However, as all this was going on, I realized that another situation has gone unmentioned. What happens when the spouse of a military person is transgender? Some might argue that this is a very rare situation, and doesn’t need attention. However, my recent interactions with a number of transgender people associated with the military say that this situation is far more common than people realize.

A few weeks ago a trans woman in the Dayton area sent me a message asking me if I remembered a female colonel I worked for while I was still on active duty. I did, and replied that I liked her because she generally had a good read on who everyone in the command was and what they were doing. What she wrote next blew my mind. “She came out as a lesbian after she retired in 2008. We’re married now.” A little further digging revealed that they had met and gotten married after the trans woman had transitioned. However, because of military regulations and DOMA, the trans woman did not have base access, Tricare, or any of the other benefits the spouse of a retired colonel would normally have.

In short, the military regards them as a same sex couple. But my marriage is regarded as a heterosexual one because I transitioned after we were married, even though in both cases we are trans women married to another woman.

At about the same time, I also spoke with a trans man in the military. He talked about the difficulties he and his boyfriend, a civilian trans man who lives in Washington DC, expect if they get married. Another situation that came up in discussion recently was a trans woman (MTF) I know who is closeted, but on active duty. She is married to a trans man (FTM) who is just starting transition. When the trans man civilian spouse went to medical to start hormone therapy, they refused to treat him unless his spouse came in and verified that she knew what was happening and approved.

Given all of these situations, figuring out which marriages the government will regard as gay or straight is a mind boggling exercise in one of the grayest areas of law. In the case of the retired colonel, the marriage is gay, but only because the trans woman transitioned before the marriage and wasn’t born in Idaho, Ohio, Tennessee, or Texas (where birth certificate gender changes are not legally allowed). However, the two trans men may or may not be a gay marriage, depending if the one in DC changed his SSN gender marker before or after they got married. The trans woman in the military married to a trans man is a heterosexual couple, but the trans man can’t change his gender in DEERS because of DOMA.

I approached four of my friends who practice law in the LGBT community about this, and how the federal government determines if a couple is same sex or opposite sex for the purposes of defining marriage.

I got four different answers.

I did have a long conversation with Jillian Weiss of Lambda Legal, who summed up the situation. It is mostly up to the states to determine whether a marriage is gay or not for federal purposes. Unfortunately, this isn’t very helpful to transgender people, since when it comes to transgender people, marriage law varies radically from state to state. A lawyer in seminal transgender marriage law case of Littleton v. Prange noted in 1999:

“Taking this situation to its logical conclusion, Mrs. Littleton, while in San Antonio, Tex., is a male and has a void marriage; as she travels to Houston, Tex., and enters federal property, she is female and a widow; upon traveling to Kentucky she is female and a widow; but, upon entering Ohio, she is once again male and prohibited from marriage; entering Connecticut, she is again female and may marry; if her travel takes her north to Vermont, she is male and may marry a female; if instead she travels south to New Jersey, she may marry a male.”

Legal reasoning since then has been divided, and has often involved complex constitutional arguments such as the full faith and credit clause. In general, though, for purposes of estate such as In re Gardiner, birth sex has been treated as the gold standard of determining whether or not a marriage is gay.

Jillian also reiterated what I was finding out on my own; there is no such thing as legal gender. There is only legal gender for a specific purpose. I am female on my driver’s license, on my passport, in my civilian company’s personnel database, and with my health care provider. However, because they didn’t offer partner benefits when I started (that changed this year on January 1), I was male for the purposes of my marriage. Just to keep things interesting, I am male in DEERS (the military personnel database) because my spouse is female in the system, and as a result of DOMA, the software will not allow me change my gender in the system.

In the end, no one can seem to agree whether a marriage involving transgender people is same sex or not. But, marriages involving transgender people do happen, and involve the military more than people know. However, until the military recognizes all marriages and DOMA is struck down, the Gordian knot that is transgender marriage law represents a barrier to determining how to effectively integrate transgender people into the military.

Afterwards, she was picked up immediately to continue working with airborne surveillance aircraft and helicopters as a contractor out of Fort Hood, Texas. As a contractor, she continued to work with military intelligence gear through three years in Korea, and tours in Afghanistan and Iraq. None of this may sound particularly unusual. Tens of thousands of military contractors have served in theater alongside the military, filling specialized and highly technical roles for more than a decade.

Except for one key detail: Rachel is transgender. She began transition in theater, and finished during her rotation out of the AOR. Then she went back into theater post transition without missing a beat. For the better part of a decade, Rachel has been “in the field” working on some of America’s most important intelligence assets, and doing it as a trans woman.

Rachel had struggled with her gender identity for years, and it came to a head in 2006 after a motorcycle accident forced her to reassess her priorities in life. She made a commitment to transition and volunteered to go back into theater to help save up for the costs of transition. From 2007 through 2010 she worked in Iraq on FLIR and electro-optical sensors, and started preparations for transition in earnest. “I found a therapist online who would do Skype sessions. I went back on HRT (Hormone Replacement Therapy) in mid 2009, and scheduled Facial Feminization Surgery (FFS) for the following year.”

Rachel took two months off in early 2010 for FFS, and notified her Human Resources (HR) department about her intention to transition. After she returned from FFS to Afghanistan, she informed her co-workers of her intent to transition in late 2010. Their reactions were mixed, and some of the blame for these mixed reactions possibly falls on her company. Her HR had no Equal Opportunity (EO) policy in place protecting gender identity, and no policy concerning how to handle an employee transitioning.

“Some of my co-workers have been extremely supportive, and others have been openly hostile… Even two years later, it is still known to me that some of them (the hostile ones) are telling newcomers about my past. I’ve been in contact with my HR to let them know that it is time to let the past be the past.”

Rachel Bolyard

In early 2011 Rachel took a three month leave of absence to have Gender Reassignment Surgery (GRS). After her surgery she had to be in-processed again via the Army’s Individual Replacement Deployment Operations (IRDO) program. While there, she was treated essentially like every other woman in the program. “While I am deployed now, I use the female latrines and showers, and my roommates are women.”

I asked her if her roommates in theater knew about her past. Unfortunately, some people have made it their business to try and influence her roommates’ opinions of her. “Because I am still with the same group of people that I was with during transition, they still feel it is OK to talk about it without my permission… I have asked them repeatedly to allow me to introduce myself and be myself without that label and in time, I will or won’t talk about it. So far, at this site, I am still being outed to newcomers without consent though”

Still, I asked, what about your roommates? Did they have any issues? Rachel’s answer was emphatic and to the point, “No. They have been very understanding.”

I also asked about her interactions with military people, and not just the contractors. How did they handle her being trans? Were they professional in their dealings with her? “The military folks generally aren’t any the wiser, unless one of the co-workers decides to reveal my past to them. If they (the military people) do know, they do a better job of hiding it than some of my co-workers. The military side actually seems to be more disciplined or doesn’t care. It’s kind of weird. You would think that the civilian side would be more understanding, but it hasn’t been my experience.”

When asked about where the issues are coming from, it wasn’t hard for her to pinpoint: “It is just a minority of people who make life more difficult than needed… Some of my co-workers are extremely transphobic, and see me as a pariah that needs to be excluded or sent home.” Ironically, she works at an international base, where she has met transgender service members from Canada and England.

Medically, being transgender in theater hasn’t been a significant factor. Every three months she gets a check up and a re-fill on her prescriptions. They’re stable even at high temperatures like the ones encountered in Iraq and Afghanistan, and she keeps a 2 month “back up” supply in case her access to her normal re-fills is interrupted for some reason.

In spite of the ups and downs, she’s where she wants to be. “I really like my job, love aircraft, so I don’t want to leave… I really want to fly again as an aircrew member like when I was in the service, but it was only last year that women were allowed onboard to be operators.”

There are a lot of lessons to be learned from Rachel’s experiences. A strong chain of command that demands professional, respectful conduct has a strong positive impact on the workplace climate and culture. She demonstrates that transgender people have been successfully working in theater for years. It also shows that the biggest impediment to transgender people serving isn’t medical or their ability to do their jobs. The issue is the same people, who for personal reasons, would prefer to see integrating LGB people into the military fails.

Many of the same arguments raised against ending DADT are being used to perpetuate the discriminatory policies against transgender service members. Highly capable and dedicated transgender DoD civilians and contractors like Rachel show that transgender people are willing and able to be a part of the military and its missions. The only thing holding them back is the same sort of fear and prejudice that kept lesbian and gay people from serving openly.

It begs the question, though: If those people shouldn’t have a say in LGB people serving openly, why should they have a say in transgender peoples’ ability to serve?

Reserve recruiters dream of people like Morgan Wade walking into their office. She had a sterling service record, was on the fast track to chief petty officer, and qualified in a field where the demand for skilled individuals is high. Top it off with a clear background check and a clean bill of health, and it should be easy, right?

The problem: Morgan Wade is female now, but that is not what was on her original birth certificate. It wasn’t what was in her records when she joined the Navy. Even before she joined the Navy, though, Morgan was already dealing with gender dysphoria. She treated it as something chronic but manageable.

“The first time I figured out I had body image issues was actually before I joined the Navy, though at that point I didn’t know what it was or meant,” she said. “I just tried to ignore it. At that moment in my life, I didn’t know what I could do other than just try to deal with it the way I always had.”

Joining the Navy

Morgan’s father, Mark, saw someone looking for a calling and not just a job. “Diving is Morgan’s passion,” he said. “She was not happy at Chico College and spent her summer vacation on our sofa just watching TV. When we told her to go out and get a job, she went to military recruiters and decided on the Navy… Morgan found the dive program and pushed for that.”

Morgan saw a great opportunity: “I wanted money for school and needed some time to figure out what I wanted to do with my life.”

When it came to her dysphoria, she counted on her newfound endurance. There were hard times early in her Navy career, but those hardships also reinforced her confidence in her own abilities. “At my first command, I was treated so badly, and hazing was such a regular thing that I sort of figured that if I could survive that, I could deal with my own personal issues.”

Despite the hardships, she loved her job. “When I was diving, nothing else in the world mattered. It didn’t matter how bad things were topside. As long as I got to be in the water it was a good day.”

She was stationed on the USS Safeguard, a salvage ship based in Sasebo, Japan. “Being that it was a small ship, and the cruise was an independent steamer, I got to go to a lot of small ports that the rest of the Navy doesn’t normally go. I loved the travel on that ship.”

Unfortunately, during the time on board the USS Safeguard, Morgan’s dysphoria began to catch up with her. “I came to the conclusion that I wasn’t going to be able to deal with my gender issues indefinitely. I did, however, make the decision to make it to the end of my contract.”

Falling in Love

After returning from Japan, Morgan met her future spouse. Katie described meeting Morgan: “We met online on a singles/friends website. We seemed to have a lot of common interests, but I think above all we were both thirsty for friendship on a deep level, and Morgan seemed lonely.”

The online, friends-first nature of the relationship led Morgan to believe they were unlikely to meet. With no expectation of romance, she opened up about her dysphoria. “I told her online, so she knew that much about me from the very start. I didn’t really know her at the time, there wasn’t the same sense of risk that I got with coming out to friends and family.”

This marked the first time Morgan had come out to anyone. She was rewarded with Katie’s unconditional support. “It was more or less a non-issue to her.”

Morgan moved to Washington, a few hours from Katie. “We had talked online for a little while, and Morgan said she was bored one weekend,” Katie said. “I invited her out to hang with me and my friends at a nightclub. Morgan hopped a ferry and came right over, and within five minutes of us being in each other’s presence, we felt very comfortable, as if we had known each other our entire lives. Morgan ended up staying for the entire weekend, and we ended up falling in love.”

Dysphoria Takes Hold

Katie could see how the dysphoria affected Morgan. “She tried very hard to be optimistic, but she was incredibly lonely. Ultimately, the Morgan I met was sort of locked in place by her choice of desperately trying not to reveal her true self at work or to those around her.”

They married in February, 2007. Katie went in knowing Morgan would finish out her time in the service, then transition. “It was a fun time, as we were in our honeymoon phase.” Still, Morgan sometimes talked of trying to tough it out to retirement, Katie said. “She kept fighting with herself saying that if she just stuck it out, she could retire. But I could see how damaging it was for her to have to be a man every day… She had come to terms with the idea that she could finally be herself at some point.”

Increasingly, Morgan struggled at work. “Toward the end of her ten-year career, she started to feel overwhelmed,” Katie said. “She had to put up with misogynistic jokes in the dive locker and jokes about her ‘putting on weight’ when she was on estrogen. Morgan hated the male part of herself and hated changing in front of other people. She had to face that daily as a diver.”

Still, it wasn’t always bad, and the solace that diving offered was what tempted Morgan to stick it out to retirement. “Some of her best days were when she got to dive and see neat things along with doing her job. She feels most at peace underwater, so at least the Navy offered that,” Katie said.

Morgan’s burden also weighed heavily on Katie as time went by. “I was the first person she openly told in person that she was trans. I was the person she spent almost every day with up until her Gender Reassignment Surgery (GRS), and I can say that it is a very heavy weight to carry. Where trust goes, there follows a huge amount of responsibility.”

Taking the Leap

Katie was convinced Morgan could not continue with the Navy or to even live as a male. “She had to pursue herself in a much more dedicated, in-depth way than she was able to do in the Navy.”

Morgan finally began getting help and taking positive steps towards dealing with her dysphoria. She sought psychological and medical services outside the Navy medical system, and in the process risked the consequences of violating UCMJ Article 92 and an administrative discharge.

Morgan also took the step of getting a prescription for Hormone Replacement Therapy (HRT). It was easier than might be expected. “I got a recommendation from my therapist for a doctor out in town, and he prescribed them for me. I actually brought him my military medical records. He even charged me less because I made his job so much easier.”

She began HRT six months before she left the Navy, and the positive effects were noticeable. The changes helped her feel at peace, happier, and easier to communicate with. The depression lifted.

“I understood completely and put everything I had worked for over the last two years on hold to cope with transition,” said Katie, who paused her efforts in nursing school to support her family. “I was prepared to be the bread winner. We were scared of how hard it would hit us financially. She was so sad to not get to dive almost every day. I’m very disappointed she never got to make chief, because she was a shoo-in.”

Despite the necessity of leaving the Navy, it was still hard for both of them. Katie described it as a grieving process. “The Navy gave her a sense of pride, accomplishment and identity. Being a Navy diver was a very large part of who she is. Diving is something that gave her the confidence that only a job you’ve done for 10 years at the top of the pack can do. Leaving the Navy was almost like mourning the loss of a friend.”

Morgan left the Navy in 2010. She gave up a $45,000 selective reenlistment bonus, a promotion to chief petty officer, and the diving she loved.

Transition

About three months before leaving the Navy, Morgan came out to the rest of her family. Her brother just thought she was gay. “My mom sat me down with the psychiatric Diagnostic and Statistical Manual and tried to convince me I was just depressed,” she said. “Now, I think she’s accepted that I’ve done the right thing, even if she doesn’t really understand it.”

The news surprised her father. “Sara and I were shocked when Morgan told us. I wondered what I had or hadn’t done during Mo’s upbringing to cause it. We are still having problems with pronouns.” Both of her parents tried to dissuade her from leaving the Navy. “We were not happy with her decision. She had ten years invested in a career field that she loved. She was so good at what she did.”

Yet, over time, Mark made a discovery about his newfound daughter. “I have realized, no matter what the outer wrapper is, Morgan is still Morgan after transition.”

When the opportunity to live as a woman finally came, she did not waste any time. “I went full time while I was on terminal leave. That was less than a month after my last day at work. I figured I was already going through so much change, what’s a little more?”

She used her educational benefits to go to culinary school. “Morgan has always been a creative, mad scientist in the kitchen,” said Katie.

At the same time, Morgan went to the Department of Veteran’s Affairs (VA) for access to psychological services and continued access to HRT. The VA benefits were a blessing, given the financial difficulties they were having. “We went from making very good money to us being afraid every day that some service was going to be disconnected since we couldn’t pay the bill,” Katie said.

The process of transitioning wasn’t easy on Katie either. “It has been an emotional roller coaster. I was so glad she was finally finding herself, and I think that is what the transition is all about. It has been a humbling journey, but it almost broke us right before her GRS. I felt like I had a big responsibility, and I tried my best not to let her down.”

After a clean bill of health from the VA, Morgan and Katie scraped up enough money to pay for GRS. By December 2011, her transition was complete. In every legal sense of the word, Morgan was female, and her body and soul were finally aligned.

The effects were profound. “She has grown into a woman with so much strength and courage, who is more outgoing, who is more self-possessed and feels more at peace with herself than I have ever seen her,” wrote Katie. The therapists with the VA agreed. They concluded she no longer had any reason to see them since her dysphoria was gone, she wasn’t depressed, and she was well adapted to her new life.

Trying to Re-enlist

With her life back together, Morgan wanted to try to re-enlist in the Navy. “I decided to try to get back in once DADT [Don’t Ask, Don’t Tell] was repealed. I knew I would have to get a waiver, but figured I could prove that I was more fit to serve now than I was when I got out.”

That recruiter she found was Petty Officer 2nd Class Kevin Campbell of Navy Recruiting Station Everett, Washington. Where others saw a hopeless cause, he saw an opportunity for continued service. “It is my job to help transition prior-service personnel into the Navy Reserve. Ms. Wade was no exception. I will do my best and continue to help every veteran re-affiliate that I can,” Petty Officer Campbell said. It didn’t hurt that Morgan was up front with the situation from the beginning. “Ms. Wade was very honest, sincere, and overall a pleasant person to speak with.”

Morgan went through exam after exam to prove she was mentally and physically fit to serve. “It seemed like every time I gave them one piece of paper, they would ask for two more. Eventually, they accepted the doctors at the VA examining me and clearing me.” In the end, all of the doctors, psychologists, surgeons, psychiatrists and therapists declared her fit to serve. The package she submitted was almost 150 pages long and documented her exemplary prior service and current fitness.

When her application was denied without explanation in August of this year, Morgan wanted to know why, so she asked for help from her congressman, Rep. Jim McDermott. His office pressed the Navy for answers and received one several weeks later:

“Standards preclude from acceptance those individuals with contagious or infectious disease who would be likely to endanger the health of other personnel; those who are likely to require repeated admissions to sick list, prolonged hospitalization, or invalidating from service; or those who present any condition that would be likely to form a basis of a claim for physical retirement benefits. The standards, therefore, are intended to define a degree of physical fitness in applicants that best meets the Navy’s needs and yet incur an acceptable minimum risk of liability in regard to health hazards, repeated or prolonged medical care or hospitalization, assignment problems, and eventual pension or retirement benefits … To authorize Ms. Wade’s enlistment in the Navy would expose her to increased risk or injury.”

None of the reasons given by the Navy made any sense to Morgan or her family. Gender dysphoria isn’t a communicable disease, she doesn’t need more medical care than any other woman, and the law specifically prohibits treatment of dysphoria as the basis for retirement benefits. The diving community is open to both men and women, so there was no reason to believe that her gender would lead to unacceptable risk of injury.

“The rejection notice was ridiculous,” said Katie. “I actually ended up laughing for a good five minutes at it.”

Her father was similarly unimpressed with the Navy’s explanation. “We heard her congressman sent a letter explaining the reason she wasn’t allowed back was because she was no longer capable of performing the duties of the job. I have no idea where that came from, and I am angry with whomever was involved with that decision.”

When Morgan heard the waiver was denied, she simply felt sad. After receiving the explanation, her frustration simmered over. “Now I’m more frustrated and mad. Every doctor that has seen me says there is no physical reason why I shouldn’t be able to serve. Every therapist and psychiatrist that has seen me says that I am healthy and well adjusted.” For Morgan, it begged the question of why she needed doctors and psychiatrists to examine her examinations if the Navy wouldn’t follow their recommendations anyway?

Life Goes On

Yet, life goes on for Morgan and Katie. Budgets are still tight; they still have to finish getting Katie through school. Morgan’s family is still adapting to her transition. Still, they can’t help feel that Morgan and the Navy would both be better off together.

“They spent a lot of money to train her, and she proved herself amazingly and boundlessly worthy of that investment. She gave 150 percent of herself to her job,” Katie said. “It seemed like a no-brainer that she would be an even better diver now that she has nothing to hide.”

Despite rejection, Morgan remains optimistic that someday she will be able to reenlist. “I’m hoping that the new [Diagnostic and Statistical Manual of the American Psychiatric Association] and the changes regarding gender dysphoria will make it easier to argue that I am healthy and able to serve. I want to finish my career. I loved the job, serving my country and the community. It hurts to be denied that opportunity.”

Cyprus and the Republic of Vanuatu are, literally, a world apart from each other. Cyprus is one of the largest islands in the Mediterranean, and Vanuatu is a tiny chain of South Pacific islands. Cyprus has been at the center of world affairs and great conflicts dating from the legendary battles between the ancient Myceneans and Persians. Vanuatu, not mapped by Europeans until 1768, didn’t even get caught up in the Pacific campaigns of World War II. Cyprus is arid with diminishing water reserves. Vanuatu tries to not to drown from 15 feet of rainfall per year. Cyprus is cosmopolitan. Vanuatu relies on agriculture and tourism to boost a limping economy with negligible natural resources.

What do these places have in common? In short, the answer is drugs, the kind transgender people desperately need for transitions but often are unable to obtain through normal channels. Because of a lack of laws governing requirements for prescriptions and lax regulations on what can be mailed overseas, these two island nations are the source of most mail-order hormones obtained by people trying to transition. As a result, online pharmacies have become a cottage industry in both these nations.

Green Bay, Protaras Cyprus, is an awesome dive site with year-round ideal conditions. There are a few sunken manmade statues ideal for underwater phtography.

Trans people trying to get Hormone Replacement Therapy (HRT) through normal channels have to jump through many hoops. The World Professional Association for Transgender Health (WPATH) publishes the Standards of Care (SOC) for people who transition. Because the SOC recommends psychotherapy and referral prior to a physician prescribing HRT, the few doctors who handle transgender patients are often hesitant to make a prescription for HRT without said therapy. Doctors who work with trans patients are so uncommon, wait time for an appointment can be six weeks. Few therapists are familiar with gender dysphoria, and few insurance policies cover gender dysphoria-related medical and psychological expenses anyway.So, you can get a prescription for HRT if you can run this course of hurdles:

• You can find a therapist who knows about gender dysphoria;
• Your insurance covers months’ worth of sessions or you’re wealthy enough to pay for them yourself;
• Your insurance company will pay for the workup labs or you can afford to pay $800 for them;
• You can find a doctor willing to work with you;
• Your insurance company will cover the doctor’s visits or you have the money to pay for the visit; and
• Your insurance covers the cost of the drugs at the pharmacy or you can pay for them out-of-pocket.

If you get through all of this, the process can take three months to a year and cost close to $2,000 if you don’t have insurance that covers trans-related care.

Or, you can go online for five minutes and place an order with one of the pharmacies in Cyprus or Vanuatu to get a three-month supply for $200 if you’re a male-to-female trans person, and about $350 for a female-to-male. Shipping time is about two weeks. FPOs and APOs are treated like any other address inside the United States—folks are self-medicating on the front lines out of desperation.

Vanuatu, an island in the South Pacific, lies in the “Ring of Fire” and regularly experiences seismic and volcanic activity. While homosexuality is legal in the country, open displays of affection between same-sex partners will attract adverse attention.

Hormone regimens for male-to-females and female-to-males differ in the particulars. Male-to-female transsexuals typically take one medication to suppress testosterone production plus provide some form of estrogen. Some take a bio-identical form of progesterone in addition to the estrogen and the androgen blocker. Female-to-male individuals generally only take testosterone as part of their HRT regimen.Both the testosterone and estrogen can be delivered as injections. Many doctors prefer injections because it reduces both the cost of the regimen and the strain placed on the liver. However, injectable testosterone or estrogen is not available from the mail-order market due to refrigeration requirements. For female-to-male trans people, the testosterone gel or dermal patch alternatives available online are typically 10 times more expensive than the injectable version. Still, most trans people will go to almost any length to align their bodies and minds and will bear almost any cost burden.

What makes the online, no-questions-asked option even more attractive is that some of the drugs used as part of HRT everywhere else in the modern world, are not approved by the U.S. Food and Drug Administration (FDA). The costs of getting FDA approval versus the small market for these particular drugs don’t balance out for the manufacturer. In the United States only one drug is available for suppressing testosterone as part of HRT. That’s because this drug, spironolactone, is also used to lower blood pressure, and its anti-androgenic effects are ancillary.

If you’re a runner (like me) and you take enough spironolactone to significantly reduce testosterone, you often suffer the pesky side effect of passing out cold every time you stand up too quickly. This leaves you with three options: stop HRT, keep fainting at work every other time you get up from your desk, or use one of the newer and better drugs available online, cyproterone acetate, which has far fewer side effects. Unfortunately, the last option carries risks.

Obtaining drugs from Cyprus and Vanuatu is something of a legal grey area. People can theoretically be prosecuted under civil law for ordering drugs from overseas, with or without a prescription. However, since 2006 customs and the FDA have rarely gone after people importing low-risk medications in quantities normal for personal use.
Many trans folk in the military who start transition prior to getting out of the military and use online pharmacies also face civil and UCMJ article 92 risks. Being in one of these countries that sells these legally does not help either; the FDA prohibits importing drugs by mail or on your person, and the UCMJ does not allow seeking medical care outside the DoD system without authorization.

The penalties for using hormones, even those obtained legally, can be severe. What follows are true stories. One trans woman Sailor bought estradiol in Spain, where it can be purchased without a prescription. Her vial was found during a drug sweep, they made her take a urinalysis, and it detected the presence of synthetic estrogen. She was given an otherthan- honorable discharge. A current case involves a trans man who obtained testosterone via a legal prescription from a doctor in the U.S. He was hospitalized for a condition unrelated to gender dysphoria, and his lab work revealed the presence of synthetic male hormones. He has been relieved of duty, had his clearance revoked, and is also facing a potential discharge.

Another risk is counterfeit or low-quality drugs. Some estimates place the value of that illegal industry in the United States at $75 billion. A constant source of discussion on transgender forums is the reliability of different websites, the reliability of the drug manufacturers whose products are being sold on those websites, and where each drug is manufactured. Do you trust the estrogen made in New Zealand or the much cheaper but supposedly identical brand made in India? Which sites are more likely to have their merchandise confiscated by customs?

Some vets will be eligible for Department of Veterans Affairs benefits that cover therapy, labs, and prescriptions for HRT. Others don’t meet the somewhat byzantine requirements for eligibility. The Affordable Care Act doesn’t mandate coverage for transgender-related care, most corporate-provided policies don’t cover transrelated care, and individual policies that cover trans-related care are prohibitively expensive.

This whole sordid story has many lessons. It demonstrates the power of free market economics and the terrible risks trans people will take to transition. It highlights the foolishness of our own medical system and the funny way drugs have of finding their way to demand.

I would sort of like to see where my money went for all those years. Going to Vanuatu seems like it would be something of an adventure.

For more information on hormone replacement therapy, Endocrine Therapy for Transgender Adults in British Columbia: Suggested Guidelines is a good place to start. It is both informative and moderate in tone.

Editor’s Note: OutServe Magazine does not endorse the illegal use of hormones.

For whatever reason, this song has become traditional to the New Year. The Scottish phrase “auld lang syne” best translates as “for old times’ sake.” It asks us to reflect on friendship, and times past. After the most tumultuous year of my life I have had the opportunity to take stock of old acquaintances, and consider what has come and gone.

Coming out is a uniquely LGBT rite of passage. However, if LGB people need a spoon full of sugar to help make the medicine go down, coming out as trans can require the entire dessert cart and an anesthesiologist. Thus, eight months after I began living as a woman full time and finished coming out to virtually everyone, the smoke has cleared. The diabetic shock is over, and I can conduct an accurate battle damage assessment.

My family is still with me, even the extended variety. We told the girls what was happening in January. They seemed to think it was funny at first, but have decided that Maddy’s a lot easier to live with. Mom is confused but supportive, and working hard to make it known I’m still welcome at home. Dad is still talking to me, but desperately trying to pretend this isn’t happening. My step-mother can’t bear to look at me or speak to me.

My step-father’s family was something of an enigma, being blue-collar, Italian Catholics, and dyed-in-the-wool, union-supporting Democrats. I don’t think they knew what to make of me coming out at first. In the end my step-family seemed to decide as a group that if being trans was what it took for me to vote for Obama, then it couldn’t be all bad.

I came out to a select few military folks early on whom I deeply respected for various reasons, but they were all from my time at the Naval Academy: The woman who was in my company, a free-thinker, and an outsider. The brilliant man who blended intellect, ethics, and wisdom seamlessly to became a great doctor. The surfer-dude plebe/summer roommate who seemed to live by the motto “It’s all good, man.” The giant of a man who knew the value of trampling stereotypes. The woman whose smile and optimism never seemed to be touched by the oppressive atmosphere of the institution. I sought each out individually, and came out to them on purpose because I valued them as friends and individuals. They reciprocated. I felt humbled and grateful.

However, those military folks from my active duty past who sought me out after transition were another story. In dribs and drabs they found me on the internet. I have given them the truth, and the option to back out gracefully.

All of them took the opportunity to avoid further contact with me.

The group of people from my past that surprised me the most, though, were my friends from high school. We were a tight knit, if eclectic and intellectual, bunch. The way they rallied to me was inspiring. I disappeared off the face of the Earth in one place, and popped up somewhere else as someone else. Yet, one by one, they found me online, and asked what the deal was. I was honest with them, and left each with option of gracefully declining to be involved. Every last one refused to bow out, and all still wanted to keep in touch regardless of who I am today.

I was humbled to have such friends. Here, almost 20 years later, and after having spent only 4 years together, there was still a sense of loyalty and camaraderie.

Somehow, though, one of the most difficult situations was also the last. My best friend through high school, whom I had kept in touch with continuously for 20+ years, was the last person I came out to. It didn’t happen until this September.

“Ethan” is probably the smartest person I know. He has a doctorate in linguistics, wrote his dissertation on why Noam Chomsky’s theory of language origins was wrong, and speaks God-only-knows how many languages now. Seriously, last I counted it was in the low-20s. He’s also one of the most thoughtful and devout evangelical Christians I know. Over the past decade he and his family have lived in China while studying and recording dying dialects. Thus, I had held back what was going on in my emails, and I hoped I could postpone the truth from him indefinitely based on our distance.

Then, I got an email from Ethan. He and his family were back in the U.S. on a yearlong sabbatical. He had found out I was trans after he stumbled onto one of my online profiles, and he wanted to talk. The jig was up, and I just hoped for the best.

He called. We talked. After perhaps ten minutes, he stopped the conversation and remarked, “You know, even though you sound different, even though the accent is different, I still hear the old you. Your choice of words, your pauses, and just how you use language; it’s still you in there.”

“Yeah, still me,” I replied. “I couldn’t tell you because I thought so much of you as a friend and as a person that I didn’t want to lose you.”

“You’re still my friend, regardless.”

“Thank you,” I said, with a giant lump in my throat. “You don’t know how much that means. I’m sorry I wasn’t forthcoming, but I didn’t know how your religious beliefs would allow it.”

“Brynn, if I shunned everyone who didn’t live the way I thought they were supposed to, I would have been really lonely in a country with 1.2 billion people,” Ethan answered simply.

I will leave it there. On New Year’s, I will be raising a cup o’ kindness yet.

For auld lang syne.

During the election cycle it was alleged that Mitt Romney, while governor of Massachusetts, told a lesbian couple with kids, “I didn’t know you people had families.” Yes, everyone who doesn’t live under a rock these days knows that LGB people have families. They can marry in some states. They sometimes have their own biological kids. They sometimes have foster kids… or adopted ones.

Sometimes though, I still get the feeling that most people look at trans folks and their children and think, “Wow, I didn’t know those people had families.” And while there may have been some truth to this in the past, today, this understanding couldn’t be further from reality.

Through the 1980’s, the medical community’s standard recommendation was for transitioning people to just disappear. Leave their families, their children and move away to become a new person and never see them again. It was judged to be less traumatic for everyone this way. Sometimes treatment would even be withheld if the transitioner didn’t comply. Transsexuals were expected to “go stealth,” abandoning their past, whether they wanted to or not. It usually wouldn’t have mattered if they tried to stay: very few spouses or partners would choose to stay in a relationship whose dynamics were being changed so dramatically without their consent.

When I was forced to confront my gender dysphoria in 2010, Jennifer Boylan was the only well known role model for intact families with a transgender parent. While studies about LGB parents seem to be more and more common (and contentious), I have never seen a study on how the children of intact families with a transgender parent fare.

Not a lot to go on.

As I branched out and met more people, I began to notice a pattern. Increasingly, transgender people no longer have to give up their families, spouses and children. Instead, they, together, navigate the transition and the challenges that come with it. The younger the generation, the more common this seems. It isn’t just true for trans women; I have met trans men who have navigated gender dysphoria, transition, spouses and children.

All of this left me grappling with my own questions. Most of them still don’t have any clear answers. Did my children lose a father? Was I ever a father to begin with, or just someone trying to play the role of a hyper-masculinized stereotype? Does being the biological father count? Does knowing how zone defense technicals are called in the NBA, how to throw a spiral, and the drop parameters of a Mk. 50 ASW torpedo make you a male role model?

Then again, did they gain a female role model in their lives? Janis, my spouse, rightly points out that my daughters have far more practice at being female in society than I do. I also can’t personally relate in terms of some biological functions, such as menstruation.

What did they get back in return, though? I would like to think they received better parent than they lost, albeit one who cannot teach them all about being a particular gender. Logically, my children lost a father figure, and got back a parent who doesn’t fit either gender role in a stereotypical way.

“Ethan” is a female-to-male trans friend of mine who is just now leaving the military after many years of service. He has twin six year old daughters who are biologically his. Ethan started transition when they were only three. His daughters have been calling him Dad ever since his voice began to change. He has had work his family around his military career, though, given he has always had a female partner, and was thus seen by society at large as a lesbian. Before the end of DADT he couldn’t take his partner to military functions or introduce her. Now, even after DADT is gone, Ethan still feels he has to be wary. He doesn’t take his children anywhere near his work, colleagues, or the commissary, for fear of being outed if they call him “Daddy.”

I talked with another, younger, female-to-male trans friend who recently left the military. Certain that he wants to have a family someday, he worries about how you deal with issues surrounding children, spouses. He even wonders whether it is a good idea for trans people to have kids. “I’m terrified about having my family someday and never having the answers. Taking my son to the locker room. Changing to go swimming. Explaining to my kids that I’m a special kind of boy. What if they tell their friends? What if their friends’ parents find out and I hurt their social life?” he asked me.

I don’t know. Science and research don’t help us here, unless you make the (probably faulty) assumption that the effects of having same sex parents are exactly the same as having a trans parent and a cis parent. There are so few role models. There certainly isn’t a “For Dummies” book on the topic. All I could tell him was that there are no right and wrong answers. Just your own.

I can’t know that my children would be better off with a “normal” family, or even a single parent family. There isn’t real research either way. I continually work on being a better parent, listen to Janis’ feedback, and work with her as a team. In the end though, that is true for every parent. We don’t know what we’re doing when we start; there is no one size fits all solution to parenting or marriage. All any of us can do is our best, and hope for the same.

I found out the leader of a local transgender support group in Jacksonville was a retired Navy LCDR.  She had also been a Naval Flight Officer in P-3’s for 22 years, and had fast-tracked her transition soon after retiring. She was also a very out and prominent local activist.  Her name was Terrianne Summers.

Transgender Day of Remembrance

I e-mailed Terianne quite a bit and spoke with her 3 or 4 times on the phone.  She was soft spoken, kind, empathetic to my plight, and had a wry sense of humor. We decided that we would meet sometime around the holidays, when both of us had a little time off.  I was terrified, but she was my only lifeline to figuring out why I felt the way I did.  The meeting never happened, though.

Eleven months earlier, in January of 2001, Winn-Dixie fired one of their drivers for being a cross dresser.  The company’s headquarters were located in Jacksonville.  Terrianne led marches, protests, boycotts, and even made national cable news.  It was very embarrassing for Winn-Dixie, and resulting lawsuit by the driver eventually became the infamous Oiler v. Winn-Dixie court case.

On December 12^th 2001, Terrianne Summers was found shot to death in her driveway.  Whoever did it ignored the purse she had left in the car, along with the keys to the car and the car itself. She had been shot in the back of the head at point blank range. She was killed just 22 days after she participated in the Transgender Day of Remembrance in Florida.

The Jacksonville police blamed it on a robbery, even though nothing was taken. They refused to investigate it as a hate crime. No persons of interest were named, no arrests ever made.  Not that it would have mattered: gender identity wasn’t protected under Florida hate crimes laws.  It was obvious to everyone besides the police, though, that this wasn’t some random murder or botched mugging. It was a pre-meditated execution.

Eleven years later, I am in Terrianne’s shoes.  I have transitioned, I am out, and I advocate.  Someone, including myself, might ask: “Why do you do it? You know the risks.  You have a partner and children.”

Because if violence buys my quiescence, then we let whoever did this win by forfeit.

Please, take a minute this Transgender Day of Remembrance to think of Terrianne, and others like her.  The only way to give their deaths meaning is if it rallies us to resolve that we cannot be intimidated into silence.

A few weeks ago, late one Saturday night, long after the kids were in bed, my cell phone rang.  The caller ID said it was someone I knew from OutServe, so I picked it up. “Hello?” I queried.  No one answered back. I did hear loud music, and people talking.  Sounded like a club of some sort.  After a few more attempts to get an answer back, I hung up, figuring my friend’s cell phone accidentally dialed me.

Come Monday morning my friend e-mails me with a sheepish, “I am so embarrassed, I butt dialed you that late on a Saturday.  I was at a drag show with some friends.”  Now, this friend of mine is gay, not trans, and the incident highlights the next point in my series of articles on trans service.

When the issue of transgender service comes up, those opposed to it often jump straight to the practice of cross-dressing or drag (which are often conflated).  Drag queens are usually gay men who wear heavy makeup and outrageous costumes for performance and entertainment purposes, and are generally trying to be “campy.”  Cross-dressers are usually heterosexual men who do it for reasons of personal expression.  Transsexuals wear clothing appropriate to the gender they live in day to day.

The people who raise this flag automatically assume that people who cross dress or do drag will insist on wearing whatever they want on base or on duty.  Other accusations include the idea that people will switch between men’s uniforms and women’s uniforms indiscriminately.  One blogger, the wife of a Marine, laid out the standard assertion:

“We need the best and the brightest, the strongest fighters and the fiercest warriors. (And by fierce, I don’t mean Tyra Banks “that outfit is fierce!” fierce.) Conformity and discipline rule in the military. Individuality is not promoted or encouraged. And it is that way for a reason… There is a reason that service members can only have certain haircuts, can’t have visible tattoos and earrings and have to wear uniforms. Explain to me how that works with cross-dressers and trannies, hmm? How does that uniformity and conformity work out when you’ve got a cross-dresser standing in formation?”

 The assumption is that if transgender individuals are allowed to serve openly, you will end up with drag queens flouncing around at morning formation like a pancake-makeup coated Monty Python sketch comedy routine. People assume individuals will exploit the situation to show up for duty wearing whatever they want.  The belief is they will make a mockery of good order and discipline.

The problem with these arguments is cross-dressing is already allowed, de facto, in the military.  I met several cross dressers when I started looking into support groups in the Dayton area. My friend at the drag show knows performers who are military and has done it himself for fun.  The guy who owns the salon just outside the main gate to Area A at Wright Patterson Air Force Base?  He gets a lot of customer traffic from the base.  There are copies of OutServe Magazine in his waiting area. He also does make up for folks doing local drag shows at least twice a month.  What are the odds none of them are in the Air Force?  In fact, one of the Navy’s oldest traditions features cross dressing as part of the “Crossing the Line” ritual when sailors go south of the equator for the first time.

Despite the presence of all these groups, the worst fears of the Marine Corps wife have not come to pass. People don’t show up to work wearing whatever they want. Nor are they being routinely busted for wearing the wrong clothing out in town. And they do not suddenly decide that attire worn when crossing the equator is now a regular uniform of the day.

Crossing the Line: circa 1966

Another interesting angle is that so many of the trans folks I know through OutServe are Female to Male (FTM). I can tell you, most spend their time in public wearing men’s jeans,  binder (a spandex garment meant to compress their chests), and men’s shirts.  They often have haircuts that meet regulations for men.  However, they’re not getting busted either.  Their appearance is not even considered remarkable.  They just look “butchy” to society as a whole, if they are even noticed at all.  They too seem to have no trouble figuring out what uniforms to wear.

According to David McKean, legal counsel for OutServe-SLDN, no one has been kicked out for cross-dressing since the mid-90’s, when one individual was foolish enough to drive onto the base en femme. The precedent is already pretty well established now: as long as you’re following regulations on base and at work, you’re relatively free to do what you want in town.  Part of this precedent comes from restrictions on pursuing individuals suspected of being gay during DADT.

As such, the argument is a straw man. There already are cross-dressers, drag performers, and genetic women who dress like guys in the military, but they are not being kicked out for it. They are not having a hard time figuring out what uniform to wear, how to wear it, or what personal grooming standards apply.

The question arises, though, of what to do about transsexuals. This is particularly true for Male to Female (MTF) transsexuals who are in the process of transitioning.  This is a bit more complex. The standards of care released by the World Professional Organization of Transgender Health (WPATH) recommends at least one year of Real Life Experience (RLE) living in your target gender prior to surgical transition (i.e. Gender Reassignment Surgery).  This requires presenting as a member of your target gender at all times, to include attire.  This is required to ensure the individual is capable of adapting to their new role, as well as making sure people who want surgery really are transsexuals.

This creates two possibilities based on whether the service member is required to transition in uniform.  If the service member is in a position that requires being in uniform each day, they must wear the uniform of their target gender and meet the same personal grooming standards of their target gender as dictated by uniform and personal regulations. This is how it has been handled in the UK, Canada, and Australia.  In other words, when an individual starts transitioning in these militaries they will wear the uniform of their target gender during their RLE period.

If they transition in a position where they are not required to be in uniform during the day (such as getting a degree at a civilian institution, medical furlough, or attached to a DoD medical facility), they will have to wear civilian attire appropriate to their target gender as part of the RLE and comply with personal grooming regulations, if applicable.  This is how it has been handled in Israel. In Israel, the policy is for transitioning individuals to be placed in a medically inactive status and wear civilian clothes of their target gender until they have completed transition surgically.

While the details of how open trans service in the U.S. military have not been established, it is unlikely that an individual would transition in the same way as it is done by some of our closest allies.  Given this, the latter policy option (transition out of uniform) seems to be the one most likely to minimize disruption and objections.

Still, the conclusions remain the same.  Cross-dressing is a straw man argument.  There are people who cross dress in the military already. There hasn’t been an issue with people showing up in the wrong uniform or failing to maintain grooming standards.  For people who are permanently transitioning between genders, there are many ways to comply with the standards of care, while maintaining uniform and grooming standards.

By Brynn Tannehill

Over the next few weeks I will be writing a series of blogs devoted to the questions surrounding open transgender service. This first blog addresses the issue of whether or not transgender people can be mentally stable enough to serve.

There was the equivalent of a 8.0 Earthquake in the psychiatric community this past May. Although very few people outside the transgender community noticed it, there was a casualty. Its name was Gender Identity Disorder (GID). The funeral was poorly attended, and the only people mourning it were right wing ideologues and rabidly anti-LGBT organizations who feel that LGBT people need to be as stigmatized as possible by the medical and psychological communities.

On May 4th, 2012 the American Psychiatric Association released its proposed revisions to the Diagnostic and Statistical Manual (DSM). As of May 2013, these changes are expected to be finalized when the DSM goes to print, and the previous version of the DSM (v 4) will be revoked. GID had been removed, and was replaced by a different term: gender dysphoria. Besides having a different name, the new DSM-5 makes it clear there are substantive differences in how the psychiatric and psychological communities now sees gender dysphoria:

• Gender dysphoria is not a mental disorder
• It does not necessarily imply any loss of functionality in day to day life
• It should be treated as a medical condition, not a psychiatric one
• Health care for gender dysphoric individuals is a legitimate need
• Gender dysphoric individuals are not delusional, nor is any other mental difficulty implied by gender dysphoria
• (Medically) untreated dysphoria is associated with significantly increased risk of distress and suffering

While transgender people were elated at the changes, there also was a distinct feeling of “well duh!”

For 45 years there have been transgender individuals who have functioned at the highest levels of their fields. Lynn Conway is one of the people most responsible for the microprocessor revolution of the 60s, 70s, and 80s. She was also on Board of Visitors at the United States Air Force Academy, and a civilian two-star equivalent at DARPA. Dr. Christine McGinn was an astronaut qualified flight surgeon in the Navy. Amanda Simpson is a Presidential appointee to the position of Special Assistant to the Secretary of the Army. Dr. Chloe Schwenke is a Presidential appointee to a director’s position at USAID. The list goes on and on, but it puts to rest the notion that gender dysphoria is a debilitating mental illness. It’s a medical condition that doesn’t prevent people from doing their jobs, and often those people are doing them extremely well.

Being trans hasn’t been an adverse indicator for security clearances since the mid-1990s. Given that, the government has tacitly recognized that gender dysphoria doesn’t imply an inability to function, nor does it imply a dysphoric person is untrustworthy.

It also begs the question: if the U.S. government was and is willing to trust Lynn and Amanda with the highest levels of decision making and responsibility for national security, why is it also unwilling to trust a gender dysphoric culinary specialist third class with making sloppy joes?

While the Associated Press and some LGBT media outlets picked up this story, there are few outside the trans community aware of this shift. The paradigm among the public, and even amongst some members of the LGB community, remains that trans people are mentally ill or dysfunctional. This is not altogether different from how the public saw the APA’s decision to remove homosexuality from the DSM in 1973: it took a long time for this position to become the conventional wisdom as well.

The practical effects of this change are yet to be seen. Current regulations reflect a medical position and terminology almost as outdated as Gay Related Immune Deficiency Syndrome (GRID). This view is embedded in U.S. law: the Americans with Disabilities Act specifically singles out “transsexuals… and those with gender identity disorder” as classes specifically not protected by the law. In fact, trans people are lumped in with pedophiles, pyromaniacs, kleptomaniacs, exhibitionists, and voyeurs in the law. These restrictions were deliberately put into the law by then Senator Jesse Helms, to avoid government protection of undesirables. The VA is also prohibited from providing surgical intervention to transgender individuals. The Affordable Care Act (ACA) prohibits discrimination based on gender identity, but it does not require coverage of any issues related to gender dysphoria.

The military regulations and instructions related to transgender individuals also rely on older definitions and understandings of gender dysphoria. To remain relevant (and not laughable), the sections related to “transsexualism” and “gender identity disorder” will have to be updated during their next scheduled periodic reviews.

Some opponents of open trans service will point out that trans people are statistically more likely to suffer from depression than the general populace. True. But so are LGB people, and for many of the same reasons: social isolation, ostracization, abandonment by family, harmful labeling, internalized homophobia or transphobia. These are all factors common to both groups. Despite higher rates of depression, the LGB community is given the opportunity to serve. Indeed, the US Supreme Court ruled as far back as 1978, in City of Los Angeles Department of Water and Power v. Mahart et al, that discriminating against groups based on probabilities was unconstitutional. While the military is not bound by constitutional law the same way the civilian world is, the old adage, “what’s good for the goose is good for the gander,” seems fitting.