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United States partial military ban on intersex people

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(DoDI) 6130.03, 2018, section 5, 13f and 14m
United States Department of Defense
  • Department of Defence Instruction 6130.03: Section 5; subheader 13 Female Genitalia System paragraph f and subheader 14 Male Genitalia System paragraph m
CitationDOD INSTRUCTION 6130.03 MEDICAL STANDARDS FOR APPOINTMENT, ENLISTMENT, OR INDUCTION INTO THE MILITARY SERVICES
Enacted byUnited States Department of Defense
Summary
Barring of people with ovotesticular disorder of sex development, "pseudohermaphroditism" and pure gonadal dysgenesis from serving in the United States military
Keywords
Intersex, military service, Armed Forces of the United States, Urological disorders
Status: Current legislation
Intersex topics
Intersex flag
Human rights and legal issues
Medicine and biology
Society and culture
History and events
Rights by country
See also

The (DoDI) 6130.03, 2018, section 5, 13f and 14m is the writing which bars persons with "true hermaphroditism" (ovotesticular disorder of sex development), "pseudohermaphroditism" and "pure gonadal dysgenesis" from serving in the United States Armed Forces. The three are all intersex conditions and are as of now considered to be medically incompatible with military service in the United States. "DoDI" stands for "Department of Defense Instruction," the 6130.03 instruction concerns "Medical Standards for Appointment, Enlistment, or Induction in the Military Services" in the Armed Forces of the United States. Section 5 focuses on disqualifying conditions of the male and female reproductive system, on the female page the subheader 13 and paragraph f name true hermaphroditism, pseudohermaphroditism and pure gonadal dysgenesis specifically, and on the male page the subheader 14 and paragraph m also name exactly true hermaphroditism, pseudohermaphroditism and pure gonadal dysgenesis, respectively. There is no differentiation made between males and females with these conditions.[1] Many doctors, medical professionals and intersex advocates find the terms hermaphroditism to be outdated and stigmatized,[2] therefore it and its derivative words are seldom used in the 2000s,[3] with the word hermaphrodite itself being considered a slur when used against a human.[4][5]

Statement

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  • SECTION 5: DISQUALIFYING CONDITIONS
13.
—Female Genitalia System:
f.
History of major abnormalities or defects of the genitalia, such as hermaphroditism, pseudohermaphroditism, or pure gonadal dysgenesis.[1]
Page 24
14.
—Male Genitalia System:
m.
History of major abnormalities or defects of the genitalia such as hermaphroditism, pseudohermaphroditism, or pure gonadal dysgenesis.[1]
Page 26

Context

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"True hermaphroditism," which is clinically known as ovotesticular disorder of sex development,[6] is a medical term for an intersex state in which a human is born with both testicular and ovarian tissue. Often one or both gonads is an ovotestis which contains both types of tissue. It is similar in some ways to mixed gonadal dysgenesis but the conditions can be distinguished histologically.[7] The condition has several effects on the body, one of which is imbalanced hormonal output, which is why it is currently considered a disqualifying condition for military service in the United States.

"Pseudohermaphroditism" on the other hand is an old clinical term for a person that is born with primary sex characteristics of one sex but develops the secondary sex characteristics[8][9] that are different from what would be expected on the basis of the gonadal tissue (ovary or testis). Use of the term "pseudohermaphroditism" can be problematic, and is now widely considered redundant.[10] Because of this, the language still used by the armed forces has fallen out of favor in the 21st century due to misconceptions and pejorative connotations associated with the term hermaphrodite.[11]

Several militaries, whether they accept intersex people (such as Israel) or not, use different wording.[12] The website Military.com clumps all three conditions together as "hermaphroditism" on their list of conditions which disqualify one from service.[13]

History

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Background

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Barring of intersex persons with ovotesticular disorder of sex development and "pseudohermaphroditism" like states dates back to at least as far back as 1956. Despite this, John F. Patton of the Office of the Surgeon General and Center of Military History of the U.S. Army, wrote in 1988 that "Lesser degrees of these abnormalities, however, were obviously overlooked or regarded as compatible with military service."[14] Mentions of gonadal agenesis as an obstacle in military servie has been recorded since the early 1970s if not before.[15]

Developments

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The guideline with the current wording was first conceived in 2010 and implemented in 2011.[16][17] At first it was not addressed if persons who have had surgeries to address their genital abnormalities were acceptable or not but later updates added in notes about people also being barred if they had medical interventions done. In 2013 guidelines stated that "a history of, or current manifestations of, personality disorders, disorders of impulse control not elsewhere classified, transvestism, voyeurism, other paraphilias, or factitious disorders, psychosexual conditions, transsexual, gender identity disorder to include major abnormalities or defects of the genitalia such as change of sex or a current attempt to change sex, hermaphroditism, pseudohermaphroditism, or pure gonadal dysgenesis or dysfunctional residuals from surgical correction of these conditions render an individual administratively unfit," which while specifying that only unsuccessful corrective surgeries for the conditions rendered someone unfit for service also lumped together disorders of sex development (DOSD) with gender identity, fetishes, mental illness, neuroatypicality, personality disorders and paraphilias in the same level of disqualification, which is not consistent or optimal for rules of enlistment.[18][19][20] The 2016 amendments to the 6130.03 guidelines to allow transgender people to serve did not touch on intersex people whatsoever and their situation remained unchanged.[21] At the time the location of the writing was at "Enclosure 4, 14f. and 15r," here it was listed as "major abnormalit[y] or defect of genitalia."[22] The amendments made for transgender people were motivated by changes in the medical and psychological community, and while the use of the word hermaphroditism was criticized as archaic and medically outdated there was no major push by the larger LGBT community to have it corrected nor was any effort made on the part of the military to consider having it reworded.[23][24][25]

Effectiveness

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The Consensus Study Report from the Board on Children, Youth, and Families (part of the DOD's Military Family Readiness System) in 2019 notes that despite the restriction it is very possible for someone whose genitalia have been surgically modified to comply with social norms due to these conditions to enter the military completely undetected.[26]

See also

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References

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  1. ^ a b c "DoD Instruction 6130.03 Medical Standards For Appointment, Enlistment, Or Induction Into The Military Services" (PDF). September 27, 2018. Archived from the original (PDF) on September 27, 2018 – via Wayback Machine.
  2. ^ "Frequently Asked Questions" (printable). Intersex Society of North America. Archived from the original on January 30, 2019. Retrieved January 30, 2019. The words "hermaphrodite" and "pseudo-hermaphrodite" are stigmatizing and misleading words. Unfortunately, some medical personnel still use them to refer to people with certain intersex conditions, because they still subscribe to an outdated nomenclature that uses gonadal anatomy as the basis of sex classification.
  3. ^ "Frequently Asked Questions". Intersex Society of North America. Archived from the original (printable) on January 30, 2019. Retrieved January 30, 2019. In a paper titled "Changing the Nomenclature/Taxonomy for Intersex: A Scientific and Clinical Rationale":/node/979, five ISNA-associated experts recommend that all terms based on the root "hermaphrodite" be abandoned because they are scientifically specious and clinically problematic. The terms fail to reflect modern scientific understandings of intersex conditions, confuse clinicians, harm patients, and panic parents. We think it is much better for everyone involved when specific condition names are used in medical research and practice.
  4. ^ Wallace Swan; The Routledge Handbook of LGBTQIA Administration and Policy
  5. ^ "Slurs". Genderkit.org.uk. Gender Construction Kit. Retrieved January 24, 2019.
  6. ^ Lee P. A.; Houk C. P.; Ahmed S. F.; Hughes I. A. (2006). "Consensus statement on management of intersex disorders". Pediatrics. 118 (2): e488–500. doi:10.1542/peds.2006-0738. PMC 2082839. PMID 16882788.
  7. ^ Kim, Kyu-Rae; Kwon, Youngmee; Joung, Jae Young; Kim, Kun Suk; Ayala, Alberto G.; ťRo, Jae Y. (2002). "True Hermaphroditism and Mixed Gonadal Dysgenesis in Young Children: A Clinicopathologic Study of 10 Cases". Modern Pathology. 15 (10): 1013–9. doi:10.1097/01.MP.0000027623.23885.0D. PMID 12379746.
  8. ^ "Dorlands Medical Dictionary". Archived from the original on December 28, 2007. Retrieved December 7, 2007.
  9. ^ "MESH". Retrieved December 7, 2007.
  10. ^ Lee PA, Houk CP, Ahmed SF, Hughes IA (August 2006). "Consensus statement on management of intersex disorders. International Consensus Conference on Intersex". Pediatrics. 118 (2): e488–500. doi:10.1542/peds.2006-0738. PMC 2082839. PMID 16882788.
  11. ^ Dreger, Alice D.; Chase, Cheryl; Sousa, Aron; Gruppuso, Phillip A.; Frader, Joel (August 18, 2005). ""Changing the Nomenclature/Taxonomy for Intersex: A Scientific and Clinical Rationale."" (PDF). Journal of Pediatric Endocrinology and Metabolism. 18 (8): 729–733. doi:10.1515/JPEM.2005.18.8.729. PMID 16200837. S2CID 39459050. Archived from the original (PDF) on December 20, 2016. Retrieved July 27, 2016.
  12. ^ Speckhard, Anna and Paz, Reuven; " Transgender Service in the Israel Defense Forces: A Polar Opposite Stance to the U.S. Military Policy of Barring Transgender Soldiers from Service" (2014); Academia.edu
  13. ^ "Medical Conditions That Can Keep You From Joining the Military". Military.com. Archived from the original on January 30, 2019. Retrieved January 30, 2019.
  14. ^ John F. Patton; Urology – Page 148
  15. ^ Military Medicine; Association of Military Surgeons, United States, 1970 – Page 788-790
  16. ^ Assessing the Implications of Allowing Transgender Personnel to Serve Openly – Page 65
  17. ^ Sexual Assault in the U.S. Military: The Battle Within America's Armed – Page 87
  18. ^ Staff (2013). "Chelsea Manning illuminates the struggle of transgender individuals in the U.S." The Louisville Cardinal. Retrieved January 24, 2019.
  19. ^ Diane H. Mazur (October 2014). "Arbitrary And Capricious: Six Inconsistencies Distinguishing Military Medical Policies For Transgender And Non-transgender Personnel" (PDF). PALM Center; Blueprints for Sound Public Policy. Retrieved January 24, 2019.
  20. ^ "AR 40-501 STANDARDS OF MEDICAL FITNESS". Milreg.com. Archived from the original on August 19, 2018. Retrieved January 24, 2019.
  21. ^ Inclusion in the American Military: A Force for Diversity – Page 163
  22. ^ Inclusion in the American Military: A Force for Diversity – Page 154
  23. ^ Brynn Tannehill; Allyson Dylan Robinson; Sue Fulton (February 2015). "Transgender Military Service: A Guide to Implementation" (PDF). SPλRT*A: Service Members Partners Allies For Respect And Tolerance For All. Retrieved January 24, 2019.
  24. ^ "UNITED STATES COURT OF APPEALS FOR THE DISTRICT OF COLUMBIA CIRCUIT * JANE DOE et al. v. DONALD J. TRUMP et al" (PDF). Jane Doe v. Trump. GLAAD. Retrieved January 24, 2019.
  25. ^ "IN THE UNITED STATES COURT OF APPEALS FOR THE NINTH CIRCUIT * RYAN KARNOSKI, et al., Plaintiffs-Appellees, STATE OF WASHINGTON, Attorney General's Office Civil Rights Unit, Intervenor-Plaintiff-Appellee, v. DONALD J. TRUMP, in his official capacity as President of the United States, et al. Defendants-Appellants. ON APPEAL FROM THE UNITED STATES DISTRICT CO" (PDF). Cdn.ca9.uscourts.gov. Retrieved January 24, 2019.
  26. ^ Kenneth W. Kizer; David Albright; Stephen J. Cozza; Ellen DeVoe; et al. (July 19, 2019). Kizer, Kenneth W; Menestrel, Suzanne Le (eds.). Chapter: 3 Demographic and Military Service Characteristics of Military Families. The National Academic Press. p. 76. doi:10.17226/25380. ISBN 978-0-309-48953-9. PMID 31600043. S2CID 199850390. Retrieved September 22, 2019 – via nap.edu. {{cite book}}: |work= ignored (help)

Further reading

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