AMA: Mattis memo distorted medical evidence on transgender troops

The country’s largest medical organization Wednesday told Defense Secretary James Mattis that it believes his recommendations on excluding most transgender people from military service “mischaracterized and rejected” evidence on treatment for gender dysphoria.

“We believe there is no medically valid reason — including a diagnosis of gender dysphoria — to exclude transgender individuals from military service,” American Medical Association (AMA) CEO James Madara wrote in a letter to Mattis. “Transgender individuals have served, and continue to serve, our country with honor, and we believe they should be allowed to continue doing so.”

The association has previously waded into the issue, releasing a statement that said “there is no medically valid reason” to ban transgender troops after President Trump’s July tweets calling for the ban.

Late last month, the Pentagon released a three-page memo and 44-page report Mattis submitted to Trump outlining his recommendations on how to handle transgender troops.

Trump then signed his own memo banning most transgender people from serving in the military “except under certain limited circumstances” and giving Mattis and Homeland Security Secretary Kirstjen Nielsen, who oversees the Coast Guard, “authority to implement any appropriate policies concerning military service by transgender individuals.”

No new policy can go into effect immediately, as courts have issued preliminary injunctions that require the Pentagon to continue allowing open-service while lawsuits work their way through the court system.

In his memo, Mattis wrote that there is “substantial risk” from allowing the service of people with gender dysphoria, or the condition of someone’s biological sex being in conflict with their gender identity. The accompanying report argues that people diagnosed with gender dysphoria suffer from high rates of suicide, anxiety, depression and substance abuse, and that treatment such as hormone therapy and surgery has not proven effective.

The report’s analysis of medical research has come under fire as misrepresenting the findings or leaving out vital context. For example, three of the studies cited in the report pointed to discrimination as a root cause of the increased likelihood of suicide.

In its letter, the American Medical Association echoed those concerns.

“We share the concerns recently expressed by former Surgeons General M. Joycelyn Elders and David Satcher that the Defense Department’s February 22, 2018, Memorandum for the President mischaracterized and rejected the wide body of peer-reviewed research on the effectiveness of transgender medical care,” Madara wrote.

“This research, demonstrating that medical care for gender dysphoria is effective, was the rationale for the AMA’s adoption of policy by our House of Delegates in 2015, that there is no medically valid reason to exclude transgender individuals from military service,” he wrote.

Madara also defended a Rand Corp. study commissioned by the Obama administration that Mattis’s memo said “contained significant shortcomings.” 

“We support the finding of the RAND study conducted for the Department of Defense on the impact of transgender individuals in the military that the financial cost is negligible and a rounding error in the defense budget,” he wrote. “It should not be used as a reason to deny patriotic Americans an opportunity to serve their country. We should be honoring their service.”