Military children diagnosed with gender dysphoria will no longer have access to gender-affirming health care through the Pentagon's insurance plan for service members under this year's military budget.
The exact number of military children receiving gender-affirming care by either military providers or covered by military insurance isn’t clear but it’s estimated several thousand families will be affected.
Zander, 17, lives in a small coastal city in north San Diego County. His father recently retired from the Navy. Zander has been covered by Tricare his whole life.
It was Navy doctors who have provided his gender-affirming care over the last few years — care he’ll now have to find elsewhere.
Zander spoke on the condition that only his first name be published because he’s concerned for his family’s safety.
He said it’s frustrating when politics interferes with medical care.
“I can kind of believe that some people are genuinely concerned for the kids,” Zander said. "But I have a hard time believing that, for politicians specifically, it's actually a concern for the kids. Politicians don't seem to be very empathetic to the people.”
The provision banning gender-affirming care was added to the House version of the annual National Defense Authorization Act (NDAA) by Republicans before the House passed the bill Dec. 11. One week later, the Senate easily passed the bill.
Rep. Doug LaMalfa, a Republican from Northern California, spoke in favor of the anti-trans provision from the House floor.
“Children should have the chance to grow up without being subjected to experimental procedures that could cause permanent damage to their bodies and futures” LaMalfa said. “These are minors we’re talking about here. What business is it of the Department of Defense to be engaging in this?”
The $895 billion spending bill, considered “must-pass” legislation, funds the entire military for the 2025 fiscal year. President Joe Biden signed it into law Dec 24.
Rep. Sara Jacobs, a Democrat from San Diego, sits on the House Armed Services Committee. She says the anti-trans language wasn't part of the bipartisan bill that came out of that committee.
"I'm incredibly disappointed that House speaker Mike Johnson and Republican leadership put in these culture war partisan issues into what has historically been a bipartisan bill," Jacobs said in an interview. "We don't know the exact numbers, but we do think it's at least thousands, if not tens of thousands of families who are going to be affected."
The provision bans Tricare from covering gender-affirming care — specifically hormone therapy and puberty blockers — for anyone under 18. Tricare covers service members, military retirees and their families.
Hormone therapy and puberty blockers are approved treatments for gender dysphoria in kids, said Kathie Moehlig, the founder and director of TransFamily Support Services, a San Diego-based nonprofit.
"This has been approved care by the medical associations, by the pediatric associations, by the psychological associations as important medical care for gender dysphoria," Moehlig said. "And so when we withhold medical care from anybody, we are creating harm."
Moehlig helps families with trans-kids across the country access care. Many of them are military families.
"People are afraid," Moehlig said. Her organization is helping these families find alternative care options, which isn't always easy.
"Our military families struggle financially," she said.
The language in the Pentagon spending bill echoes that in bills passed in 26 states banning gender-affirming care.
Moehlig said trans kids are weary of being the targets of these laws.
"Remember these are kids — these are some of our most vulnerable population that adults have politicized and decided to attack," she said. "We have youth ... that say things like, 'I don't even know why I should exist — my government hates me.' That is a huge burden for a kid to walk around with."
Robyne, Zander’s mother, said the only concern people should have for trans kids is what it will mean for them to lose health care.
“I think people need to remember trans kids are just kids,” Robyne said. “Just because they change their pronouns or maybe the way they look — their clothes, their haircut — they're still the same person. And so all of this concern is unfounded. The only change you see is kids being happy and feeling like they fit with their bodies.”
Zander said he wished lawmakers would start listening to trans kids and their families.
“A lot of my friends and a lot of the people that I've talked to who are trans — they have felt so much happier after transitioning,” Zander said.
His transition, he said, has clarified for him who he really is.
“A lot of people think that it's gender dysphoria that defines being trans,” Zander said. “But a lot of times it's like gender euphoria … it's almost like putting on glasses if you have, like, really blurry vision.”
Robyne said their family will be able to absorb the added healthcare costs but she’s worried that thousands of military families won’t.
“It's going to be hard,” she said. “They're going to have a child in distress … my heart breaks. I'm very worried that there are kids that are going to be physically harmed because of this.”
She said military kids go through a lot. They have to move, change schools and make new friends every few years.
That makes the anti-trans provision especially cruel.
“They're called dependents — but I think they're the bravest of all,” Robyne said. “They're making a sacrifice that they didn't choose to make. And now their country is turning their back on them. It just it hurts.”
Republicans in the House this summer failed in a broader effort to strip insurance coverage for gender-affirming care for everybody covered by Tricare — including troops and military retirees. But advocates are preparing for more anti-trans proposals to emerge from the Trump Administration.
Jacobs, who represents thousands of military families living in and around San Diego, said she hears from them frequently.
"Our military families are not calling me about drag shows — they're not calling me about these culture war issues," she said. "They're calling me about the housing they need, child care — they need the health care."
Lawmakers sometimes struggle to see things from the perspectives of those serving, she said.
"A lot of my colleagues are really much more focused on the hardware that is built in their district," Jacobs said. "One of the things I spend a lot of my time doing is actually educating (them) about what it's actually like for service members and their families."
Moehlig said her organization is standing by to help connect any family — including military families — to the resources they need.
