gender-affirming-surgeries-rarely-performed-on-transgender-youth/. Accessed January 2, 2025.
Iris de Nee et al. “Successful restoration of spermatogenesis after gender-affirming hormone therapy in transgender women” cell report medicinevol. 4, no. 1, Elsevier BV, January 2023, pages 100858-58, https://doi.org/10.1016/j.xcrm.2022.100858.
Joyce, David. “Text – HR5009 – 118th Congress (2023-2024): Military Quality of Life Improvement and National Defense Authorization Act for Fiscal Year 2025.” congress.govDecember 23, 2024, www.congress.gov/bill/118th-congress/house-bill/5009/text. Accessed January 2, 2025.
Klein, David A., et al. “Transgender Children and Youth in Care in the U.S. Military Health System.” JAMA Pediatricsvol. 173, no. May 5, 2019, p. 491, https://doi.org/10.1001/jamapediatrics.2019.0105. Accessed January 2, 2025.
Leon, Angela et al. “Outcomes of assisted reproductive technology in female-to-male transgender patients compared to cisgender patients: A new frontier in reproductive medicine.” Fertility and infertilityvol. 112, no. 5, November 2019, pages 858-65. https://doi.org/10.1016/j.fertnstert.2019.07.014.
Oregon Health & Science University and Doernbecher Children’s Hospital. “Maintain fertility” OHSU.eduDecember 2020, www.ohsu.edu/sites/default/files/2020-12/Gender-Clinic-Fertility-Preservation-Handout.pdf. Accessed January 2, 2025.
white house. “President Joe Biden’s Statement on H.R. 5009, Military Quality of Life Improvement and National Defense Authorization Act for Fiscal Year 2025 | White House.” white houseDecember 23, 2024, www.whitehouse.gov/briefing-room/statements-releases/2024/12/23/statement-from-president-joe-biden-on-hr-5009-servicemember-quality-of- life- Fiscal Year 2025 Improvements and National Defense Authorization Act/. Accessed January 2, 2025.
“Using other health insurance | Tricare” www.tricare.milwww.tricare.mil/Plans/OHI. Accessed January 2, 2025.
