In the sitcom “M*A*S*H,” Cpl. Maxwell Klinger was so desperate to escape his assignment to a mobile army surgical hospital during the Korean War that he dressed as a woman in an attempt to prove he was mentally unfit to serve.
At the time, it was accepted that people who suffered from what is now called “gender dysphoria” weren’t suited for military duty. But in today’s military, Klinger would be considered “transgender” or “gender-nonconforming” and would be accepted openly without fear of dismissal.
That’s been the case for pediatrician Rachel Levine, a man who identifies as a woman. In 2021, Levine was named President Joe Biden’s assistant secretary for health for the U.S. Department of Health and Human Services.
Levine began wearing a skirted military uniform after being ceremonially sworn in as a four-star admiral. That makes Levine the highest-ranking official in the U.S. Public Health Services Commissioned Corps. But that doesn’t change what one former Army neuropsychologist considers to be serious issues with allowing those with gender dysphoria into the military.
Transgender soldiers taking hormones are more likely to suffer from mood swings and health problems, making them a higher mission risk when deployed, according to Alan Hopewell, a neuropsychologist in Fort Worth, Texas. The effects of medication taken by “sexually confused individuals” on military induction and retention could be significant, Hopewell told The Epoch Times.
“Nobody has addressed the medication issue,” he said.
Department of Defense officials didn’t respond by press time to a request for comment about whether the effects of transgender treatments on soldiers had been studied.
A large Danish transgender suicide and mortality study published in the Journal of the American Medical Association on June 27 showed that transgender individuals had “significantly higher rates of suicide attempt, suicide mortality, suicide-unrelated mortality, and all-cause mortality compared with the non-transgender population.”
Fit to Serve?
Hopewell was asked to write about the issue for Combat Stress magazine. He is a retired U.S. Army major, and he was awarded the Bronze Star as a prescribing psychologist in Operation Iraqi Freedom. Under the Biden administration, the U.S. Army changed its rules in 2021 to allow those with gender dysphoria—confusion and distress over biological sex—to serve.
Gender identity would “no longer be a basis for involuntary separation or military discharge, denied reenlistment or continuation of service, or subjected to adverse action or mistreatment,” according to an explanation of the policy changes on the U.S. Army website.
As a neuropsychologist able to write prescriptions, Hopewell spent much of his career determining whether soldiers were fit to serve in the Army. While the military is allowing transgender personnel, it appears no studies have been done on how the prescription drugs that are needed to maintain a “gender transition” may affect combat readiness, he said.
As a general rule, Army soldiers who need more sophisticated health monitoring can’t be deployed on a mission to a place where medical access is limited, he said. Army policy requires deployed soldiers to be treatable by a general practitioner because specialized care isn’t available in places such as Iraq, where he served, he said.
Hopewell pointed to testimony from transgender patients before the Texas Legislature this spring—one testified that receiving care from anyone other than an endocrinologist was difficult.
Medications that transgender patients need could even cause health and mental problems, he said. Testosterone, the male hormone used to help women appear more masculine, has been connected to sudden outbursts of intense anger termed “roid rage.”
Transgender patients take “massive” doses of testosterone or estrogen, which disrupt brain function and the entire physical system of the body, he said.
“There are substantial issues” that likely affect transgender people who join the military, Hopewell said.
“I’m not saying that nobody [transgender] could serve. But we have to recognize that this is a very complicated, serious issue and many of these people aren’t going to be able to be retained.”
Challenging, Expensive Medical Needs
And even if they are allowed to serve, it could take significant medical resources to deal with transgender medical needs, he said.
High doses of hormones have contributed to erratic behavior exhibited by some gender dysphoric people, he said, and Army medics aren’t equipped to deal with such issues in the field. But some military officials, such as Coast Guard Capt. Jay Caputo, have dismissed medication concerns surrounding transgender soldiers.
Hormone treatment for transgender soldiers is no different from birth control pills for female soldiers, Caputo wrote in a December 2017 article published by the U.S. Naval Institute magazine.
“Military members deploy worldwide every day while taking the same medications transgender persons use, just for different reasons,” Caputo wrote. “While the situation is not ideal, it would not limit a person’s ability to perform their duties.”
Caputo, a transgender service member who has served openly since June 2017, chalked up resistance to transgender soldiers to “transphobia.”
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“Many do not understand what it means to be transgender,” Caputo wrote. “They think it is a mental illness (it is not). They think it is a choice (it is not). They think the costs are exorbitant (they are not). They worry transgender persons will flood into the military for a taxpayer-funded sex change (not realistic). Once the myths are debunked and the facts established, what is left?”
Hopewell, who treated people with gender dysphoria decades ago, disagrees. Patients he saw in the 1970s while working at the University of Texas Medical Branch at Galveston struggled with mental illness, he said.
Transgender patients often have other mental issues, such as depression and anxiety, Hopewell said, and giving hormones to a person already under mental stress could produce adverse outcomes. Testosterone abuse in weightlifting and bodybuilding circles brought attention to the issue when a law against steroid use was passed in 1990.
As Caputo pointed out, critics of allowing transgender people to serve in the military have speculated that many join for free sex-change operations and hormones and that that would burden the health care system for the military.
The U.S. Department of Defense spent $11.6 million on psychotherapy for service members with gender dysphoria from Jan. 1, 2016, to May 14, 2021, according to Military.com. Within the department, 637 service members received hormone therapy for gender dysphoria during the same time at a cost of $340,000. And there were 243 “gender-transition” surgeries, performed at a cost of $3.1 million.
The Pentagon’s total annual medical budget for health care programs in 2016 was $33.5 billion. The proposed budget for fiscal 2022 called for $35.6 billion in discretionary spending for health care, according to the website, which is run by a private company that tracks news on all branches of the U.S. military.
Gender-Altering Care for Veterans
The Department of Veterans Affairs (VA) also appears poised to cover gender transition surgery under a new policy being reviewed by VA Secretary Denis McDonough. But resistance to the policy change is building.
In June, the Congressional House Appropriations Committee crafted a budget prohibiting the use of federal dollars for gender-transition hormones and surgeries at VA facilities.
It would be hard to prove that gender-confused people sign up for the military to get sex-change operations and treatment paid for at taxpayer expense, Hopewell said. Yet once they’re in the military, their ongoing care would be covered under the Veterans Administration, including after discharge.
“So the reality is that we’re going to have a tremendous cohort of people that maybe come in for a year” and get care for a lifetime, he said.
Article cross-posted from our premium news partners at The Epoch Times.