On Wednesday, the House of Representatives passed the fiscal 2025 National Defense Authorization Act (NDAA), approving over $895 billion in military funding despite bipartisan efforts being undermined by a last-minute amendment from Republican lawmakers. With a vote tally of 281 to 140, the bill authorized critical defense priorities, a yearly necessity for Congress, but faced backlash over a provision aimed at stripping healthcare for transgender children within military families. Over 120 Democrats, alongside 16 Republicans, voted against the bill, highlighting the contentious nature of this legislation, which is comprised of 1,813 pages.
The controversial GOP-controlled amendment, positioned discreetly on page 399 of the NDAA, restricts “medical interventions for the treatment of gender dysphoria that could result in sterilization” for minors. This generalization holds significant ramifications for military families who are affected by gender dysphoria, as it places parents in a challenging position between their military duties and the health needs of their transgender children. Estimates suggest that in 2017 alone, around 2,500 minors sought care for gender dysphoria through the military’s TRICARE healthcare system, with about 900 receiving puberty blockers or hormones.
Critics of the provision, including House Democrats, emphasize that it misrepresents the nature of gender-affirming care. They argue the provision erroneously equates all forms of required medical interventions with permanent surgical procedures — which do not occur in young children and are heavily regulated for adults. For adolescents, gender-affirming care primarily involves mental health support and the administration of puberty blockers, which can safely delay natural puberty without causing irreversible changes. The lawmakers opposing the amendment cite its unnecessary inclusion in a defense funding measure, pointing to escalating GOP attacks on trans healthcare as the driving force behind it.
Speaker Mike Johnson (R-La.) openly endorsed the anti-trans measure, challenging Democratic members to vote against the NDAA that encompasses support measures favored by military personnel, such as a 4.5% pay increase for all military members. Notably, Rep. Adam Smith (D-Wash.), who contributed to the bill’s development, ultimately voted against it due to its harmful implications for trans minors. He called the provision a denial of necessary and life-saving care and condemned the vague language surrounding “sterilization,” asserting that it could lead to broader restrictions on essential care like puberty blockers.
Other Democratic representatives also condemned the inclusion of this anti-trans provision. Rep. Jill Tokuda (D-Hawaii) characterized it as a disgraceful assault on military families, highlighting that gender-affirming care represents fundamental healthcare needs for transgender individuals. She criticized the bill’s intended approach to improve “Servicemember Quality of Life,” stating that it paradoxically strips some service members’ children of necessary health services, pointing to the cruel irony of the situation.
As the NDAA moves on to the Senate, it remains unclear if majority Democrats possess the votes or political will to amend or reject the anti-trans provision. The ongoing debate over the inclusion of transgender healthcare in defense legislation encapsulates a broader struggle over the rights and recognition of LGBTQ+ individuals in American society, particularly within the context of military families who should not have to choose between adequate healthcare and their service commitments. The future of this provision hangs in the balance as legislators continue to grapple with the implications of their policies on the lives of service members and their families.
