House Democrats Face Difficult Vote on Defense Bill Banning Transgender Care for Military Children
WASHINGTON — House Democrats face a tough vote this week on the final compromise annual defense bill. While the bill includes pay raises for troops, it also controversially bans coverage for transgender care for children of U.S. service members. All Democrats present on Tuesday opposed a procedural vote (211-207) to advance the historically bipartisan legislation, but a final vote is expected as early as Wednesday. Congress has passed this annual package for the past 63 years.
Rep. Adam Smith, the top Democrat on the House Committee on Armed Services, announced his intention to vote against the bill. The Washington state lawmaker stated that denying healthcare based on bias against transgender individuals is wrong. He further emphasized that this provision jeopardizes children’s lives and may force service members to choose between their careers and their children’s healthcare. President Biden has yet to indicate whether he will sign the bill.
The nearly $900 billion National Defense Authorization Act for fiscal year 2025 includes a 4.5% across-the-board pay raise for troops, along with a 10% April pay hike for junior soldiers. The bill also allocates funds for military housing upgrades and new protocols for addressing traumatic brain injuries. However, it also incorporates several far-right priorities, including a hiring freeze for diversity, equity, and inclusion positions and a ban on federal funding for “critical race theory” in military education, although academic freedom protections for instructors are included.
The most contentious aspect is a four-line provision prohibiting TRICARE (military health program) coverage for minors undergoing “medical interventions for the treatment of gender dysphoria that could result in sterilization.” The bill doesn’t specify which interventions are prohibited. Gender dysphoria, defined by the medical community as incongruence between expressed gender and assigned sex at birth, often leads to mental distress and increased risk of self-harm.
Rep. Mark Pocan, chair of the Congressional Equality Caucus, urged Democrats to vote against the bill, calling the inclusion of this provision hypocritical. Rep. Teresa Leger Fernández, a bill manager, criticized the provision for ignoring the link between lack of care and suicide. She accused House Republicans of believing they know better than parents and doctors about their children’s healthcare needs.
House Speaker Mike Johnson praised the bill’s investments and pay raises, highlighting the ban on TRICARE coverage for certain transgender care and the elimination of DEI bureaucracy as key achievements. A Democrat-led attempt to remove the transgender care provision failed in the House Committee on Rules. Rep. Smith argued that the provision is fundamentally wrong, citing the effectiveness of treatments for gender dysphoria in helping young people struggling with suicidal thoughts and mental health issues. While treatment options include therapy, hormone therapy, and surgery, the World Professional Association for Transgender Health only recommends adolescent surgery under very specific circumstances. Some gender-affirming surgeries can cause sterilization, and the association recommends counseling regarding fertility preservation options.
Smith estimated that 6,000 to 7,000 children of service members are receiving treatment for gender dysphoria, though the House Armed Services Committee did not confirm this figure. Gender-affirming care was not covered by military insurance until September 2016. A 2019 study in *JAMA Pediatrics* found that just over 2,500 military-affiliated youth received this treatment between 2009 and 2017.
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