JOINT BASE SAN ANTONIO-LACKLAND, Texas –
Earlier this year, President Joe Biden signed an executive order making it possible for transgender service members to openly serve in the military, which further strengthened the Transgender Health Medical Evaluation Unit at the 59th Medical Wing.
“What I’m doing is enabling all qualified Americans to be able to serve their country in uniform,” Biden said during a press conference in January. “Essentially restoring the situation where transgender personnel who have qualified in every other way can serve their government in the United States military.”
For service members to receive transitional medical care, they first undergo a mental health evaluation.
“In order to have medical interventions you have to have a diagnosis of gender dysphoria,” said Chari’ McMahon, 59th Medical Specialty Squadron THMEU licensed clinical social worker. “Gender dysphoria is a marked incongruence between the gender assigned at birth and the gender that you most closely align with causing clinically significant distress.”
Once the diagnosis has been made, treatment at the THMEU begins.
“Once the provider sends the referral to our case managers, then our nursing staff reaches out to the member directly to arrange time for them to come out for the medical temporary duty assignment,” said McMahon.
During the TDY, THMEU creates an individual medical treatment plan which patients follow at their home-stations medical treatment facility.
“One of the benefits of having a centralized case management for all of the Air Force is that everything comes through us, but patients’ individual treatment facilities provide the continuing care,” said McMahon.
Not all medical treatment plans include surgery or hormones and may cover anywhere from a few months to multiple years of care.
“Each plan has a timeline in it and it’s a projection of the different interventions that the patients may need,” said Lt. Col. (Dr.) Joshua Smalley, 59th Medical Specialty Squadron THMEU flight commander.
In order to build an encompassing plan, providers in the THMEU review the patient’s medical records and schedule appropriate appointments such as nutrition, mental health, endocrinology, dermatology, legal, TRICARE, and speech therapy should they want to seek voice training during their transition. Patients also attend a gender expressions group.
“This is an opportunity for transgender service members to really develop a peer group of other transgender service members and provide support along the way,” said McMahon. “We want them to be able to build that connection and walk with each other through the process.”
If services aren’t available locally, the THMEU’s providers are available near or far through virtual health providing hormone therapy and mental health appointments.
“We are working to assist our service members to move forward in a way that affirms who they are and allows them to be the absolute best service members they can be,” said McMahon.
As a result, the Air Force is dedicated to ensuring equality and supporting all service members.
“I love seeing patients come back because so often I see them when they’re starting out,” said McMahon. “They’re uncertain about what the next steps are, what the military can do for them, how they can really be who they are. Being able to see them when they come back and they’re able to live fully in their affirmed gender. They’re just happier. They’re healthier, and being able to see the impact of how assisting them on their journey has really helped them thrive is amazing.”