House Passes Defense Bill That Strips Health Care From Military Families’ Trans Kids

The House passed a bill on Wednesday that authorizes funding for the military — with a last-minute GOP provision to striphealth care from military families’ transgender kids tucked into it. 

Lawmakers voted 281 to 140 to pass the fiscal 2025 National Defense Authorization Act, authorizing more than $895 billion in defense spending through next September. More than 120Democrats opposed it, along with 16 Republicans.

Congress votes every year on an NDAA, which is considered must-pass legislation because it authorizes funding for all of the country’s defense priorities. House Democrats worked with Republicans to craft the bulk of the current bill, which is a whopping 1,813 pages long.

But GOP leaders inserted the anti-trans provision after bipartisan negotiations were done. It’s buried on page 399: “Medical interventions for the treatment of gender dysphoria that could result in sterilization may not be provided to a child under the age of 18.”

This language — if it stays in the version of the bill that is ultimatelypassed by the Senate and signed into law by President Joe Biden — will put parents in the position of having to choose between their careers in the military and providing medically necessary health care for their loved ones.

It’s not clear how many transgender kids are enrolled in TRICARE, the military’s health care system, but one analysis in 2022 found that 2,500 minors sought care for gender dysphoria through TRICARE in 2017, and 900 received puberty blockers or gender-affirming hormones.

The language of this provision also mischaracterizes the health care offered to young trans people. The procedures that Republicans often point to when talking about trans health care — surgeries performed on a patient’s genitals — are never done on young children; they are tightly regulated even for adults and are only ever approved after consultations with medical professionals.

Gender-affirming care that trans kids get before they’ve hit puberty is typically mental health support and guidance for social transitioning. Once a kid hits adolescence, they may take puberty blockers, medicine that delays the changes of puberty. This doesn’t cause permanent physical changes; when someone stops taking puberty blockers, their natural puberty resumes.

There is no requirement or policy reason to include a provision like this in an NDAA. But Republicans have been relentlessly attacking trans 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, was essentially daring Democrats to oppose the NDAA over it. The bill includes lots of things they do like, including a 4.5% pay raise for everyone in the military and a 14.5% pay raise for junior enlisted troops.

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-trans language.

“This is denying health care to minors who clearly need it,” Smith said on the House floor. “We have an outright ban on care that undoubtedly is saving lives of minors experiencing gender dysphoria, and the anxiety and depression and suicidal thoughts that come with that.”

He noted that the provision’s reference to “sterilization” is written so vaguely that it could be interpreted as a ban on any gender-affirming care necessary for transgender kids’ health and well-being, including medicine like puberty blockers.

“We are doing it because of ignorant, bigoted reasons against the trans community,” said the Washington Democrat. “The medical profession has no dispute that in some instances, this treatment is crucial to the health and well-being of our children, and we are now denying that to the children of servicemembers. I think that is problematic.”

Rep. Jill Tokuda (D-Hawaii), a member of the House Armed Services Committee, called the provision “a shameful attack” on military families.

“For transgender people, gender-affirming care is health care,” said Tokuda. “To deny them this care is to deny they exist. The reality is, they do.”

She noted the irony of the GOP’s name for the bill, the Servicemember Quality of Life Improvement and National Defense Authorization Act, as it would striphealth care from some service members’ children.

“It’s not just ironic, it’s twisted,” said the Hawaii Democrat. “It’s cruel and it’s plain wrong.”

The bill now heads to the Senate, where Democrats hold a slim majority. But it’s not clear if Democrats have to votes or the will to remove the anti-trans provision, pass the bill without it and send it back to the House to approve.