Now that transgender soldiers are allowed to serve openly in the Army, the service is rolling out its transition policy for those who hope to serve as their preferred gender.
The Defense Department lifted its ban on transgender service members in July, and, with that announcement, required each service to put together new policies and procedures for troops who want to transition and stay in uniform by October.
A new directive dated Oct. 7 lays out the path for soldiers to obtain a transgender diagnosis from an Army medical provider, put together a transition plan and timeline with their doctor and their command, and eventually change their gender in the Defense Enrollment Eligibility Reporting System to begin living and serving as their preferred gender.
The Army does not track the number of transgender soldiers currently serving, according to Paul Prince, an Army spokesman, but a 2016 Rand Corp. report commissioned by the Defense Department estimated that there are about 2,400 transgender men and women currently serving in the military as a whole.
There are no physical requirements to begin a gender change, other than confirmation from a doctor that a transition is medically necessary, according to the directive.
Transition plans will be completely individual as far as surgeries, hormones or other medical interventions.
Costs associated vary widely, as each person has to determine the mix of physical transformations they want to undertake. Hormone therapy, for instance, costs about $100 a month, according to the Transgender Law Center.
Sex reassignment surgery can costs tens of thousands of dollars, but is not required for an individual to transition. Other surgeries can include breast implants, breast reductions, tracheal shaving and numerous facial tweaks, but the Army won't necessarily cover all of those.
"The Army is committed to the appropriate levels of medical care and resources that best support our leaders, soldiers and families, which ultimately enhances total force readiness and capability," Prince said. "To this end, Army offices responsible for its transgender policy are currently collaborating with officials in DoD Health Affairs to develop further guidance concerning approved medical operations and procedures."
To complete a transition, as soldier must provide written confirmation from their doctor that they are "stable" -- according to the doctor -- in their new gender to their brigade-level commander.
Then they must submit legal evidence of their gender change, including a reissued birth certificate, a court order or a passport with their preferred marker.
Once that is cleared, the commander will send a written letter to Human Resources Command, which has 30 days for active duty and 60 days for reserve component soldiers to make the change in DEERS.
Reservists and Guardsmen go through the same plan, though if they are not eligible for Army medical care at the time of the transition, they must get a diagnosis from a civilian provider and have it approved by the Army Reserve Command's command surgeon, or the chief surgeon at the Army National Guard.
Capt. Jennifer Peace poses near her home in Spanaway, Wash. Peace is one of an estimated 2,400 transgender people who serve in the active-duty military.
Photo Credit: Drew Perine/The News Tribune via AP
It's up to commanders, according to the directive, to manage their soldiers and their units to make transitions go as smoothly as possible.
"Commanders should approach a soldier undergoing gender transition in the same way they would approach a soldier undergoing any medically necessary treatment," according to the directive. "Commanders will continue to minimize effects to the mission and ensure continued unit readiness."
In order to keep things running smoothly, commanders will have the power to adjust a soldier's transition date, offer extended leave or put the soldier on temporary disability status.
"In cases where soldiers require medically necessary but non-urgent procedures, the commander by regulation may adjust the date on which a soldier’s procedure will take place," Prince said.
As long as a soldier is reporting for duty every day during a transition, policy dictates that they will be treated according to their gender marker in DEERS, following uniform and grooming regulations as well as physical fitness standards.
"The Army is a standards-based institution, and for policies and standards that apply differently to soldiers according to gender, the Army recognizes a soldier’s gender by the soldier’s gender marker," Prince said.
However, according to the directive, commanders are allowed to change a soldier's billet or local bathroom and shower rules to protect privacy or modesty interests, but commanders cannot require that -- for example -- a male-to-female transitioning to use women's facilities.
Units also aren't allowed to modify or redesignate facilities to make them "transgender-only."
The Army has a Nov. 1 deadline to put out training and guidance for commanders to pass down to soldiers on how to navigate a unit with a transitioning soldier. By July 2017, that training will be integrated into the service's existing training rotation.
By Oct. 2018, the inspector general will have completed a report on the Army's compliance with the transgender integration policy.
Meghann Myers is the Pentagon bureau chief at Military Times. She covers operations, policy, personnel, leadership and other issues affecting service members. Follow on Twitter @Meghann_MT