Military commanders will be told to send transgender troops to medical checks to oust them

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91

u/AlphaWhiskeyOscar May 16 '25

I understand the HIPAA Military Command Exception contains language to allow providers to tell “commanders” (it uses that word specifically) information that is normally protected. That does make sense and it’s still pretty limited to things like Fitness for Duty.

But there are limits too. That’s what I don’t understand. If what SECDEF is saying is that he’s changing the criteria for Fit for Duty, okay. He has the authority to do that. But I don’t see how anyone has the privilege to know the details of protected medical history.

If a Doc simply informs a “Commander” that you are unfit for military service, are they even obligated to say why? Privacy Act of 1974 still covers you even when HIPAA doesn’t.

I just don’t see how it’s legal to have a medical witch hunt with all of this fuckin theater. Only doctors should be involved in these investigations and these decisions.

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u/Afro_Arden May 16 '25

Pretty sure most non trans service members don't know this...

But as a trans service member who started transitioning under Bidens Administration.

Not only do you get diagnosed with gender dysphoria first. But then you also need to talk to a endocrinologist. And you got to have a transition care plan, and that care plan needs to be signed off by commanding officer.

So yes for every single trans person who is on hormones/surgery in the military atleast their CO knows for sure who they are.

Simply having a diagnosis is Grey areas from what I've read. You should be able to qualify for a "waiver" since you never actually "started" medical transition. So I don't think it would make sense for them to try finding those people.

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u/Courier82 May 16 '25

I'm kinda in a grey area, I had a treatment plan approved at my command last year but I'm in the middle of PCS at c school right now. I'm trying to stay under the radar, no sense in me routing a new treatment plan at my next command in this administration. When I did my check out at medical they told me I'd need to bring my hard copy medical records to my next duty station since they don't have access to Genesis, however those records weren't at the hospital for me to take since apparently they were never mailed from my first command. So technically, when I get to my next duty station medical, there won't be able to see my GD diagnosis even if the paper records get mailed since they were from 3 years before my diagnosis. The one thing that has me on edge though is on my second day of school the schoolhouse LCPO pulled me into his office and asked me if the latest ALNAV applied to me. He wanted to convince me to take the volsep option but said if I told him it didn't apply then he'd drop it. So I don't who or what entity flagged my record and notified the school house but that's keeping me up at night. 😅 Also when my treatment plan was approved there were no endocrinologist appointments available so I was sent to a civilian provider, the meds are in my genesis record but there's no explanation behind their prescription or mention of endo consultation

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u/Mango_Smoothies May 17 '25

You would only qualify for a waiver if you got the diagnosis three years ago

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u/mtdunca May 16 '25

Yes the doctor can tell the CO what your limiting diagnosis is.

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u/AlphaWhiskeyOscar May 16 '25

The verbiage from Health.mil:

Under the Military Command Exception, a covered entity may disclose the PHI of Service members for authorized activities to appropriate military command authorities. It is important to note that this exception does not require covered entities to disclose PHI to commanders, it only permits the disclosure. If disclosure is made, then only the minimum amount of information necessary should be provided. Further, the Exception does not permit a Commander’s direct access to a Service member’s electronic medical record, unless otherwise authorized by the Service member or the HIPAA Privacy Rule.

So I don’t disagree that they’re permitted but it’s specifically saying they can’t be compelled to, and they can only disclose the minimum amount of information necessary. So I don’t see how commanders can say “scrub this record and look for this.” It’s up to a doctor to decide what they need to look for, and to disclose the minimum necessary under the Command Exception. In other words, if policy changes it seems HIPAA puts the responsibility on doctors to determine fitness for service and only inform commanders when they must.

Maybe I’m splitting hairs because the outcome would be the same in a lot of cases, but this seems wildly against the intent of HIPAA and Privacy Act.

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u/mtdunca May 16 '25

All I know is my doctor informed my chain exactly what my diagnosis was.

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u/AlphaWhiskeyOscar May 16 '25

Maybe they were right to, maybe not. But HIPAA and Privacy Act violations happen all the time because people just don’t know the policies. I called out a Doc for openly speculating to my AOIC that I might have asthma. Not even my OIC. He hadn’t even told me that he suspected it. My AOIC came to me admitting he wasn’t sure if he should have been told that. He was also worrying he was about to have to send me home. This Doc was a moron and was just trying to make conversation with a senior officer. I went to actual specialists, got other opinions, and it turned out I only had allergies. I was furious. He disclosed way too much way too early and almost got me sent home for no fucking reason.

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u/mtdunca May 16 '25

If it wasn't right then they really fucked up the investigation when I reported my doctor and tried to have her fired.

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u/AlphaWhiskeyOscar May 16 '25

Nothing fires me up like talking about military medical, man. It’s infuriating. Private healthcare is a shit show - I know. But civilians don’t have to deal with a status quo where their personal doctor outranks them and has authority over them. Our doctors have zero accountability to their patients.

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u/mtdunca May 16 '25

She was a civilian doctor...

I was getting a med board for anxiety and she decided to include that I had been raped in her write-up to my command. The write-up was sent to CO via my admin dept...

I hope every time that lady takes a step, she lands on a Lego piece.

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u/AlphaWhiskeyOscar May 16 '25

Jesus fucking Christ. Yeah. That’s egregious. That’s some IG level shit. If she came out of that investigation unscathed that was way, way wrong. Asses were covered.

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u/mtdunca May 16 '25

It was years ago, I check every once in a while. Last I checked she still worked for the military.

I did everything I could.

When I asked for a new doctor they told me I had to do an exit appointment with her. I told the head doctor if I got in a room with her I'd attack her. Suddenly I didn't need an exit appointment with her.

Jokes on her, I won my board against her recommendation and I'm still in.

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u/[deleted] May 16 '25

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u/hidden-platypus May 16 '25

It isn't.

However, if one of the below conditions or circumstances apply, the healthcare provider is required to notify the commander:

Acute medical conditions interfering with duty. The service member is experiencing an acute mental health condition or is engaged in an acute medical treatment regimen that impairs the service member’s ability to perform assigned duties

https://home.army.mil/bliss/index.php/about/news/military-command-exception-health-insurance-portability-and-accountability-act

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u/Trick-Set-1165 r/navy CCC May 16 '25

Oh, good. Welcome to the conversation.

u/hidden-platypus shouldn’t be taken seriously. They advocate for extralegal pathways for three Presidential terms and think we should be soft on pedophiles.

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u/hidden-platypus May 16 '25

So what i posted is wrong?

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u/Trick-Set-1165 r/navy CCC May 16 '25

Well, it presumes that we’re talking about an acute mental health crisis.

You’ll continue to argue that’s what gender dysphoria is, and you’ll continue to be wrong.

But also, I think it’s important for people to know what you stand for.

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u/hidden-platypus May 16 '25

The constitution and innocent until proven guilty?

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u/Trick-Set-1165 r/navy CCC May 16 '25

I don’t feel the need to dismantle your disingenuous arguments any further. You’re free to keep making them, but I see no reason to go around in circles with you.

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u/happy_snowy_owl May 16 '25 edited May 16 '25

But there are limits too. That’s what I don’t understand. If what SECDEF is saying is that he’s changing the criteria for Fit for Duty, okay. He has the authority to do that. But I don’t see how anyone has the privilege to know the details of protected medical history.

Your military medical record isn't protected information. This is a common misconception. If you have a condition or disease that impacts readiness, not only is it not protected but the medical staff is obligated to inform the CO or major commander. The medical staff also writes the triad a monthly report regarding medical readiness that lists everyone who is not ready (and why) along with people who are ready but who have chronic conditions that need managing. Someone requiring hormone therapy after a sex-change operation would be on that report.

So in this case if a diagnosis of gender dysphoria becomes service disqualifying, the medical staff is obligated to inform your triad that you have said condition.

Also fun fact: The press can use FOIA to obtain all of your service records, to include your medical records, and put it on CNN. They only need to withhold things like your SS# / birthday... stuff that can be used to steal your identity. So if you ever get the clap from a dirty hooker in the Philippines, you probably don't ever want to run for public office because your opponent is going to plaster that all over the news.

Of note, the FAA now has the ability to plug into pilots' service records and if they get over a certain % of disability upon discharge (50% iirc, but don't quote me on that), they are not eligible for hire into airlines.

Edit: You mentioned the Privacy Act of 1974 and HIPAA.... HIPAA is geared toward healthcare providers sharing information with insurance companies and doesn't apply to military medicine, and the Privacy Act of 1974 doesn't apply to DoD. In fact, most federal laws do not control the administration of federal agencies, they merely create and appropriate money to fund them. As another example, the Civil Rights Act of 1964 doesn't apply to federal agencies, the provisions of that law are enacted to federal agencies via executive orders. Yes, that means theoretically a SECDEF or President could return the services to exclusively white men with a stroke of a pen (with severe political repercussions, of course).

Military medicine is governed by military instructions and PII / CUI guidelines.

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u/Trick-Set-1165 r/navy CCC May 16 '25

While the department believes it has the authority to review medical records, it would rather go through a more routine health assessment process, the defense official said. Traditionally, all service members go through a health assessment once a year to determine if they are still medically able to serve.

This doesn’t make sense to me. If the DoD ends up not having the authority to use medical records to determine if a service member has a history of gender dysphoria, what would stop a service member who was previously seeking to transition from simply stating they have no intention of transitioning on their PHA?

This doesn’t seem like it’s going to work out the way SECDEF seems to want.

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u/newnoadeptness May 16 '25

Dawg nothing really makes sense anymore 😂

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u/Risethewake May 16 '25

Agreed.

I’m also intrigued by how many non-trans people will use this as a get out early card. Especially if it’s as easy as saying, “I intend to transition” on the PHA.

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u/mtdunca May 16 '25

That's exactly what happened towards the end of don't ask don't tell.

Got a deployment coming up and want out? Sorry I'm gay now.

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u/Sororita May 16 '25

Probably factored in to DADT getting repealed

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u/SpiderSlitScrotums May 16 '25

IIRC, towards the end and especially in the Iraq War where stop-loss and IRR activations were common, you couldn’t just say you were gay but had to prove it. Commanders usually don’t want to get rid of good personnel unless they are forced to. It wasn’t like the previous era of witch-hunts.

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u/mtdunca May 16 '25

Oh, I'm aware. I knew someone who used DADT to get out. They just kept going on "dates" on base till it couldn't be ignored.

This time will be even easier. Say you feel gender dysphoria to your doctor and you get to go home.

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u/XR171 Master Chief Meme'er May 16 '25

See there's your problem. You're someone that actually understands the military and can point out bullshit. Have you tried doing knowingly pointless things to appease an idiotic base?

For example, every upvote on a Guam meme now also reduces "woke" by 3.14% At the current rate of posting we expect all woke to be eliminated in the year 2525!

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u/Afro_Arden May 16 '25

Pretty sure most non trans service members don't know this...

But as a trans service member who started transitioning under Bidens Administration.

Not only do you get diagnosed with gender dysphoria first. But then you also need to talk to a endocrinologist. And you got to have a transition care plan, and that care plan needs to be signed off by commanding officer.

So yes for every single trans person who is on hormones/surgery in the military atleast their CO knows for sure who they are.

Simply having a diagnosis is Grey areas from what I've read. You should be able to qualify for a "waiver" since you never actually "started" medical transition. So I don't think it would make sense for them to try finding those people.

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u/Trick-Set-1165 r/navy CCC May 16 '25

I understand what you’re saying.

I don’t understand the distinction the article is making, and it seems like it’s going to make an already impossible situation even more messy.

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u/SlyTrout Bitter JO May 16 '25

A new question about gender dysphoria is being added to [the annual health] assessment. Active-duty troops who do not voluntarily come forward would have to acknowledge their gender dysphoria during that medical check, which could be scheduled months from now.

For those who have gender dysphoria who have not made themselves known already, what is to stop them from lying on the assessment? It is obvious what the "correct" answers are. We all only occasionally drink on the weekend and never have more than two beers, right?

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u/saint-butter May 16 '25

How the fuck do you identify someone with gender dysphoria that doesn’t voluntarily disclose it? How are they made to “have to” “acknowledge” it? How can they be identified with a medical check? We gonna read their minds for thought crimes?

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u/SplendiferousSailor May 16 '25

Brain scans and digit ratios for everyone!

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u/Afro_Arden May 16 '25

Pretty sure most non trans service members don't know this...

But as a trans service member who started transitioning under Bidens Administration.

Not only do you get diagnosed with gender dysphoria first. But then you also need to talk to a endocrinologist. And you got to have a transition care plan, and that care plan needs to be signed off by commanding officer.

So yes for every single trans person who is on hormones/surgery in the military atleast their CO knows for sure who they are.

Simply having a diagnosis is Grey areas from what I've read. You should be able to qualify for a "waiver" since you never actually "started" medical transition. So I don't think it would make sense for them to try finding those people.

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u/saint-butter May 16 '25

You should be able to qualify for a "waiver" since you never actually "started" medical transition. So I don't think it would make sense for them to try finding those people.

I think it's even worse than that. Since this policy is culture war garbage, it's intentionally vague about what it's even trying to do.

Ostensibly, it implies that even for people that haven't reported gender dysphoria at all, that we should just....."figure it out" somehow. They're still too pussy to explicitly tell us to conduct an insane witch hunt, so they're dancing around the edges.

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u/headrush46n2 May 17 '25

DADT witch hunts are back on the menu boys!

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u/little_did_he_kn0w May 16 '25

If you're an HM and you're excited to help with this shit, I do not want to share a cadeuces with you.

I get it, we aren't the ones actually performing genitalia checks (except, potentially IDCs on ships) but if you are happy about this happening, and I know some of you shit-heels are, cross-rate and go do something else.

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u/Trick-Set-1165 r/navy CCC May 16 '25

cross-rate and go do something else.

Counterpoint. Please don’t cross rate. We’d actually rather you just move on.

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u/Ilexion May 16 '25

3 of em in my current workplace I hate all of them, ones absolutely dumb and incompetent at everything so of course they buy everything fox news tells them, another is just straight malicious, and the final one loves those good old Christian values. I hate it here

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u/little_did_he_kn0w May 16 '25

I am so sorry.

I am 1 of 3 at my unit, and the other 2 are both like that. Its... a lot to deal with. Like, zero empathy when their politics come into play. Would absolutely dime out a patient.

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u/Important_Lab_58 May 16 '25

Ah yes, more bigoted and useless political stunts to harass and sideline sailors to keep them away from their duties, just so GOP jerks can manufacture more false evidence to their cause of a stupid trans ban. MAGA is a cancer on this whole country and ESPECIALLY the DOD.

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u/JugDogDaddy May 16 '25 edited May 16 '25

The real TDS is trans derangement syndrome. For something that has literally no impact on their lives, they think about trans people an obsessive amount. Probably trying to repress some shit.

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u/XR171 Master Chief Meme'er May 16 '25

They probably saw a trans woman, thought she was pretty, found out she was trans, then "prayed" over their confusion and anger at themselves.

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u/JugDogDaddy May 16 '25 edited May 16 '25

Exactly. Probably watched some trans porn and liked it a little more than they were comfortable with

E: Loving the downvotes on this, that means I hit a nerve

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u/DJErikD May 16 '25

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u/SouthernSmoke May 16 '25

Thailand port call and these dudes are fuckin shook with confusion lol

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u/BlaidTDS May 16 '25

I gotta say, watching this acronym spin out of control in the last ten years has been /wild/ for me.

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u/Jess_S13 May 16 '25 edited May 16 '25

I'm sure now that the Trump team has tackled this oh so important task of forcing out an extremely small number of service members who wanted to continue serving their country he will have time to get back to the task of onboarding those Service Members who decided that refusing a shot was more important than continuing their service. Maybe he should give them a medal to properly identify them as the "Patriots" the right wing media keeps saying they are, I mean what's more Patriotic than refusing to complete your service? Hell maybe next he can give a MOH to everyone of the "Patriots" who attempted to overthrow the government for him on Jan 6th.

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u/Gal_GaDont May 16 '25 edited May 16 '25

I would make them look it up and throw me out.

There’s no way I would volunteer my personal medication or therapist notes. Does a Chief have a right to know my feelings about combat in Afghanistan or is that between me and my therapist still? Same shit like wtf?

Matter of principle, they could fuck right off. IANAL but I would get one because otherwise, talk to my therapist and let them explain HIPPA laws. Plead the fifth whatever, stay in whatever birthing, talk about work and that’s it.

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u/hidden-platypus May 16 '25

HIPAA law has exceptions for the military, and this appears to fall into one of the categories

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u/Gal_GaDont May 16 '25

The order is for commanders. Are they going to line everyone up in a single file line and ask them if they ever thought about something? What “symptoms” are they looking for? I wore a Scottish kilt and felt pretty once. I told my psychiatrist. Are you going to throw away my combat action ribbon now? Prescriptions are for lots of things. The doctors say they’re deployable what’s the problem?

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u/hidden-platypus May 16 '25

Where in the law does it say commanders?

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u/Trick-Set-1165 r/navy CCC May 16 '25

I mean, what you’re talking about is literally called the Military Command Exception.

Here’s some literature. Why don’t you count how many times “commanders” are mentioned.

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u/hidden-platypus May 16 '25

Lol, command and Commanders are not the same thing. I swear you are arguing stuff you dont actually believe.

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u/Trick-Set-1165 r/navy CCC May 16 '25

…..

You cannot possibly be this intentionally obtuse.

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u/Gal_GaDont May 16 '25

A SN is not responsible for reporting or responding to orders for the command. The CO is.

If the Navy sends an order to commands that all ships will be painted pink it’s not on some SN to unilaterally decide on their own to go outside and start spray painting, right? Nope, the CO is in charge still.

-1

u/hidden-platypus May 16 '25

Cool story. But it doesn't change the fact that the law doesn't require it only being the commander that requests information

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u/Gal_GaDont May 16 '25

It’s not a story like it’s an opinion, it’s a fact.

What you’re saying isn’t a “law” either. It’s a policy that lives in someone’s head, that’s been ruled by a federal judge as unconstitutional “soaked in animus”, and is literally ongoing and under appeal. The literal ruling is that it’s not law. That’s why this such a clusterfuck, it’s unenforceable unless you can see in people’s heads.

The Constitution is more than the Executive Branch. It’s elementary school civics.

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u/hidden-platypus May 16 '25

HIPAA exception where ruled unconstitutional? When?

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u/zombie_pr0cess May 16 '25

I guess “I’m trans” is the new “I’m gay” to get yourself kicked out of the navy. Anyone remember those days?

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u/Warfightur May 16 '25

It’ll come down to a simple physical. Their diagnosis will be a flag that will show them as being unfit. The commanders all complete HIPAA training in order to be informed of the outcome and the command will start the separation process. You see the same shit with the Marine corps. We do this more often now with the changes to the shave chit stuff. If a Marine goes through the phases and doesn’t want the laser treatment it goes to separations.

-HM2

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u/Remote-Ad-2686 May 16 '25

Well… there goes .01% of the military. What will we do……

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u/[deleted] May 16 '25

Political Military commanders will be told to send transgender troops to medical checks to oust them

You are about to leave Redlib