No. The military does not pay for transgender surgery. Under an executive order signed January 27, 2025, and implementing guidance issued through May 2025, all gender-affirming surgical procedures for service members have been cancelled, TRICARE excludes surgery for gender dysphoria for dependents and retirees, and the Department of Veterans Affairs does not provide surgical treatment either. Some hormone therapy and mental health care remain available under narrow conditions.
Surgery Is Cancelled Across the Board
The May 9, 2025 memorandum from the Assistant Secretary of Defense for Health Affairs is explicit: all unscheduled, scheduled, and planned surgical procedures associated with sex reassignment for service members diagnosed with gender dysphoria are cancelled.1Health.mil. Additional Guidance on Treatment of Gender Dysphoria The cancellation reaches every avenue by which a service member might previously have obtained the care:
- Military Treatment Facilities will not perform gender-affirming surgeries.
- Previously approved Supplemental Health Care Program waivers for surgery at civilian facilities are cancelled, and new waiver requests will be returned without action.
- TRICARE will not cover the surgeries through private-sector care, and referrals for non-covered care may not be submitted.
The one narrow opening involves complications. A service member who previously underwent gender-affirming surgery and now needs follow-up care for complications or necessary repairs may have a waiver submitted to the Assistant Secretary of Defense for Health Affairs for review.1Health.mil. Additional Guidance on Treatment of Gender Dysphoria
The statutory basis for the surgical exclusion is older than the 2025 policy shift. Under 10 U.S.C. § 1079, TRICARE contracts cannot cover “[s]urgery which improves physical appearance but is not expected to significantly restore functions,” and the statute lists “sex gender changes” alongside mammary augmentation and face lifts as examples of excluded procedures.2Office of the Law Revision Counsel. 10 U.S. Code 1079 – Contracts for Medical Care for Spouses and Children The previous administration read medically necessary gender-affirming surgery as falling outside that cosmetic exclusion. The current administration does not.
If You Were Already Mid-Transition
The May 2025 guidance contains no grandfathering provision for surgery. Every scheduled and planned procedure is cancelled regardless of how far the approval process had progressed. A commander’s memorandum in hand, a Defense Health Agency pre-authorization, a surgery date on the calendar: none of it survives the current policy.
Hormone therapy is treated differently. Service members aged 19 and older who were already receiving cross-sex hormone therapy before the May 2025 memorandum took effect may continue that treatment if a healthcare provider recommends continuation to prevent further medical complications. Military Treatment Facilities will not administer the hormones directly; eligible members are referred to private-sector providers. The continuation lasts only until the member separates from the military.1Health.mil. Additional Guidance on Treatment of Gender Dysphoria
New prescriptions for cross-sex hormone therapy are not funded with DoD dollars. Secretaries of the Military Departments may request case-by-case exceptions for newly initiated hormone therapy, but only where necessary to protect a service member’s health. The exception language reads as directed at rare medical situations, not routine transition care.
What Non-Surgical Care Still Exists
Mental health care and counseling remain available at Military Treatment Facilities for service members and beneficiaries aged 19 and older who have a gender dysphoria diagnosis, including diagnostic consultations and ongoing psychological support.1Health.mil. Additional Guidance on Treatment of Gender Dysphoria Hormone continuation, as described above, is possible for those already on treatment. Everything else related to gender transition is off the table for active duty members.
Dependents and Retirees on TRICARE
Military spouses, children, and retirees covered by TRICARE face the same surgical exclusion, and for them the restriction predates 2025. Federal regulation 32 CFR § 199.4(g)(29) excludes services and supplies related to sex gender change from TRICARE’s basic program benefits, referencing the 10 U.S.C. § 1079 prohibition. The only exception is surgery to correct intersex conditions documented at birth.3eCFR. 32 CFR 199.4 – Basic Program Benefits
TRICARE does still cover hormone therapy and psychological counseling for gender dysphoria for beneficiaries.4TRICARE. Gender Dysphoria Services So a military spouse or retiree can access mental health support and, where clinically appropriate, hormone treatment. Surgery is excluded regardless of medical necessity.
The VA After Separation
Veterans leaving military service and entering the VA healthcare system encounter parallel restrictions. On March 17, 2025, the VA rescinded VHA Directive 1341(4), which had previously governed healthcare for transgender and intersex veterans. The replacement notice states that the VA “does not provide any other medical or any surgical therapy for gender dysphoria.”5Department of Veterans Affairs. VHA NOTICE 2025-01(1) Rescission of VHA Directive 1341(4)
Hormone therapy follows a grandfathering pattern similar to the DoD’s. Veterans already receiving cross-sex hormone therapy through the VA as of March 17, 2025, or who received such care as part of their separation from military service, may continue treatment if otherwise eligible for VA healthcare. Veterans outside those criteria cannot start hormone therapy through the VA. Comprehensive preventive care and mental health services remain available to all eligible veterans regardless of diagnosis.5Department of Veterans Affairs. VHA NOTICE 2025-01(1) Rescission of VHA Directive 1341(4)
The current VA notice is scheduled for recertification on or before the last working day of March 2030, so the policy could change again within that window.
Appeals and Ongoing Legal Challenges
TRICARE’s standard appeals process allows beneficiaries to challenge medical necessity determinations by filing a written appeal with their TRICARE contractor within 90 days of the denial. If the contractor upholds the denial, the beneficiary can request reconsideration through the TRICARE Quality Monitoring Contractor, again within 90 days. For disputed amounts of $300 or more, the beneficiary can then request an independent hearing before the Defense Health Agency within 60 days of the reconsideration decision.6TRICARE. Medical Necessity Appeals
Those appeal rights address individual medical necessity denials. The current exclusion is a categorical policy, not a case-by-case judgment, so internal appeals are unlikely to change the outcome. Multiple legal challenges to the 2025 policies have been filed in federal court, and several military families have contested the ban on healthcare for transgender dependents. Court orders could alter what care is available. Service members who believe their circumstances warrant an exception should consult a military legal assistance attorney through their installation’s legal office; the military Inspector General is also available for concerns about how the policy is being implemented.