The number of military children receiving transgender-related care within the military health system increased significantly following a Defense Department policy change that gave them access to non-surgical treatment, according to a report published Monday in JAMA Pediatrics.
Between October 2009 and April 2017, 2,533 young people out of the roughly 1.7 million eligible for medical care through the military health system received transgender-associated care, increasing from 135 in all of 2010 to 528 in the first four months of 2017 alone.
In October 2016, the DoD began providing coverage to dependents and military retirees for mental health counseling and hormone therapy for gender dysphoria, the clinical diagnosis for those for whom identifying with their birth gender causes significant distress.
According to the study, the majority of youths seeking transgender treatment under the military health program were born female (65 percent) and the median associated age for gender-related treatment was 17 years old. But roughly a quarter of the children seeking gender-related care were younger than 14.
While the policy went into effect in late 2016, patients previously could seek treatment by requesting a waiver. Under the policy, military medical facilities and Tricare provide hormone treatment and counseling. Surgery is authorized only when deemed medically necessary, such as in cases of ambiguous genitalia.
According to the study, of those receiving hormone therapy, 4 percent were prescribed puberty suppression treatments at a median age of 15; 11 percent were given female hormones (median age 19); and 20 percent were administered testosterone therapy (also a median age of 19).
Co-author Dr. Elizabeth Hisle-Gorman of the Uniformed Services University of the Health Sciences, told Reuters Health that the study shows "transgender care, which was only officially available to military dependents in 2016, is used and needed."
"We hope to explore how changes in availability of transgender-related care can impact the overall health and well-being of military connected children," she said. "We also think it is important to understand how other factors related to military life, including parental deployment and frequent moves, may affect these children and adolescents."