On Monday, President Biden issued an executive order reinstating an Obama-era rule permitting transgender people to serve openly in the U.S. military. The order will also permit incoming troops diagnosed with gender dysphoria to receive so-called “sex-change surgery” and cross-sex hormones paid for by U.S. taxpayers.

The order is titled “Executive Order on Enabling All Qualified Americans to Serve Their Country in Uniform.” It charged that permitting transgender individuals to serve openly in the U.S. military “does not have any meaningful negative impact on the Armed Forces” and that it would “have only a minimal impact on military readiness and healthcare costs.”

The order then directed the Secretary of Defense to “immediately prohibit involuntary separations, discharges, and denials of reenlistment or continuation of service on the basis of gender identity” and to “identify and examine the records of service members who have been involuntarily separated, discharged, or denied reenlistment or continuation of service on the basis of gender identity.”

President Biden’s Secretary of Defense is Lloyd Austin, who was recently confirmed to the post by the U.S. Senate.

Speaking about the order, President Biden said, “What I’m doing is enabling all qualified Americans to serve their country in uniform, and essentially restoring the situation as it existed before, with transgender personnel, if qualified in every other way, can serve their government in the United States military.”

In 2016, former President Barack Obama issued a similar order permitting transgender individuals to serve in the U.S. military.

The order was rescinded by former President Donald Trump, who initially announced the change in policy in 2017. Due to legal action and court cases, the order was not fully implemented until 2019.

Though Trump’s order was dubbed by some as the “Transgender Military Ban,” it did not prohibit all transgender troops from serving in the U.S. military.

Rather, the order specified that “any person who has been diagnosed with gender dysphoria and has received medical treatment – either hormones or surgery – will not be allowed to join the military,” however, “if they have been diagnosed, but have not received medical treatment, they will still be eligible to join,” according to CBS News.

The order only applied to those attempting to join the military. It exempted all transgender soldiers who were already serving in the military, regardless of whether they had received cross-sex hormones or sex-change surgery.

Those applying to the U.S. military are barred for a plethora of mental conditions, including “anxiety issues… panic, agoraphobia, social phobia, simple phobias, obsessive-compulsive disorders, other acute reactions to stress, and post-traumatic stress.”

The American Psychological Association originally listed “gender identity disorder” as a mental disorder, before reversing itself and renaming the condition “gender dysphoria” which it claims is “not in itself a mental disorder.”

From 2016 to 2019, the Pentagon spent around $8 million to provide over 1,500 troops with medical treatment for gender dysphoria. During that time, the U.S. military paid for 161 sex-change procedures, according to USA Today.

However, some estimate the potential cost of permitting taxpayer funding of medical treatment for transgender troops to be far higher. A 2017 estimation by Rep. Vicky Hartzler, R-Mo., found that taxpayer funded sex-change surgeries could cost the Pentagon $1.3 billion over 10 years.

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