Gender dysphoria treatment included in proposed mental health services overhaul

The Pentagon is poised to make significant changes to its mental health benefits for troops, families and retirees, to include eliminating limits on inpatient services and allowing Tricare to cover hormone therapy for transgender individuals,

In a notice to be published in the Federal Register on Monday, the Defense Department will propose several changes to mental health services to better align the military health program with the Mental Health Parity and Addiction Equity Act of 2008 and the Patient Protection and Affordable Care Act.

DoD is seeking public comment on the proposed changes, which include doing away with time limits on inpatient mental health stays and annual limits for stays at residential treatment centers.

The proposed rule also would eliminate a 60-day limit on partial hospitalization, annual and lifetime limits for substance use disorder treatment and presumed limitations on weekly psychotherapy and family therapy sessions.

But the proposed rule also contains a provision that would require Tricare to cover all "medically necessary and appropriate care for the treatment of gender dysphoria," with the exception of surgery, which would still not be covered.

Under the rule, transgender service members, family members and retirees would no longer have to pay out of pocket for hormone replacement therapy.

Earlier this month, the Washington Blade newspaper quoted Pentagon spokesman Matthew Allen as saying that Defense Secretary Ash Carter will decide this spring whether to lift the ban on transgender individuals serving openly.

On Friday, Defense Department spokesman Air Force Maj. Benjamin Sakrisson said the announcement in the Federal Register is not a harbinger of a change to the ban.

"This rule being put up for public comment is in no way related to a decision by the secretary to allow transgender troops to serve openly," Sakrisson said. "It is simply an attempt to align Tricare benefits with the Mental Health Parity Act and other existing legislation."

LGBT advocacy groups estimate that more than 15,000 transgender individuals serve in the military.

Last February, Army Pvt. Chelsea Manning, formerly known as Bradley Manning, incarcerated at Fort Leavenworth, Kansas, for sending classified documents to WikiLeaks, was granted access to hormonal treatment to transition to becoming a woman.

Manning had filed suit against the federal government to get the treatments.

Patricia Kime covers military and veterans' health care and medicine for Military Times. She can be reached at pkime@militarytimes.com 

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