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SSG Diane R.
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Thank you LTC Stephen F. for a very thoughtful commentary. There certainly are some unresolved issues but nothing is insurmountable.

Post op Transgender women generally do not general require injectable hormones, usually just estradiol, given orally or via patch is sufficient. Unlike diabetic medications it is possible to go without HRT for extended periods of time, the worst discomfort might be hot flashes and menopause like symptoms.

Surgery is another question and I do not believe the military or Veterans Administration has competent personnel to perform these procedures. First that will be a very small number of personnel will opt for them on a year-to-year basis.

One of the best clinics for this kind of procedure is in Montreal, Canada and the cost is about $15,000, M2F which if the Department of Defense were to negotiate, they could probably bring the price down even further.

18 Allied Nations now allow these Personnel to serve openly and the Rand Corporation report was quite thorough so again for problems can be managed for these small number of people and Readiness can still be maintained at a high level.

Pardon me if there are typos I am dictating this from my phone as the keyboard is just too darn small and voice to text sometimes creates a spelling or grammar faux pas.
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LTC Stephen F.
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As is typical with top down decisions, thinking through the process is not a common commodity SFC Joe S. Davis Jr., MSM, DSL. I remember the top-down Army decisions for (1) the Army to adopt the black beret and later (2) the decision that everybody in the Pentagon would wear battle dress uniforms after 9-11-2001 instead of Class B uniforms. In the later case nobody ensured that sufficient stocks were available. In the former case, the Rangers needed to switch from black to Tan, the XVIIIth Airborne Corps pushed to retain the distinctive maroon berets, etc.
Those changes pale in comparison to the DoD-wide policy changes of the Obama administration - allowing and encouraging women to serve in all areas of the military and now "allowing transgender service members to serve openly in the U.S. military is moving too quickly, arguing that details must still be resolved, several."
The emperor has no clothes if he thinks these changes don't need to be supported by a host of changes and some funding increases. Women have served in the military for decades so changes to uniforms are minimal but infrastructure changes to provide suitable facilities for the women in ships primarily required physical changes and rule changes.
Transgender is another issue entirely because transgender people are not intuitively obvious to the casual observer - especially after somebody has gone through gender reassignment surgery.
1. Medical issues are the primary area for transgender because hormonal injections are necessary for life as the gender reassigned women most frequently and man are alive. This may change in the future but hormonal therapy is a requirement.
2. Gender reassignment surgery needs to be thought through in terms of who will pay for what, ensuring the federal government has no liability for complications in good faith operations.
3. Transgender has the potential to be a game changer for necessary and elective surgery. If psychological desires to change genders are grounds for a federally funded gender reassignment surgery, then other elective surgeries may have grounds for inclusion - expect courts to rule in this area soon.
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Maj Rob Drury
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MORE time? This issue deserves NO time.
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