Under the plan, a soldier must obtain a diagnosis from an Army medical provider and put together a transition plan and timeline approved by both their doctor and their command, before eventually changing their gender in DEERS (Defense Enrollment Eligibility Reporting System) and beginning to live and serve in the gender they identify with. [The document uses the phrase "preferred gender"...showing that they are still struggling a bit with the concept].
The Army does not track the number of transgender soldiers currently serving, according to Paul Prince, an Army spokesman, but a 2016 Rand Corp. report commissioned by the Defense Department estimated that there are about 2,400 transgender men and women currently serving in the military as a whole.
There are no physical requirements to begin a gender change, other than confirmation from a doctor that a transition is medically necessary, according to the directive.
Transition plans will be completely individual as far as surgeries, hormones or other medical interventions.
Costs associated vary widely, as each person has to determine the mix of physical transformations they want to undertake. Hormone therapy, for instance, costs about $100 a month, according to the Transgender Law Center.
Sex reassignment surgery can costs tens of thousands of dollars, but is not required for an individual to transition. Other surgeries can include breast implants, breast reductions, tracheal shaving and numerous facial tweaks, but the Army won't necessarily cover all of those.
The Army is committed to the appropriate levels of medical care and resources that best support our leaders, soldiers and families, which ultimately enhances total force readiness and capability. To this end, Army offices responsible for its transgender policy are currently collaborating with officials in DoD Health Affairs to develop further guidance concerning approved medical operations and procedures.
To complete a transition, as soldier must provide written confirmation from their doctor that they are "stable" -- according to the doctor -- in their new gender to their brigade-level commander.
Then they must submit legal evidence of their gender change, including a reissued birth certificate, a court order or a passport with their preferred marker.
Once that is cleared, the commander will send a written letter to Human Resources Command, which has 30 days for active duty and 60 days for reserve component soldiers to make the change in DEERS.
Reservists and Guardsmen go through the same plan, though if they are not eligible for Army medical care at the time of the transition, they must get a diagnosis from a civilian provider and have it approved by the Army Reserve Command's command surgeon, or the chief surgeon at the Army National Guard.
Commanders should approach a soldier undergoing gender transition in the same way they would approach a soldier undergoing any medically necessary treatment. Commanders will continue to minimize effects to the mission and ensure continued unit readiness.
In order to keep things running smoothly, commanders will have the power to adjust a soldier's transition date, offer extended leave or put the soldier on temporary disability status.
--Army Directive 2016-35
In cases where soldiers require medically necessary but non-urgent procedures, the commander by regulation may adjust the date on which a soldier’s procedure will take place.
As long as a soldier is reporting for duty every day during a transition, policy dictates that they will be treated according to their gender marker in DEERS, following uniform and grooming regulations as well as physical fitness standards.
The part most everyone seems to be most interested in:
According to the directive, commanders are allowed to change a soldier's billet or local bathroom and shower rules to protect privacy or modesty interests, but commanders cannot require that -- for example -- a male-to-female transitioning to use women's facilities.
Units also aren't allowed to modify or redesignate facilities to make them "transgender-only."