Preparatory to ending the ban on transgender military service, which is expected to happen this Spring, the Department of Defense has proposed a new rule in regard to TRICARE benefit coverage.

This proposed rule seeks to comprehensively update TRICARE mental health and substance use disorder benefits, consistent with earlier Department of Defense and Institute of Medicine recommendations, current standards of practice in mental health and addiction medicine, and our governing laws. The Department of Defense remains intently focused on ensuring the mental health of our service members and their families, as this continues to be a top priority. The Department is also working to further de-stigmatize mental health treatment and expand the ways by which our beneficiaries can access authorized mental health services. This proposed regulatory action is in furtherance of these goals and imperative in order to eliminate requirements that may be viewed as barriers to medically necessary and appropriate mental health services.

Under part 1(a) of the proposed rule, Eliminating Quantitative and Qualitative Treatment Limitations on SUD and Mental Health Benefit Coverage and Aligning Beneficiary Cost-Sharing for Mental Health and SUD Benefits With Those Applicable to Medical/Surgical Benefits, one eventually finds:

Additionally, this rulemaking proposes to remove the categorical exclusion on treatment of gender dysphoria. This proposed change will permit coverage of all non-surgical medically necessary and appropriate care in the treatment of gender dysphoria, consistent with the program requirements applicable for treatment of all mental or physical illnesses. Surgical care remains prohibited by statute at 10 U.S.C. 1079(a)(11), as discussed further below.

I admit I was not until now familiar with 10 U.S.C 1079(a)(11). U.S.C. stands for United States Code and Title 10 is ARMED FORCES; Subtitle A is General Military Law, Part II of that is PERSONNEL, and under Chapter 55 (Medical and Dental Care), one finds Sec. 1079(Contracts for medical care for spouses and children: plans). Part (11) of that reads

Surgery which improves physical appearance but is not expected to significantly restore functions (including mammary augmentation, face lifts, and sex gender changes) may not be provided, except that—
(A) breast reconstructive surgery following a mastectomy may be provided;
(B) reconstructive surgery to correct serious deformities caused by congenital anomalies or accidental injuries may be provided; and
(C) neoplastic surgery may be provided.

For the naysayers who struck my last diary concerning medical insurance coverage of transgender healthcare:

Creating additional levels, providers, and types of mental health care (e.g., intensive outpatient programs, opioid treatment programs, non-surgical coverage for gender dysphoria, and also allowing outpatient substance use treatment) will increase costs to the program by approximately $16.8 million.