The Senate has voted 85 to 14 to pass the National Defense Authorization Act (NDAA), a $895.2 billion military bill containing a provision to restrict gender-affirming care for trans children covered by Tricare, the military’s medical insurance. Lesbian Sen. Tammy Baldwin (D-WI), who unsuccessfully tried to get the provision removed, said that Republicans had “broken” and “poisoned” the final bill with the provision.

The NDAA contains a provision banning any medical treatment for “gender dysphoria that could result in sterilization” for those under 18. It’s unclear if the current legislation would ban puberty blockers (which don’t affect fertility), hormone replacement therapies (which can), or mastectomies (which are rarely ever performed on minors).

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The NDAA would remove gender-affirming care coverage for servicemembers’ trans children.

The bill will now head to President Joe Biden to be signed into law. Biden has previously pledged to veto any legislation that harms the LGBTQ+ community, but the NDAA is traditionally considered a “must pass” bipartisan bill that typically becomes law without much opposition.

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That tradition has changed in recent years as House Republicans have inserted “culture war” items into the NDAA meant to combat “wokeism” in the military. Last year, Republicans tried to remove any gender-affirming care coverage for trans troops, ban any book that has “pornographic materials,” and eliminate any offices overseeing diversity, equity and inclusion (DEI) efforts. All of the anti-LGBTQ+ provisions were removed from last year’s bill.

This year, House Speaker Mike Johnson (R-LA) inserted the gender-affirming care provision into the NDAA, turning some congressional Democrats against it. Yesterday, Sen. Baldwin debated alongside three other Democratic senators to get the provision removed. Baldwin also introduced an amendment to eliminate the provision; 20 other Democratic senators supported her amendment, but it failed to pass.

In a statement, Baldwin argued that lawmakers’ commitment to U.S. service members has been “broken” and noted that the provision will affect between 6,000 and 7,000 military families. 

“It has been broken because some Republicans decided that gutting the rights of our service members to score cheap political points was more worthy,” she said before the Senate vote. “We’re talking about parents who are serving our country in uniform, having the right to consult their family’s doctor and get the health care they want and need for their transgender children, that’s it.”

“Some folks poisoned this bill and turned their backs on those in service and the people that we represent,” she added.

Last week, the House passed the NDAA in a 281-140 vote. Rep. Chris Pappas (D-NH) was among the 81 Democrats who supported the bill and was the only out gay House member to do so. Pappas said he supported the bill because it contains pay raises for junior servicemembers and Pentagon childcare workers, addresses staffing shortages at Veterans’ Affairs centers in rural areas, and funds projects that generate $1.5 billion to his home state of New Hampshire.

Pappas wrote that he remains “incredibly frustrated that this process was politicized in the worst way” and blamed House Speaker Johnson (R-LA) for adding “unnecessary riders to limit care for some LGBTQ+ individuals.” Johnson may have allowed the Tricare restriction into the bill to buffet conservative support for the upcoming 2025 vote to keep him as House Speaker.

In a statement condemning the Senate’s vote, Human Rights Campaign President Kelley Robinson wrote, “A majority in the Senate failed [military] families today, thousands of whom now face the possibility of losing access to medically necessary care. President Biden has the power to put a stop to this cruelty. He should make good on his promises to protect LGBTQ+ Americans, defend military servicemembers and their families, and ensure this country’s politics reflect the best of who we are. President Biden must veto this bill.”

In a separate statement, Advocates for Trans Equality’s Director of Federal Policy Olivia Hunt wrote, “Denying lifesaving, medically necessary care to trans members of military families creates profound hardships, forcing service members to make impossible choices between their duty and the health and wellbeing of their loved ones. Politicizing access to evidence-based healthcare undermines the principles of fairness, dignity, and respect that our nation aspires to. No one should have to choose between their duty and protecting their family.”

“Including this discriminatory provision in what has historically been bipartisan legislation is a disgraceful move by anti-trans politicians pandering to a fringe segment of their base…. This decision prioritizes political gamesmanship over the dignity, rights, and well-being of those who serve our nation and set a dangerous precedent of governmental overreach into decisions that should remain between doctors and families.”

Last week, the House passed the NDAA in a 281-140 vote. In addition to the trans healthcare restriction, the bill also contains provisions blocking the Defense Department from teaching about critical race theory in its academic institutions or military trainings and freezes any military hiring on positions related to diversity, equity, and inclusion (DEI) efforts. It also didn’t contain a provision to expand access to in vitro fertilization (IVF) services to service members whose infertility wasn’t caused by service-related illnesses or injuries.

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