WASHINGTON – The House of Representatives passed a bill Wednesday that would allow funding for the military — with a last-minute GOP provision to strip health care from the transgender children of military families put into it.
Lawmakers voted 281 to 140 to pass the 2025 National Defense Authorization Act, which would authorize more than $895 billion in defense spending through September 2025. More than 120 Democrats opposed it, along with 16 Republicans.
Congress votes on an NDAA every year, which is considered must-pass legislation authorizes funding for all of the nation’s defense priorities. Democrats in the House of Representatives worked with Republicans to draft the bulk of the current bill, which is a whopping 1,813 pages long.
But Republican leaders inserted the anti-trans provision after bipartisan negotiations concluded. It is buried on page 399: “Medical interventions for the treatment of gender dysphoria that could lead to sterilization should not be given to a child under the age of 18.”
House Republicans have stopped a provision in the National Defense Authorization Act that would eliminate health care coverage for trans children of military families. The House Rules Committee
This language — if it is in the version of the bill that ultimately passed by the Senate and signed into law by President Joe Biden – will put parents in the position of having to choose between their career in the military and providing medically necessary health care to their loved ones.
It’s not clear how many transgender children are enrolled in TRICARE, the military’s health care system, but one analysis in 2022 found that in 2017, 2,500 minors sought help for gender dysphoria through TRICARE, and 900 minors received puberty blockers or gender-affirming hormones.
The wording of this provision also mischaracterizes the health care provided to young transgender people. The procedures that Republicans often point out when it comes to trans healthcare: surgery on a patient’s genitals is never performed on young children; in fact, they are strictly regulated adults And are only approved after consultation with medical professionals.
Gender-affirming care that trans children receive before they reach puberty typically consists of mental health care and social transition guidance. Once a child reaches puberty, he or she can take puberty blockers, medications that slow the changes in puberty. This does not cause permanent physical changes; when a person stops taking puberty blockers, natural puberty resumes.
There is no requirement or policy reason to include such a provision in an NDAA. But Republicans have been relentlessly attacking transgender health care access all year, and their decision to add this language is simply an extension of those efforts.
Speaker Mike Johnson (R-La.), who wanted the anti-trans language in the bill, essentially challenged Democrats to oppose the NDAA on it. The bill includes a lot of things they like, including a 4.5% pay increase for everyone in the military and a 14.5% pay increase for junior enlisted men.
But even Rep. Adam Smith (D-Wash.), the top Democrat on the House Armed Services Committee who worked with Republicans to help craft the bill, voted against it on Wednesday because of its anti-transgender language.
“This denies health care to minors who clearly need it,” Smith said on the House floor. “We have an outright ban on care that will undoubtedly save the lives of minors experiencing gender dysphoria, and the anxiety, depression and suicidal ideation that comes with it.”
Speaker Mike Johnson (R-La.) said he was “proud” of the NDAA bill that includes a provision that would strip health care from trans children from military families. via Associated Press
He noted that the provision’s reference to “sterilization” was written so vaguely that it could be interpreted as a ban on each gender-affirming care necessary for the health and well-being of transgender children, including medications such as puberty blockers.
“We’re doing it for ignorant, bigoted reasons against the trans community,” the Washington Democrat said. “The medical profession does not dispute that in some cases this treatment is critical to the health and well-being of our children, and we are now denying that to the children of service members. I think that’s a problem.”
Rep. House Armed Services Committee member Jill Tokuda (D-Hawaii) called the provision “a shameful attack” on military families.
“For transgender people, gender-affirming care is healthcare,” Tokuda says. “If you deny them this care, you deny that they exist. The reality is that they do.”
She noted the irony of the Republican Party’s name for the bill, the Servicemember Quality of Life Improvement and National Defense Authorization Act, since it would deprive health care some service members children.
“It’s not just ironic, it’s twisted,” the Hawaiian Democrat said. “It’s cruel and it’s downright wrong.”
The bill now goes to the Senate, where Democrats have a slim majority. But it’s not clear whether Democrats should vote or have the will to eliminate the anti-trans provision, pass the bill without it and send it back to the House of Representatives for approval.
