U.S. Defense Secretary Pete Hegseth has implemented one of the most restrictive anti-LGBTQ+ military policies in recent history, mandating an immediate cessation of gender-affirming medical care for transgender service members and prohibiting new enlistments of individuals with a history of gender dysphoria.
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This decision, a direct attack on the rights of transgender Americans in uniform, comes in the wake of President Donald Trump’s January 28 executive order dismantling the inclusive policies that had previously allowed transgender individuals to serve openly.
Trump and Hegseth’s latest action has reignited a contentious debate over civil rights, military readiness, and the politicization of marginalized communities.
Paula M. Neira is a Navy veteran, nurse, lawyer, and the Johns Hopkins Medicine Program Director of LGBTQ+ Equity and Education.. She spoke to The Advocate in a personal capacity.
Neira played a pivotal role in the years-long battle to lift the original ban, and spoke to The Advocate in a personal capacity on the impact of Trump’s latest executive order. She was the first transgender Navy veteran to have her discharge documentation corrected to reflect her correct name by order of the Navy.
Neira’s journey from Navy officer to one of the foremost advocates for transgender health and rights is a testament to her dedication. After leaving the military, she became a nurse and later a lawyer, using her unique perspective to educate policymakers and health care providers about types of gender-affirming care. In 2017, she cofounded the Johns Hopkins Center for Transgender Health, addressing one of the military’s common arguments against inclusion: a lack of medical expertise.
Under her leadership, the center has become a hub for training and advocacy, dismantling myths about the cost and realities of providing gender-affirming care.
“The military claimed it couldn’t accommodate transgender service members because health care providers didn’t know how to care for us,” Neira said. “My response was ‘Nobody does, because we don’t teach it.’”
Some military leaders were especially concerned with those who have had gender-affirming surgeries. Surgery is one aspect of gender-affirming care that some trans people elect to undergo.
“It’s not rocket science,” she said. “The notion that gender-affirming surgery makes someone nondeployable is absurd. I’d have been nondeployable for about six weeks which is less time than recovering from a torn ACL [anterior cruciate ligament].”
For Neira, the fight for transgender military inclusion was deeply personal. A graduate of the U.S. Naval Academy, she served in Operation Desert Storm before leaving the military in 1991 to live authentically as a transgender woman.
The 2017 ban, which started with a presidential tweet, was a devastating blow to progress. However, it also galvanized advocates, including Neira, who collaborated with organizations like SPARTA and The Palm Center to challenge discriminatory policies.
“When President Biden overturned the ban in 2021, it was a monumental step forward,” Neira said. “It acknowledged the contributions of transgender service members who have always been there, serving with honor and integrity, even when forced to hide their true selves.”
The 2021 policy change allowed transgender individuals to enlist and serve openly, provided access to gender-affirming medical care, and underscored the Pentagon’s commitment to diversity and inclusion. Yet, as Neira noted, the progress was fragile. “We always knew that policies not grounded in law could be reversed with the stroke of a pen,” she said. “That’s why this fight has never been just about the military. It’s about ensuring dignity and equality for everyone.”
“What we’re seeing now is an utter onslaught,” Neira said. “Whether it’s attacks on reproductive rights, birthright citizenship, or LGBTQ+ protections, the message is clear: The government is no longer a protector of rights but an adversary.”
For younger LGBTQ+ people, who have grown up during a period of rapid but imperfect progress, the rollback of rights can be especially disheartening. “Yes, the community is resilient,” Neira acknowledged, “But individuals aren’t invincible. That’s why we need to share our experiences in ways that resonate, without coming across as ‘OK, Boomer.’”
Social media, she noted, has amplified both support and hostility. “The level of animus probably hasn’t changed much in 40 years, but now people can hide behind anonymity online to spew hate. We haven’t taught people to recognize that for what it is,” she said. “Social media isn’t the place for nuanced conversations about complex issues.”
As LGBTQ+ Americans brace for renewed attacks on their rights, Neira says that to combat it, there needs to be a coherent message and a thought-out strategy. “Yes, it’s bad. Yes, you should be scared,” she said. “But fear can’t paralyze us. Courage isn’t the absence of fear; it’s recognizing it and moving forward anyway.”
She urged advocates to be smart and strategic.
“You don’t fight every battle. You pick the time and place to maximize your ability to win. And you always, always stand by your core values,” she said. “We’ve seen this before. From Stonewall to ACT UP, our community has a history of resilience and resistance. This moment is no different.”
Neira warned that the Trump administration won’t stop at prohibiting transgender people from serving. “You’re not paying attention if you think that trans service members will be the only ones disallowed,” she forecasted. “Trans people are the easy, initial target because they’re least understood. But if they’re successful in getting rid of trans troops, then what’s to stop them from denying women and LGB individuals from serving?”
As Trump and Hegseth’s ban takes effect, the future for transgender service members remains uncertain. Yet advocates like Neira refuse to give up.
“They want us to be afraid. That’s the point,” she said. “But we’re not going anywhere. We’re not going back into the closet. And they can’t erase us from society.”
“This fight isn’t just about us,” she concluded. “It’s about the kind of country we want to be. And that’s a fight worth having.”
