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In an essay entitled The Pentagon's Transgender Problem Mother Jones writers Adam Klasfeld and Brett Brownell consider the situation of military service by transgender people and the treatment of transgender veterans.  They have subtitled the piece, in very small type:

New studies suggest that transgender civilians are twice as likely to enlist, and transgender veterans are 20 times as likely to commit suicide.

The piece starts with an examination of the service of Zoey Gearhart.

Ever since she was a boy growing up in small-town Pennsylvania, Zoey Gearhart had "tendencies that were odd."  Raised as Robert Gearhart, she would identify with female characters in books and on TV, in video games and movies.  She would also wear her mother's fake nails, or make her own out of clay. "I was told to stop in no uncertain terms by my father," she said.  In 2007, at the age of 19, she decided to join the Navy.  "I thought maybe joining the military would just help straighten me out," she said.  "Make me into a normal individual."
She applied and was accepted into the Navy SEALS, but her then fiancee pleaded with her not to continue on to BUDS (Basic Underwater Demolition School), so Gearhart became a linguist instead.  All the while she was doing this, she kept her female identity secret.

She decided not to re-enlist in March so she could begin transition.

Even after the repeal of Don't Ask, Don't Tell in 2011, the military still officially forbids openly transgender people from serving.  The end of DADT, Gearhart said, "is this landmark for the LGBT movement.  But there's that hanging T.  Trans service was not even addressed."
A recent study published by the Harvard Kennedy School's LGBTQ Policy Journal Still Serving in Silence: Transgender Service Members and Veterans in the National Transgender Discrimination Survey (pdf), found that 20% of transgender respondents had served in the military…twice the rate of the general public.  A 2011 study by the Williams Institute (pdf) estimates that there are nearly 700,000 transgender people living in the US (3 per thousand).  The American Journal of Public Health (AJPH) was scheduled to release a report yesterday, drawing from Department of Veterans Affairs data.  It documents that the number of people accepting treatment for transgender health issues has double in the past decade.

The article is Prevalence of Gender Identity Disorder and Suicide Risk Among Transgender Veterans Utilizing Veterans Health Administration Care, by Blosnich, Brown, Shipherd, Kauth, Piegari, and Bossarte.

Abstract

Objectives. We estimated the prevalence and incidence of gender identity disorder (GID) diagnoses among veterans in the Veterans Health Administration (VHA) health care system and examined suicide risk among veterans with a GID diagnosis.

Methods. We examined VHA electronic medical records from 2000 through 2011 for 2 official ICD-9 diagnosis codes that indicate transgender status.  We generated annual period prevalence estimates and calculated incidence using the prevalence of GID at 2000 as the baseline year.  We cross-referenced GID cases with available data (2009–2011) of suicide-related events among all VHA users to examine suicide risk.

Results. GID prevalence in the VHA is higher (22.9/100 000 persons) than are previous estimates of GID in the general US population (4.3/100 000 persons).  The rate of suicide-related events among GID-diagnosed VHA veterans was more than 20 times higher than were rates for the general VHA population.

Conclusions. The prevalence of GID diagnosis nearly doubled over 10 years among VHA veterans.  Research is needed to examine suicide risk among transgender veterans and how their VHA utilization may be enhanced by new VA initiatives on transgender care.  (Am J Public Health. Published online ahead of print August 15, 2013: e1–e6. doi:10.2105/AJPH.2013.301507)

Why is the suicide rate so much higher?  It is not something intrinsic to being transgender as some may believe.  Rather, the culprit is STIGMA.

I found this, which was published in May, same journal.

There is a video abstract of Stigma, Mental Health, and Resilience in an Online Sample of the US Transgender Population, by Bockting, et. al.

Back to Mother Jones:

These two new peer-reviewed studies indicate that, beyond being discriminatory, the military's current policy starves the armed services of some of their likeliest recruits, and puts transgender people who serve at greater risk of discrimination, homelessness, and assault than those who don't.
It's wrong that these brave men and women—who sacrifice so much through their service to our nation—should have to fight for their rights both as active military and then as veterans.

--Darlene Nipper, NGLTF

Blosnich says that this newest study is the largest examination of the American transgender community that he knows of.  But it only counts people diagnosed with GID.  
Thus, we strongly believe that our findings underestimate the actual population of transgender veterans in the US.

--John Blosnich, University of Rochester

While many transgender people find the whole notion of a gender identity "disorder" offensive, the GID diagnosis is often the only way for veterans to obtain treatments such as hormone therapy and sex reassignment surgery.  Brown sat on the board of the World Professional Association for Transgender Health (WPATH), which has pushed to replace GID with "gender dysphoria"—a term related to the stress transgender people encounter while transitioning, as opposed to their identities per se.  The American Psychiatric Association officially adopted the change this past May in its new (and particularly controversial) DSM-5 manual.
The military bases its ban on transgender enlistment on what it considers "medical restrictions."  Transsexualism is placed in a category the military calls "psychosexual conditions," which include "exhibitionism, transvestitism, voyeurism, and other paraphilias."  Under current standards a heterosexual male with a missing testicle can be barred from the military.
Transsexuality, in military law, it's treated like a mental disorder, some sort of psychosis.

--Gearhart

The VA is supposedly somewhat more enlightened.  A memo last year emphasized that local Veterans Health Administration facilities are supposed to provide "culturally and clinically competent care" to LGBT veterans.
The VA is progressing.  The VA is trying, but it is a bureaucracy.

--Denny Meyer, Transgender American Veterans Association

Brown, Blosnich and their colleagues found that veterans with a GID diagnosis who use VA services were 20 times more likely to kill themselves than other veterans who use VA services.
Veterans Affairs reported recently that ex-military members "comprised approximately 22.2% of all suicides reported" from 2009 to 2012.  'If this prevalence estimate is assumed to be constant across all US states, an estimated 22 veterans will have died from suicide each day in the calendar year 2010."

--Suicide Data Report, 2012 (pdf)

Blosnich attributes the elevated suicide risk among transgender vets to
high levels of discrimination, violence, and being held to the margins of society.  To be clear, there is no scientific evidence that GID or being transgender causes suicidal behavior…It is likely that suicide risk stems from the stress, isolation, and stigma projected onto transgender populations.

--Blosnich

Gearhart had gotten married.  Her marriage collapsed after her wife said:
If you're trans, I'm going to be really pissed.

I can relate to that.

I think those were her exact words, I think that I was trying to keep my male self intact for her sake.  I really loved her and I didn't want to hurt her, and I didn't want to kill off this person that she loved.

No matter how deep down you try to send it into your subconscious, it's still there and it still breaks itself out.

--Gearhart

Gearhart is currently in New York City, on hormone therapy, and trying to launch a new career as a chef.
I don't want to lose my benefits, and I don't want to end up with a dishonorable discharge.  So I have been forced to live a lie.

--Gearhart

Originally posted to TransAction on Fri Aug 16, 2013 at 04:00 PM PDT.

Also republished by LGBT Kos Community and Voices on the Square.

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