SECRETARY OF DEFENSE ASH CARTER: Good afternoon, everyone. Thanks for being here.
I am here today to announce some changes in the Defense Department's policies regarding transgender service members. And before I announce what changes we're making, I want to explain why.
There are three main reasons, having to do with their future force, our current force and matters of principle. The first and fundamental reason is that the Defense Department and the military need to avail ourselves of all talent possible in order to remain what we are now, the finest fighting force the world has ever known.
Our mission is to defend this country and we don't want barriers unrelated to a person's qualification to serve preventing us from recruiting or retaining the soldier, sailor, airman or Marine who can best accomplish the mission.
We have to have access to 100 percent of America's population for our all-volunteer force to be able to recruit from among them the most highly qualified and to retain them.
Now, while there isn't definitive data on the number of transgender service members, RAND looked at the existing studies out there, and their best estimate was that about 2,500 people out of approximately 1.3 million active-duty service members, and about 1,500 out of 825,000 reserve service members are transgender, with the upper end of their range of estimates of around 7,000 in the active component and 4,000 in the reserves.
Although relatively few in number, we're talking about talented and trained Americans who are serving their country with honor and distinction. We invest hundreds of thousands of dollars to train and develop each individual, and we want to take the opportunity to retain people whose talent we've invested in and who have proven themselves.
And this brings me to the second reason, which is that the reality is that we have transgender service members serving in uniform today. And I have a responsibility to them and to their commanders to provide them both with clearer and more consistent guidance than is provided by current policies.
We owe commanders better guidance on how to handle questions such as deployment, medical treatment and other matters. And this is particularly true for small unit leaders, like our senior enlisted and junior officers. Also, right now, most of our transgender service members must go outside the military medical system in order to obtain medical care is judged by doctors to be necessary, and they have to pay for it out of their own pockets. This is inconsistent with our promise to all our troops that we will take care of them and pay for necessary medical treat.
I, and the Defense Department's other senior leaders who have been studying this issue the past year, have met with some of these transgender service members. They've deployed all over the world, serving on aircraft, submarines, forward operating bases and right here in the Pentagon. And while I learned that in most cases, their peers and local commanders have recognized the value of retaining such high-quality people, I also learned the lack of clear guidelines for how to handle this issue puts the commanders and the service members in a difficult and unfair position.
One service member I met with described how some people had urged him to leave the military, because of the challenges he was facing with our policies, and he said he just wouldn't quit. He was too committed to the mission, and this is where he wanted to be. These are the kind of people we want serving in our military.
The third and final reason for the change, also important, is a matter of principle. Americans who want to serve and can meet our standards should be afforded the opportunity to compete to do so. After all, our all-volunteer force is built upon having the most qualified Americans, and the profession of arms is based on honor and trust.
Army Chief-of-Staff General Milley recently reminded us of this when he said, and I quote him, "The United States Army is open to all Americans who meet the standard, regardless of who they are. Embedded within our Constitution is that very principle, that all Americans are free and equal. And we, as an Army, are sworn to protect and defend that very principle. And we are sworn to even die for that principle. So, if we in uniform are willing to die for that principle, then we in uniform should be willing to live by that principle." That's General Milley.
In view of these three reasons to change our policy, last July I directed the commencement of a study to identify the practical issues related to transgender Americans serving openly, and to develop an implementation plan that addresses those issues consistent with military readiness, because our mission -- which is defending the country -- has to come first.
I directed the working group to start with the presumption that transgender persons can serve openly without adverse effect -- impact, excuse me, on military effectiveness and readiness, unless and except where objective, practical impediments are identified.
I think it's fair to say this has been an educational process for a lot of people here in the department, including me. We had to look carefully and deliberately at medical, legal and policy considerations that have been evolving very rapidly in recent years. And we had to take into account the unique nature of military readiness and make sure we got it right.
I'm proud of the thoughtful and deliberate manner in which the department's leadership has pursued this review. I've been guided throughout by one central question. Is someone the best-qualified service member to accomplish our mission?
Let me now describe the process we used to study this over the last year. The leadership of the armed services, the Joint Chiefs of Staff, the service secretaries, myself, together with personnel, training, readiness and medical specialists from across the Department of Defense, studied all the data available to us. We also had the RAND Corporation analyze relevant data and studies to help us with our review. And we got input from transgender service members, from outside expert groups, and from medical professionals outside of the department.
We looked carefully at what lessons could be learned from the outside, including from allied militaries that already allow transgender service members to serve openly. And from the private sector also, because even though we're not a business and are different than a company in important ways, their experience and their practices are still relevant.
It's worth noting, for example, that at least 18 countries already allow transgender personnel to serve openly in their militaries. These include close allies such as the United Kingdom, Israel, and Australia. And we were able to study how they dealt with this issue.
We also saw that among doctors, employers and insurance companies today, providing medical care for transgender individuals is becoming common and normalized in both public and private sectors alike. Today, over a third of Fortune 500 companies, including companies like Boeing, CVS, and Ford, offer employee health insurance plans with transgender-inclusive coverage. That's up from zero such companies in 2002.
Similarly, nondiscrimination policies at two-thirds of Fortune 500 companies now cover gender identity, up from just three percent in 2002.
And for the public sector, all civilian federal employees have access today to a health insurance plan that provides comprehensive coverage for transgender-related care and medical treatment.
All this represents a sea-change from even just a decade ago.
Based on its analysis of allied militaries and the expected rate at which American transgender service members would require medical treatment that would impact their fitness for duty or deployability, RAND's analysis concluded that there would be, quote, "minimal readiness impacts from allowing transgender service members to serve openly," end quote.
And in terms of cost, RAND concluded that health care costs would represent, again in their words, "an exceedingly small proportion of DOD's overall health care expenditures."
Now, as a result of this year-long study, I'm announcing today that we're ending the ban on transgender Americans in the United States military.
Effective immediately, transgender Americans may serve openly and they can no longer be discharged or otherwise separated from the military just for being transgender.
Additionally, I have directed that the gender identity of an otherwise qualified individual will not bar them from military service or from any accession program.
In taking the steps, we are eliminating policies that can result in transgender members being treated differently from their peers based solely upon their gender identity, rather than upon their ability to serve and we are confirming that going forward we will apply the same general principles, standards and procedures to transgender service members as we do to all service members.
What I heard from the transgender service members I met with overwhelmingly was that they don't want special treatment. They want to be held to the same standards and be treated like everybody else.
As I directed, the study identified practical issues that arise with respect to transgender service, and it developed an implementation plan to address those issues.
Let me briefly describe that implementation plan. I want to emphasize that in this case, as in the department's decisions on Don't Ask, Don't Tell and women in service, simply declaring a change in policy is not effective implementation.
That is why we have worked hard on the implementation plan and must continue to do so. These policies will be implemented in stages over the next 12 months, starting most immediately with guidance for current service members and their commanders, followed by training for the entire force and then beginning to access new military service members who are transgender.
Implementation will begin today. Starting today, otherwise qualified service members can no longer be involuntarily separated, discharged or denied reenlistment or continuation of service just for being transgender.
Then, no later than 90 days from today, the department will complete and issue both a commander's guidebook for leading currently serving - for leaders of currently serving transgender members and medical guidance to doctors for providing transition-related care, if required, to currently serving transgender service members.
Our military treatment facilities will begin providing transgender service members with all medically necessary care based on that medical guidance. Also starting on that date, service members will be able to initiate the process to officially change their gender in our personnel management systems.
Next, over the nine months that follow, based on detailed guidance and training materials that will be prepared, the services will conduct training of the force and commanders to medical personnel, to the operating force and recruiters.
When the training is complete, no later than one year from today, the military services will begin accessing transgender individuals who meet all standards, holding them to the same physical and mental fitness standards as everyone else who wants to join the military.
Our initial accession policy will require an individual to have completed any medical treatment that their doctor has determined as necessary in connection with their gender transition and to have been stable in their identified gender for 18 months, as certified by their doctor before they can enter the military.
I have directed that this succession standard be reviewed no later than twenty-four months from today to ensure it reflects what we learn over the next two years as this is implemented as well as the most up-to-date medical knowledge.
I've discussed the implementation plan with our senior military leaders, including Chairman Dunford. The chief sent specific recommendations about the timeline, and I made adjustments to the implementation plan timeline to incorporate those recommendations. The chairman has indicated the services support the final implementation timeline that I've laid out today.
Overall, the policies we are issuing today will allow us to assess -- excuse me, access talent of transgender service members to strengthen accomplishment of our mission, clarify guidance for commanders and military medical providers, and reflect better the department's and our nation's principles.
I want to close by emphasizing that deliberate and thoughtful implementation will be key. I, and the senior leaders of the department will therefore be ensuring all issues identified in this study are addressed in implementation.
I'm confident they can and will be addressed in implementation. That's why we are taking the step-by-step approach I've described. And I'm 100 percent confident in the ability of our military leaders and all men and women in uniform to implement these changes in a manner that both protects the readiness of the force and also upholds values cherished by the military -- honor, trust and judging every individual on their merits.
I'm also confident that we have reason to be proud today of what this will mean for our military, because it is the right thing to do, and it's another step in ensuring that we continue to recruit and retain the most qualified people.
And good people are the key to the best military in the world. Our military and the nation it defends will be stronger.
Thank you. And now, I'll take some questions. And -- Phil, you want to start?
Q: Sure. Mr. Secretary, could you talk a bit about -- I know you spoke about the costs for health care. Are there other costs associated with this implementation plan? And could you elaborate a bit on the timing issue, the adjustments in timing you spoke to?
SEC. CARTER: Sure. With respect to cost -- by the way, I will mention that Peter Levine will be here later and will be prepared to answer questions in detail.
But the reason that RAND concluded the costs would be minimal is that the medical treatment that service members who are currently transgender requires fairly straightforward, well-understood -- they were able to make those estimates. And that was, as they said, minimal.
And with respect to accessing new members as I indicated, they will have already completed and been stable in their transition for a period of not less then 18 months before they can access service, so there will be no medical costs associated with that.
And with respect to the timetable for implementation, the -- there's -- as I indicated in the stages, there's the -- the preparation of the medical guidance, that is up to the doctors who need to do that, so that doctors at military treatment facilities all have a standard protocol.
I'm giving them 90 days to that. That is what they asked for. The commanders' guidance, the -- as I indicated, the chairman and the chiefs asked for 90 days in that regard -- to prepare that commanders guidance and the training guidance.
And I agreed to that. I think that's reasonable. That's the amount of time it will take them to complete the job. Obviously, they've begun some of that.
And then, the rest of the time is time to train the force, which is comparable to the time we took to train the force say, in Don't Ask, Don't Tell. We do have some experience in this kind of thing, and we're following that template to successful implementation -- change of this kind.
Q: (inaudible) -- on Russia?
SEC. CARTER: Sure.
Q: –On a separate subject -- there's a report today that spoke to a proposal to strengthen coordination -- military coordination with Russia in targeting al-Nusra in Syria. And I'm just wondering is there -- you've been a skeptic in the past about cooperating with Russia militarily in Syria, given that their motives are different than those of the United States. Has something changed? Would you support this proposal?
SEC. CARTER: Well, we do have a professional relationship with the Russian military to make sure that there are no incidents and no safety issues as we both operate in neighboring areas of Syria. But I -- I've said before, the Russians got off on the wrong foot in Syria. They said they were coming in to fight ISIL. And that they would assist the political transition in Syria towards a post-Assad government that could run the country and put that terribly broken country back together and give the people the future they deserve.
They haven't done either of those things. So I think while I'm still hopeful that they will do both of those things, and I think that's what Secretary Kerry's talks, which are very frequent with the Russians, are all about. But meanwhile, we have a channel which is focused on safety issues, and we maintain that. And that's a very professional working channel between us.
Q: Can I follow up on that and ask you something else? It's a follow-on to Phil's question. You're well known to be skeptical of the Russians and some of the things that they have -- their military has done. So, really straight up, are you willing -- are you in favor now of an expanded effort for military cooperation with the Russians inside Syria?
Because most people in this town think you are not.
SEC. CARTER: If the Russians would do the right thing in Syria, and that's an important condition, as in all cases with Russia, we're willing to work with them. That's what we've been urging them to do since they came in. That's the objective that Secretary Kerry's talks are aimed at. And if we can get them to that point, that's a good thing.
Q: But may I follow up on two small items? Are you willing to include an effort for the U.S. to begin airstrikes against al-Nusra? And may I also ask you about Raqqah? As the world has watched what's happened in Istanbul, how urgent now are you, beyond the usual discussion of accelerants, to see the Syrian Arab coalition and the other fighters get to Raqqah? Because --
SEC. CARTER: Oh, very, very eager to get them to Raqqah. This is the same group that we've been working successfully with, that is they have been successful, and we've been enabling and supporting them, in -- to envelop and take, which they will, from ISIL the city of Manbij, which like Raqqah, isn't as well known, but Manbij is a city from which external plotting has been conducted by ISIL into Europe and into the United States as well.
And was part of the transit hub from the Turkish border down to ISIL in Syria. So that was an important objective. Those same forces, and that same approach, or really the same approach and some larger forces, actually, are the ones that we plan -- and I just was discussing this with General Votel and General MacFarland the other day, along with General Dunford.
Those are the forces that we are going to position to, again, envelop and collapse ISIL's control of Raqqa.
And the reason I want to do that, Barbara, as soon as possible is that Raqqa is the self-proclaimed capital of the self-proclaimed caliphate of ISIL. And it's important to destroy the ISIL in Iraq and Syria, because that's absolutely necessary.
It's not sufficient to avoid all kinds of radicalization and so forth, but it's necessary in order to eliminate the idea that there can be a state based upon that ideology. That's why we are so intent in our military campaign against ISIL on Iraq and Syria. So we would like to get Raqqah as soon as -- as soon as we possibly can, like everything else.
Q: Mr. Secretary, a couple of questions about what this change will mean for the transgender service members. First, can you verify that the health -- the military health care coverage will cover all aspects of transition-related care, including gender reassignment surgery?
And second, will the Pentagon add gender identity or transgender status to the military equal opportunity policy in the event that a transgender service member feels like they're experiencing discrimination?
SEC. CARTER: The answer to the first one is the medical standards don't change. The transgender individual, like all other servicemembers, will get all medical care their doctors deem necessary.
They will have to do that with their -- subject to, if it's non-urgent medical care, subject to their commanders. Because, you know, if they need to be deployed, they need to be deployed. And it's normal that if you -- if you have, say, a procedure which is not urgent, that you have to defer that if you are being deployed.
So we don't have any -- we're not going to have any different medical policy for transgender service members than others. Our doctors will treat them -- give them medically necessary treatment according to the protocols that are determined by the medical profession.
Q: (inaudible) -- MEO policy? Will you add transgender status for the MEO?
SEC. CARTER: You know, I don't know the specific answer to that. I certainly assume the answer is yes, and Peter is telling me yes, that certainly stands to reason that we would. That makes sense.
Let's see. Cory. Cory is not here. How about Paul?
Q: I wanted to follow-up on that question. So there's been some debate on whether the military would only cover hormone therapy versus covering full reassignment surgery. So will reassignment surgery be covered?
SEC. CARTER: This is for currently serving members. Again, that's going to be a matter that the doctors will determine in accordance with what is medically necessary. That's a decision that they make with their physician.
And the timing of it -- of any treatment, of any kind, like any other non-urgent medical care, will be something that their commanders will have a voice in for the very simple reason that we -- we as, in this matter as in all matters, readiness and deployability are critical. Tom?
Q: Mr. Secretary, if I could follow-up very quickly. You said a current service member --
SEC. CARTER: Only because --
Q: So incoming service members who are transition would not be eligible for that transitional surgery?
SEC. CARTER: It depends, Nick. If someone who is transgender and comes out will need to and be required to have undergone transition and be stable in that state for 18 months before they can enter the military.
Q: But the U.S. military will not provide that surgery. Is that what you're saying?
SEC. CARTER: They won't be in the U.S. military at that time because they won't have accessed until they have undergone transition. Tom --
Q: Just wondering, if I could -- how many transgender troops have been dismissed under the old policy? And also, I'm wondering why Chairman Dunford isn't here to discuss this policy since it affects the uniformed military --
SEC. CARTER: I'll take the second part first. This is my decision. However, I have, we have arrived at it together, the senior leadership of the department. They support this timetable, this implementation plan, as I indicated, I actually made some adjustments in it specifically to take into account some of the desire by some of the chiefs to have a little more time on the front end, particularly for the commanders in training guidance, and so I agreed to that because I thought that was reasonable. And I have a general principle around here which is very important which is that it's important that the people who have to implement decisions be part of the decision making, and the armed services are the ones that are going to have to implement that, so it's very important that they've been part of this study, but now, they're a critical part of implementation, because they and I all agree, as I said before, that simply declaring the military open to transgender individuals does not constitute effective implementation. We have work to do and we'll do it and we'll do it together.
Q: Mr. Secretary, in light of the events this morning at Andrews Air Force Base, are you getting a little fed up about all these false alarms for an active shooter? And why the communications problems this morning?
SEC. CARTER: Well, I wouldn't say fed up, because I think we have to take these things seriously when they occur, and I'm sure if a mistake was made here, if somebody inadvertently did, they weren't doing that on purpose, and it also shows a high degree of readiness and rapidity of responses. So it does appear, based on the information that I have at this moment, that this was mistaken, and that this was a drill that was going on that was mistaken for a real event, and a response was made, and that is something -- because it has happened before, that I think we need to pay attention to -- how to minimize the chances of false alarms like that. At the same time, I think it's important to have a reasonable level of awareness of the possibility of this kind of event and what to do, and I thought the response was strong and solid. So that's the good news. The bad news is, it appears to have been a mistake, and we'd like to reduce the number of mistakes made in this way, no question about it. David --
Q: Mr. Secretary, I'm still confused by your answer to Mik's question. Someone who is already in the military, if he is -- he or she is deemed medically -- if sex change surgery is deemed medically necessary, the military will pay for it?
SEC. CARTER: That's correct.
Q: What happens now -- and then you explained the 18 month stable before you commit, but what happens to a service man or woman who joins --
SEC. CARTER: They'll receive --
Q: They join as a man or woman and then decide at some point after they've joined the service that they need --
SEC. CARTER: Any medical treatment in that instance, that is determined to be medically necessary by their doctors, will be provided like any other medical care. However, and I emphasize this, they're subject to the normal readiness requirements that are imposed upon any military serviceman.
Q: So, this is not a one-time -- one-time offer? It -- this is going to --
SEC. CARTER: No, I think our -- our offer in this is an all medical -- because there is no change in medical policy. Medically-necessary policy to serving service -- medically-necessary care to -- as determined by doctors, which is appropriate, will be provided to service members in -- as is part of our promise about medical care in general.
Can I -- one -- one more?
Q: Reaction to the response from Capitol that's, of course, already come in. This is the way things work and this electronic age as -- Chairman Mac Thornberry of the House Armed Services Committee has already reacted to your announcement, even as you're still making it.
And I -- if I could just read a tiny bit of his statement, and just get your response. He says, quote, "This is the latest example of the Pentagon and the president prioritizing politics over policy. Our military readiness, and hence, our national security, is dependent on our troops being medically ready and deployable. The administration seems unwilling or unable to assure the Congress and the American people that transgender individuals will meet these individual readiness requirements."
Can you --
SEC. CARTER: Well, the chair -- the chairman is right -- that is Chairman Thornberry -- is right to emphasize readiness. That is a key part of our -- was a key part of our study, and will be a key part of implementation.
And the chairman and other members of the committee and I -- committees and -- I've actually heard a variety of opinions on this, some urging us to move even faster than we have moved, and some wanting -- and this is very legitimate -- to understand what the effects on readiness and so forth are.
But we have some principles here. We have a necessity here. And we're going to act upon that. We're going to do it in a deliberate, and thoughtful and step-by-step manner. But it's important that we do it.
Q: One question. Is that in Afghanistan -- (inaudible)?
SEC. CARTER: Thank you very much.