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Speaker of the House Mike Johnson (R-LA) talks to reporters during a news conference at the U.S. Capitol Visitors Center on February 14, 2024 in Washington, DC.
The move has been called "discriminatory" by LGBTQ+ rights advocates.
As Congress nears an agreement on a normally bipartisan military budget, Republican leadership in the House has successfully pushed for restrictions on medical care for transgender youth.
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The House and Senate Armed Services Committees released text of a final version of this year’s National Defense Authorization Act (NDAA). The language agreed to includes language originally included in the GOP-controlled House that would prohibit TriCare coverage of any medical intervention for “gender dysphoria that could result in sterilization” for anyone under age 18. That would mean an end to care for any military families using TriCare as their health insurance.
Speaker Mike Johnson released a statement ironically arguing the NDAA refocuses the Department of Defense on its core mission, while also implementing policy directives that have nothing to do with military spending.
“This legislation includes House-passed provisions to restore our focus on military lethality and to end the radical woke ideology being imposed on our military by permanently banning transgender medical treatment for minors and countering antisemitism,” Johnson said in a statement.
“This legislation also reinforces our commitment to America’s brave men and women in uniform, and their families, by making landmark investments in their quality of life.”
If Congress passes the provision and the bill becomes law with President Joe Biden's signature, it will be the first anti-LGBTQ+ provision passed by Congress since "don't ask, don't tell" and the anti-marriage equality Defense of Marriage Act in the 1990s, according to the American Civil Liberties Union.
The organization reports that while it isn't known how many trans youth are insured through TriCare or who are currently receiving coverage for gender-affirming care, a previous found from 2022 found that 2,500 trans youth went for care through the insurance in 2017. Of those, 900 received puberty blockers and gender-affirming hormones.
"That amounts to one-tenth of one percent (or 0.1%) of the 918,000 youth aged 6 to 18 years who have at least one parent on active-duty or ready reserve military status. TRICARE has covered gender-affirming treatments for transgender youth since 2016," according to the ACLU.
LGBTQ+ advocates immediately cried foul on the legislative maneuvering.
“Instead of focusing on the needs of the American people and our national security, anti-equality House Republican leaders are hijacking a defense bill to play politics with the healthcare of children of servicemembers. This is not leadership, it’s bullying, and it is a direct attack on military families,” said Human Rights Campaign President Kelley Robinson.
“This discriminatory provision is a slap in the face to servicemembers and their families, who sacrifice every day for our country. We ask our servicemembers to defend our country, and in return, we should defend their rights. This cruel and hateful bill suddenly strips away access to medical care for families that members of our armed forces are counting on, and it could force servicemembers to choose between staying in the military or providing healthcare for their children. Politicians have no place inserting themselves into decisions that should be between families and their doctors. We call on members of Congress to do what's right and vote against this damaging legislation.”
The group reminded that President Joe Biden has promised a veto of any legislation discriminating against trans Americans. As recently as July, Biden confirmed he supports trans health care for minors specifically — though that statement notably came immediately after the Democratic commander-in-chief suggested his administration may oppose gender-affirming procedures for minors.
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The ACLU also condemned the addition to the bill.
“This is a dangerous affront to the dignity and well-being of young people whose parents have dedicated their lives to this country’s armed forces,” Mike Zamore, national director of policy and government affairs, said in a release. “Medical care should stay between families and their doctors but this provision would baselessly and recklessly inject politics into the health care military families receive. Nobody should have to choose between serving the country and ensuring their child has the health care they need to live and thrive. Members of Congress must vote against the defense bill because of the inclusion of this deeply harmful, unconstitutional provision.”
House Democrats signaled the provision could make the normally bipartisan bill harder to pass during a lame-duck session. U.S. Rep. Adam Smith, the top Democrat on the House Armed Services Committee, told POLITICO that while the provision was watered down in negotiations with the Democrat-controlled Senate, the language still could offend many members of his party as the bill moves to the floor.
On Monday, Smith urged Johnson to reconsider.
"House Armed Services Democrats were successful in blocking many harmful provisions that attacked DEI programs, the LGBTQ community, and women’s access to reproductive health care. It also included provisions that required bipartisan compromise. And had it remained as such, it would easily pass both chambers in a bipartisan vote," he said in a press release.
Smith explained that the final text bans gender-affirming care for those under 18.
"Blanketly denying health care to people who clearly need it, just because of a biased notion against transgender people, is wrong. This provision injected a level of partisanship not traditionally seen in defense bills," Smith said.
He went on to call out Johnson for "pandering to the most extreme elements of his party to ensure that he retains his speakership." Smith said Johnson's decision corroded the bipartisan process.
“I urge the Speaker to abandon this current effort and let the House bring forward a bill — reflective of the traditional bipartisan process — that supports our troops and their families, invests in innovation and modernization, and doesn’t attack the transgender community,” Smith said.
The jockeying by Republicans comes only a week after the Supreme Court heard oral arguments U.S. v. Skrmetti — a case brought by the ACLU, the ACLU of Tennessee, Lambda Legal, and Akin Gump that challenges Tennessee's ban on certain gender-affirming care. The plaintiffs in the case argue the ban violates the Equal Protection Clause of the U.S. Constitution.
