On Monday, President Joe Biden signed the “Servicemember Quality of Life Improvement and National Defense Authorization Act for Fiscal Year 2025” (H.R. 5009), a sweeping Pentagon policy bill worth an estimated $895 billion. While the measure includes key military priorities—such as a 14.5 percent pay raise for junior enlisted troops, expanded funding for defense programs in the Indo-Pacific, and the construction of new ships and aircraft—it also carries a controversial provision that bans the military’s health care program, TRICARE, from providing certain forms of gender-affirming care to transgender minors.
This provision, championed by Speaker of the House Mike Johnson (R-La.), has been roundly criticized by transgender advocates, medical professionals, and many military families, who say it undermines both the well-being of trans youth and the fundamental freedom of parents to decide on the best possible care for their children. Despite calling the language “bigoted” and promising to veto legislation that discriminates against transgender Americans, President Biden signed the bill—sparking anger and disappointment among families who rely on TRICARE for crucial health services.
Below is a closer look at the bill’s provisions, the response from the White House and advocacy groups, and what all this may mean for the thousands of transgender military dependents who stand to be affected.
Controversial Provision on Gender-Affirming Care
The most significant sticking point in this new defense legislation lies in a clause that restricts TRICARE from covering certain forms of gender-affirming care for transgender dependents under 18. Specifically, the law bans coverage for treatments “that could result in sterilization,” effectively limiting access to puberty blockers, hormone therapy, and in some interpretations, medically necessary surgical interventions—even if recommended by medical professionals.
According to supporters of the provision, this ban maintains “military readiness” by preventing funds from being used on procedures they see as outside the military’s core mission. Opponents, however, argue that withholding coverage for medically recognized treatments does nothing to advance military strength or troop morale. Quite the opposite: it puts transgender children at serious risk of mental and physical distress, potentially driving service members to leave the armed forces in order to seek health care for their children elsewhere.
President Biden, who signed the measure into law, did not mince words when voicing his opposition. “This section undermines our all-volunteer military’s ability to recruit and retain the finest fighting force the world has ever known,” the president said. “No service member should have to decide between their family’s health care access and their call to serve our Nation.”
Broader Concerns for Trans Youth
Transgender youth are already disproportionately affected by mental health challenges, with limited access to specialized care compounding those risks. Research shows that denial of gender-affirming treatment often leads to self-medication or other risky behaviors. In a statement to NBC News, Dr. Jason Nagata of the University of California, San Francisco, highlighted that many transgender youth may resort to restricting their diets or developing disordered eating patterns to suppress gendered traits that cause them distress.
For example, trans boys may severely limit their caloric intake to avoid menstruation, while trans girls sometimes engage in disordered eating to minimize facial hair growth or changes in body shape. These coping mechanisms can lead to long-term health problems, including malnutrition, organ damage, and severe psychological distress.
A 2019 study in the Journal of Adolescent Health, titled “Eating Disorder Screening in Transgender Youth,” found that 63 percent of surveyed participants had manipulated their weight for gender-affirming purposes. Such data underscore how quickly trans young people can resort to dangerous methods when medically sanctioned avenues—like puberty blockers or hormone therapy—are withheld.
Moreover, mental health and suicide prevention organizations such as The Trevor Project have reported spikes in crisis contacts following anti-LGBTQ legislation or major political events that threaten the rights of transgender individuals. A notable 700 percent increase in outreach was documented after a tumultuous election, suggesting that government actions—and even rhetoric—can profoundly influence trans youths’ sense of security and well-being.
Fallout Among Military Families
For many families that rely on TRICARE, the new ban feels like a betrayal of the very government they serve. Military life already entails frequent moves, long deployments, and demanding schedules. Having accessible, consistent health care is critical for these families, who now worry they may be forced to uproot themselves again—this time in pursuit of the health services their children desperately need.
Rachel Branaman, executive director of the Modern Military Association of America (MMAA), said the NDAA’s inclusion of this anti-trans provision is “in direct opposition to claims that this administration is the most pro-LGBTQ+ in American history.” Branaman and others argue that the legislation disproportionately harms some of the most vulnerable individuals: young people juggling both a transgender identity and the unique pressures of military life.
“It’s a slap in the face,” said one military spouse who requested anonymity for fear of reprisals. “My child has already endured so much—dealing with deployments, new schools, new friend groups—and now, they’re being told that the government my spouse serves doesn’t value their right to access medically necessary care.”
President Biden included a formal statement alongside his signature, reiterating his “strong opposition” to the measure’s anti-trans language. He called on Congress to repeal the restriction, describing it as an attack on the rights of parents to make medical decisions on behalf of their children.
Still, many in the transgender community question why Biden, who previously vowed to veto legislation targeting trans health care, chose to sign the NDAA rather than block it. The White House defends the decision by pointing to the NDAA’s must-pass nature—defense authorization bills have passed annually for over six decades, typically with bipartisan support. Failing to sign the bill could have jeopardized crucial military funding, pay raises, and other vital programs. As a compromise, the Biden administration asserts that it will push Congress to remove the provision at the earliest opportunity.
Political Maneuvering and Future Implications
The debate over the NDAA’s transgender health provision highlights a broader pattern of cultural controversies attached to military policy. From the repeal of “Don’t Ask, Don’t Tell” over a decade ago to more recent disputes over diversity and inclusion initiatives, the U.S. military is frequently at the center of hot-button social issues.
Republican leaders who championed the anti-trans amendment argue that the military must prioritize what they label “lethal readiness” over what they see as “social experiments.” Democrats like Rep. Adam Smith (D-Wash.), a senior figure in the House Armed Services Committee, call that framing disingenuous, pointing out that denying a standard of care recognized by major medical associations hardly furthers readiness—and, by potentially pushing out skilled service members, could do just the opposite.
The NDAA’s trans care ban also affects a vulnerable population already scrutinized by a flurry of state-level anti-trans bills and court rulings. Though the White House has historically endorsed policies that protect LGBTQ+ individuals, its critics are quick to note that a single signature can overshadow rhetorical support. Looking ahead, the measure’s ultimate fate may lie with future legal challenges, potential amendments, or the Defense Department’s own interpretations of how strictly the ban is enforced.
Standing With Trans Youth and Military Families
For transgender individuals, their families, and allies, the NDAA’s passage is bittersweet—celebrating needed gains for military families in one breath and, in the next, grieving over the singled-out discrimination against trans youth. Organizations like The Trevor Project and the Human Rights Campaign remain vigilant, offering resources and emotional support to those who feel threatened or isolated by the new legislation.
Kelley Robinson, president of the Human Rights Campaign, noted that many military families will face “significant hardships” as they attempt to navigate inconsistent coverage and uncertain care pathways for their children. “For them, this law is not about politics—it’s about losing the freedom to make their own health care decisions.”
Transgender advocates stress that hope and support remain—both within and outside the military community. They encourage families to seek out inclusive providers in their local areas and to stay connected with advocacy organizations that are pushing back against the NDAA’s discrimination. Grassroots efforts, along with potential lawsuits challenging the legality of the TRICARE ban, may serve as a lifeline for families caught in the crossfire of this political tug-of-war.
The Bottom Line
Ultimately, the NDAA’s new provision on trans health care brings the intersection of politics, military life, and medical ethics into sharp focus. While the bill secures vital funds for national defense, it also raises pressing questions about whether transgender youth—especially those with parents serving in uniform—are being left behind. This precarious balance between national priorities and individual freedoms will remain a point of contention as both legislative battles and court challenges unfold.
For transgender youth and their loved ones, the immediate path forward calls for resilience, community support, and continued advocacy. As many service members and their families now face an uncertain landscape of restricted medical coverage, organizations serving transgender and military communities urge them not to lose hope.
President Biden’s signature on the NDAA has concluded one chapter in this saga—but it may only be the beginning of a broader fight for the well-being, dignity, and rights of transgender military children. In the words of one LGBTQ+ military advocate: “Our trans kids deserve better. And we’ll keep working until they get it.”
