Senate passes defense bill with anti-trans language; now goes to Biden

The U.S. Senate has passed the National Defense Authorization Act, which includes a provision denying insurance coverage for gender-affirming care for transgender youth under the military’s TriCare plan, primarily affecting children of service members.

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The bill, considered a must-pass piece of legislation, passed the Senate Wednesday by a vote of 85-14, with several Democrats voting against it. Those voting no included Tammy Baldwin of Wisconsin, and Ed Markey and Elizabeth Warren of Massachusetts.

The act says that under TriCare, “medical interventions for the treatment of gender dysphoria that could result in sterilization may not be provided to a child under the age of 18.” Medical experts say these treatments, such as puberty blockers and hormone therapy, don’t usually result in sterilization, but LGBTQ+ advocates say those who added this provision intended to ban coverage for all this care and that an incoming Donald Trump administration will undoubtedly enforce it this way. Genital surgery is almost never performed on minors.

Baldwin led an effort to amend the bill to remove the anti-trans language, which was added to the House version through a push by anti-LGBTQ+ Speaker Mike Johnson. The Senate approved the House version and did not add Baldwin’s amendment — it never even came to a vote. It authorizes $884 billion in defense spending for fiscal year 2025; there is another $11 billion in defense funding not covered by the NDAA, bringing the total to $895 billion.

Baldwin, a Wisconsin Democrat and a lesbian, issued a statement against the bill. “Our country’s safety and support for our servicemembers and their families has always been — and should be — politics-free,” she said. “And in this year’s annual defense bill, we had a lot of bipartisan agreement. This bill has some great things for our servicemembers, my home state of Wisconsin, and measures that I have long pushed for, including a pay raise for troops, increasing access to contraception and mental health care, investments in Wisconsin’s military installations, and improving Buy America standards for our national defense programs that will support Wisconsin businesses and workers.

“But, despite all the common ground we found — some folks poisoned this bill and turned their backs on those in service with a partisan provision that will rip away the rights of our servicemembers to get the health care their kids need. I cannot support this bill, turn my back on these families, and take away parents’ right to get the healthcare they need for their kids.”

The American Civil Liberties Union, the Human Rights Campaign, and Advocates for Trans Equality called on President Joe Biden to veto the bill. “By passing this bill, the House and Senate are forcing thousands of active-duty service members to choose between their careers in the military and the future of their transgender children,” said a statement from Mike Zamore, national director of policy and government affairs at the ACLU. “This unconscionable and unjustifiable attack on those families stands in direct contrast to President Joe Biden’s legacy of defending the civil rights of transgender Americans — including when few in his own party showed the courage to do so. President Biden should cement his legacy by vetoing this bill and sending it back to Congress to pass without Speaker Johnson’s last minute health care ban for servicemembers’ kids.”

“We entrust our nation’s safety and freedoms to those who serve in the military,” said a statement from HRC President Kelley Robinson. “We ask them to make incredible sacrifices in defense of this country. In exchange, they deserve to be treated with respect and trusted to make decisions about their own families’ health care needs. A majority in the Senate failed those families today, thousands of whom now face the possibility of losing access to medically necessary care. President Biden has the power to put a stop to this cruelty. He should make good on his promises to protect LGBTQ+ Americans, defend military servicemembers and their families, and ensure this country’s politics reflect the best of who we are. President Biden must veto this bill.”

“If signed by the president, the passage of the NDAA will mark the first piece of federal legislation to restrict access to medically necessary healthcare for transgender adolescents," Advocates for Trans Equality Director of Federal Policy Olivia Hunt said in a press release. "It would be heartbreaking for an administration that has sought to advance the rights of LGBTQI+ Americans more than any other to date, to enact a law that would endanger countless trans youth. We urge President Biden to take a strong stance for trans youth and their families and veto this bill. “

The Trevor Project urged members of Congress to oppose any additional restrictions on care for trans youth. “We urge lawmakers to listen to the military families who will be harmed by this bill, and oppose any further restrictions on this necessary care,” CEO Jaymes Black said in a statement. “For any transgender young person who is feeling overwhelmed by this news, please know that you are not alone. The Trevor Project’s crisis counselors are here to support you 24/7 — and we will never stop fighting for your right to be safe, accepted, and seen exactly as you are.”

Dr. Kellan Baker, executive director of Whitman-Walker Institute, added that the bill "sets a dangerous precedent by withholding medically necessary health care as a matter of politics. It is disheartening that Congress has decided politicians know better than families and healthcare providers when it comes to medical care for transgender youth."