The landmark repeal of "don't ask, don't tell" in 2011 allowed gays and lesbians to serve openly in the U.S. military.

Now, transgender individuals on active duty and veterans who have served are fighting for the same right.

At a one-day conference in Washington, D.C., on Oct. 20, troops and veterans who switched sexes while on active duty or afterward said transgender people serving in uniform should not have to hide who they are.

Transgender men and women are barred from serving openly in the U.S. military by Defense Department Instruction 6130.03, which prohibits people with "current or history of psychosexual conditions, including but not limited to transexualism, exhibitionism, transvestism, voyeurism and other paraphilias."

Also see: Leadership is key to troops' tolerance of transgender persons, allied forces say But transgender service members who spoke at "Perspectives on Transgender Military Service from Around the Globe," sponsored by the American Civil Liberties Union and the Palm Center, a California-based policy think tank, say sexual identity is neither a mental nor physical barrier to serving.

"The bottom line is This change needs to happen because it benefits the military," said Paula Neira, a former lieutenant and surface warfare officer who served in the Navy as a man from 1985 to 1991. "We accomplish the mission better, we're more effective as a force, we have more combat efficiency if we can all be who we are ... as opposed to trying to hide, trying to fit in."

A March 2014 report released by the Palm Center by the Transgender Military Service Commission estimated that 15,450 transgender individuals serve in the military U.S. armed forces — across all branches and all components. active duty, National Guard and reserves.

Servicemembers, Partners and Allies for Respect and Tolerance for All, or SPART*A, claims 300 transgender active-duty troops on its rolls and says there are roughly 134,000 transgender veterans.

Medical concerns

SPART*A members, including former Navy Cryptologic Technician 3rd Class Landon Wilson, are lobbying the Pentagon to change its policy that keeps transgender service members from serving.

Wilson enlisted in the Navy as a woman and was serving in Hawaii when the sailor received individual augmentation orders to Afghanistan. During pre-deployment training and leave, Wilson underwent hormone therapy at his own expense and served in the war zone as a man.

He was monitoring a special operations mission on a video feed when a sergeant major pulled him aside to ask about his paperwork, which identified Wilson as female.

"'What are you?'" Wilson recalls the senior non-commissioned officer asking.

He was sent home after being in Afghanistan for less than a month.

"There's not a day that passes that I don't think about rejoining the military, so I look forward to the day I can," Wilson said.

DoD maintains that transgenderism is both a psychological and physical barrier that is incompatible with military service.

Defense Secretary Chuck Hagel said in May he believes all qualified individuals who "want to serve their country ... should have the opportunity to do so."

But he added that the transgender issue is "different because there are certain medical dimensions" to it.

The transgender community cites a change last year to the diagnostic manual used by psychiatrists to define mental health conditions as one of the most powerful reasons against the DoD medical argument.

In late 2012, the American Psychiatric Association approved a revision to the Diagnostic and Statistical Manual that eliminated the term "gender identity disorder" in favor of "gender dysphoria" to describe men and women whose biological sex conflicts with the gender in which they identify.

The drop of the word "disorder" is seen by many as an acknowledgment that the condition is not pathological, and any distress or anxiety associated with gender identification issues may be related to the angst of living in a body one doesn't believe is gender-correct and outside stressors related to the stigma of falling outside gender norms.

'I'm still me'

The five transgender U.S. service members who spoke at the D.C. conference — the first and largest international summit on the topic held in the U.S. — said they do not have anxiety or mental health disorders now that they have transitioned to the gender they should have been from birth.

"I'm still me no matter what I wear — I still have the capability to kick ass," said retired Navy Senior Chief Special Warfare Operator Kristin Beck, who served 20 years in the military as Chris Beck, during which he deployed 13 times with Navy SEAL teams.

Beck proudly wears her Bronze Star, Purple Heart and Special Warfare insignia miniatures on her civilian blazer and is the most public face of transgender military service next to Army Pvt. Bradley Manning.

The subject of a book, "Warrior Princess," and documentary, "Lady Valor," Beck has been meeting with lawmakers and Pentagon officials to push for a policy change.

"This is a personnel issue. What are NCOs, officers, Secretary Hagel supposed to be doing? They are supposed to be taking care of their people," . ... It needs to change," It's one of these issues that's getting kind of tiring," Beck said.

Soon after Beck came out as a woman, Manning announced the day after his sentencing on espionage charges that his name was Chelsea and he planned to live at the U.S. Disciplinary Barracks in Fort Leavenworth, Kansas, as a woman. Manning filed suit in September to force the government to provide hormone replacement therapy.

Beck and others said they are conflicted about Manning — happy that she has called attention to the issue of transgender personnel in the military but deeply troubled by her crimes.

Looking to leadership

At the Washington, D.C., conference, Army Reserve Capt. Sage Fox was the only U.S. service member to appear in uniform. A signal officer, Fox returned home from deployment to Kuwait in 2012 and, while on the inactive ready reserve list, decided to divorce his wife and transition to becoming a woman.

But Fox was recalled to active duty to undergo a medical evaluation board for an injury and surgery unrelated to her sexual reassignment. She told her unit she was in gender transition and planned to serve as a woman, which the unit initially appeared to accept.

But after serving on active duty for several weeks, she was placed back on inactive status while the disability process played out.

"It was devastating to me to get pushed out like that," Fox said.

The Pentagon has not launched a formal review of the ban on transgender service, but the Army has asked Hagel for permission to evaluate treatment options for prison inmates diagnosed with gender dysphoria, DoD officials said.

According to Beck, many transgender advocacy groups have been working for a policy change.

Several sources said representatives also have met with Defense Department officials and Department of the Army senior-level executives to discuss the issue.

And although the Army would not publicly confirm it, Beck said Debra Wada, assistant secretary of the Army for manpower and reserve affairs, met Oct. 22 with representatives of SPART*A to discuss current the policies. — a sign members see as encouraging.

Fox, who is prior-enlisted, said transgender individuals will be able to serve once leadership demands that it happen and military jobs occupational specialties that are now closed to women become open., allowing individuals to serve regardless of gender.

"The attitude has to come from the leadership, from the top on down like anything else. And once we gender-neutralize everything ... for positions, MOS, etc., the issue is going to go away," Fox said.

This story was updated on Nov. 14 to reflect new information.

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Transgender Q and A

Q. What is "transgender"?

A. Transgender individuals are people who identify with a gender different from the physical gender they were born with. Biological sex — male or female — is defined by chromosomes and sex organs. Transgender individuals possess a psychological self different from their physiological sex.

Q. What is "transexual"?

A. Transexual individuals believe they mistakenly were born into the wrong biological sex. Some undergo hormone treatments or surgery to switch their physical sex to match their gender identity.

Q. What pronouns do transgenders use to identify themselves?

A. At the recent conference in Washington, D.C., transgenders identified themselves with the pronouns appropriate for their gender identity, not their biological sex at birth. Former men now living as women or who have undergone surgery to become female have adopted feminine names or kept their gender-neutral names and prefer being referred to as "she" and "her" while men who were once women have adopted male names and prefer "he" and "him."

Q. What is "passing"?

A. It's the term used in the transgender community to describe a person's ability to be viewed as a biologically born male or female. Hair, makeup, clothing and mannerisms as well as physical attributes associated with one gender or the other can help transgenders assimilate in their gender identity group.

Q. How many transgenders are estimated to serve in the U.S. military?

A. The Transgender Military Service Commission estimates that 15,450 transgender individuals serve, across all service branches and components.branches and on active duty and in the National Guard and reserves.

Q. Does the military pay for hormone therapy or sex reassignment surgery?

A. Sexual reassignment surgery is not covered by the Defense Department or Tricare, with the exception of the treatment of ambiguous genitalia documented to have been present at birth, as in the case of some intersex individuals who are born with reproductive or sexual anatomy not typical of a male or a female.

Q. Why does DoD not allow transgenders to serve openly?

A. DoD instructions define transgenderism and transexualism as a psychological condition incompatible with military service. — Patricia Kime

Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.

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