INTERIM GUIDANCE FOR SERVICE OF TRANSGENDER NAVY PERSONNEL​

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R 071827Z NOV 16

FM CNO WASHINGTON DC

TO NAVADMIN

INFO CNO WASHINGTON DC

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NAVADMIN 248/16

MSGID/GENADMIN/CNO WASHINGTON DC/N1/NOV//

SUBJ/INTERIM GUIDANCE FOR SERVICE OF TRANSGENDER NAVY PERSONNEL//



REF/A/DOC/DOD/1JUL16//

REF/B/DOC/SECDEF/30JUN16//

REF/C/MSG/SECNAV WASHINGTON DC/051937ZAUG16//

REF/D/DOC/SECNAV/4NOV16//

REF/E/DOC/BUMED/27SEP16//

REF/F/DOC/COMNAVPERSCOM/7NOV16//

REF/G/DOC/COMNAVRESFOR/5JUN12//

REF/H/DOC/BUPERS/7SEP17//

REF/I/DOC/DOD/24SEP15//

NARR/REF A IS DODI 1300.28, IN-SERVICE TRANSITION FOR TRANSGENDER SERVICE 
MEMBERS.  REF B IS SECDEF DTM 16-005, DIRECTIVE-TYPE MEMORANDUM (DTM) 16-005, 
MILITARY SERVICE OF TRANSGENDER SERVICE MEMBERS.  REF C IS ALNAV 053/16, 
SERVICE OF TRANSGENDER SAILORS AND MARINES INTERIM GUIDANCE.  REF D IS 
SECNAVINST 1000.11, SERVICE OF TRANSGENDER SAILORS AND MARINES.  REF E IS 
BUMEDNOTE 6000, MEDICAL TREATMENT OF TRANSGENDER SERVICE MEMBERS INTERIM 
GUIDANCE.  REF F IS MILPERSMAN 1000-131, MEMBER GENDER MARKER CHANGE 
PROCEDURES.  REF G IS RESPERSMAN 6000-010, SELECTED RESERVE MEDICAL.  REF H 
IS BUPERSINST 1001.39F, ADMINISTRATIVE PROCEDURES FOR NAVY RESERVISTS.
REF I, DODI 1322.22, SERVICE ACADEMIES.//

RMKS/1.  The Secretary of Defense announced in references (a) and
(b) that the Armed Forces will allow transgender Service Members to serve in 
the military.  Consistent with that announcement and references (c) and (d), 
this NAVADMIN provides interim guidance for policy, regulations and 
procedures related to the service of transgender Navy personnel.  This policy 
applies to all Navy military personnel.  Questions on Department of the Navy 
(DON) transgender civilian personnel shall be referred to the DON Office of 
Civilian Human Resources and/or the DON Office of the General Counsel, and 
questions on transgender civilian contractors serving with the Navy should be 
referred to the Contracting Officers Representative.

2.  Service
    a.  Consistent with references (a) through (d), transgender individuals 
shall be allowed to serve openly in the Navy.
Department of Defense (DoD), DON, and Navy policies applicable to all active 
component (AC) and reserve component (RC) are premised on the conclusion that 
transgender persons are fully qualified and are subject to the same standards 
and procedures as other Service Members with regard to their medical fitness 
for duty, physical fitness, uniform and grooming standards, deployability, 
and retention.
    b.  No otherwise qualified Service Member may be involuntarily separated, 
discharged, or denied reenlistment or continuation of service solely on the 
basis of gender identity or an expressed intent to transition gender.
    c.  A Service Member whose ability to serve is adversely impacted by a 
medical condition or medical treatment related to gender identity should be 
treated, for purposes of separation and retention, in a manner consistent 
with a Service Member whose ability to serve is similarly affected for 
reasons unrelated to gender identity or gender transition.

3.  Timeline
    a.  1 October 2016:  Military personnel may transition gender as directed 
in references (a) through (d) and policy herein.
    b.  1 November 2016:  U.S. Fleet Forces Command (USFF) will commence 
transgender training.  A DoD handbook to help commands and members in 
understanding the gender transition process will be included with Navy 
training materials.  Details have been announced in separate correspondence 
in Guidance for Transgender Military Service, Message 1, NAVADMIN 203/16 and 
in a series of NAVADMINS released by USFF dated 231945Z SEP 16, 042025Z OCT 
16, 281725Z OCT
16 and 311241Z OCT 16.
    c.  31 January 2017:  Transgender training for all AC Service Members is 
complete.
    d.  30 April 2017:  Transgender training for all RC Service Members is 
complete.
    e.  1 July 2017:  Transgender applicants who meet updated accession 
standards may be accessed into the U.S. Armed Services as directed by 
reference (b).

4.  In-Service Transition
    a.  A key element of In-Service gender transitions is a commanding 
officer (CO) approved transition plan, which includes the individual Service 
Members medical treatment plan (as developed with a military medical provider 
(MMP)), accounts for the desires of the individual, and considers the 
operational requirements of the command.  Transition medical treatment 
differs for each individual and may include any or all of the following:  
behavioral health counseling, cross-sex hormone therapy, surgery, and real-
life experience.
    b.  Starting Gender Transition.  Gender transition begins when a Service 
Member on active duty receives a diagnosis from a MMP indicating that gender 
transition is medically necessary, develops a medical treatment plan in 
concert with his or her MMP, coordinates with the responsible Transgender 
Care Team as directed in reference (e), and requests CO approval of the 
timing of medical treatment associated with gender transition.  The timing of 
the medical treatment plan will be incorporated into the Service Members 
overall gender transition plan developed in coordination with the MMP, the 
Service Member, and the CO.  The CO is the final approval authority for the 
transition plan.  Timing of the various aspects of the medical treatment plan 
should consider the individuals planned rotation date (PRD), deployment or 
other operational schedules, and potential impact on major career milestones, 
whenever possible.
Cases evaluated by the MMP as requiring immediate medical treatment should be 
handled consistent with any other emergent medical situation, of which the 
outcome may require transfer to a limited duty status and result in an 
unplanned loss to the command.
    c.  COs Action on the Request.  The CO, informed by the MMPs 
recommendations, the Navy Service Central Coordination Cell (SCCC), and 
others, as appropriate, will respond to a gender transition request within a 
framework that ensures readiness by minimizing impacts to the mission 
(including deployment, operational, training, exercise schedules, and 
critical skills availability), as well as to the morale, welfare, and good 
order and discipline of the command.
As directed by reference (a) and this NAVADMIN, the CO will:
        (1) Promptly respond to any request for medical care, as identified 
by the MMP, and ensure that such care is provided consistent with applicable 
regulations.
        (2) Respond to any request for medical treatment or an Exception to 
Policy (ETP) associated with gender transition, as soon as practicable, but 
not later than 90 days after receiving a request determined to be complete as 
directed by reference (a) and this NAVADMIN.  A request that, upon review by 
the CO, is determined to be incomplete, will be returned to the Service 
Member, with written notice of the deficiencies identified, as soon as 
practicable, but not later than 30 days after receipt.
            (a) For complete medical treatment requests, the CO will include 
notice of any COs actions taken and provide a written copy to the Service 
Member and MMP.
            (b) In the case of a complete ETP request seeking a service 
policy waiver under paragraph 4h of this NAVADMIN, the CO will provide a 
written endorsement with recommendation and route via the first flag officer 
in the chain of command to Deputy Chief of Naval Operations (Manpower, 
Personnel, Training and Education (DCNO N1)).
    d.  Real-Life Experience (RLE).  RLE is the phase in the gender 
transition process during which the individual commences living socially in 
the gender role consistent with his or her preferred gender.  For Service 
Members, this will normally occur only in an off-duty status, prior to the 
change of their gender marker in the Navy Personnel Administrative 
Systems/Defense Enrollment Eligibility Reporting (DEERS) and according to 
their CO-approved transition plan.  Maintaining good order and discipline is 
expected at all times.
        (1) Service Members will be considered to be in an on-duty status at 
official functions, either on base or off, subject to the discretion of their 
CO.
        (2) The following are examples of situations where RLE may occur, 
each with its own considerations or restrictions:
            (a) Foreign Locations.  Commands need to be cognizant of host-
nation laws and social norms when considering RLE in an off-duty status in 
foreign nations.  Travel warnings, the State Departments country-specific 
website, the DoD Foreign Clearance Guide, and any U.S. regional military 
commander directives should be reviewed and heeded.
            (b) Stationed in United States, Shipboard.  When a Service Member 
is onboard ship, they are considered in an on-duty status, even after working 
hours.  As directed by reference (a), RLE takes place away from the working 
environment.  As part of the approved transition plan, COs may allow for 
embarkation and debarkation from the ship in RLE attire for Sailors going on 
liberty to commence after-hours RLE.
            (c) Stationed in United States, Shore Based.  When a Service 
Member is stationed at a shore facility, they will execute RLE away from the 
workplace.
    e.  Completing Transition.  The transition plan is considered complete 
when the MMP documents that the Service Member has completed the medically-
necessary care to achieve stability as outlined in the medical treatment 
plan, the Service Member obtains appropriate documentation pursuant to 
section 4f below, the CO provides written permission to change the gender 
marker in the Navy Personnel Administrative Systems/DEERS, the Service Member 
submits for the gender marker change, and the gender marker is changed in the 
Navy Personnel Administrative Systems/DEERS.
    f.  Documentary Evidence Requirement.  Service Members are responsible 
for obtaining one of the following federal or state legal documents as legal 
proof of gender change.  No documents other than (1) through (3) below are 
acceptable:
        (1) A certified true copy of a State birth certificate reflecting the 
Service Members preferred gender.
        (2) A certified true copy of a court order reflecting the Service 
Members preferred gender.
        (3) A U.S. passport reflecting the Service Members preferred gender.
    g.  Obtaining the Gender Marker Change in the Navy Personnel 
Administrative Systems/DEERS.  Service Members shall submit the required 
documentation and the COs written approval, as directed by reference (f), to 
Navy Personnel Command.  Once the gender marker is changed in the Navy 
Personnel Administrative Systems/DEERS, the Navy will recognize the Service 
Member in the preferred gender, to include assignment of berthing, and 
applicability of all standards, to include physical readiness, grooming and 
uniform regulations, at all times.
    h.  ETP During Transition.  Service Members shall comply with all 
standards of the gender marker currently in the Navy Personnel Administrative 
Systems/DEERS.  Service Members and COs may request ETP via the first flag 
officer in the chain of command to DCNO (N1) for any service policy waivers 
as part of the approved transition plan as directed in references (a) and 
(d), when it is in the best interest of the individual and as it makes sense 
for good order and discipline within the command.  Examples of ETPs requiring 
DCNO (N1) approval prior to completion of the gender marker change in the 
Navy Personnel Administrative Systems/DEERS include:  grooming, uniform and 
appearance standards, change of berthing, head and shower facilities, and 
urinalysis observation.  Physical readiness testing, body composition 
assessment standards or deployability determinations require medical waivers, 
not ETPs.  COs may contact the SCCC with questions regarding ETPs.

5.  Navy Policy
    a.  All Service Members will continue to treat each other with dignity 
and respect.  There is zero tolerance for harassing, hazing, or bullying in 
any form.
    b.  The following policy changes apply now and will be reflected in 
updates to the listed instructions currently in staffing:
        (1) Privacy considerations in berthing and shower facilities are 
being incorporated into the Standard Organization Regulations of the U.S. 
Navy, OPNAVINST 3120.32D:
            (a) Berthing
                1.  COs are expected to implement appropriate policies that 
ensure privacy protection of individual Sailors out of courtesy to all as the 
tactical situation allows in order to maintain good order and discipline.
                2.  No person will sleep fully unclothed.  Clothing items 
considered to be appropriate sleepwear include:
undergarments, PT/gym shorts and shirts, pajamas and sweat suits.
                3.  No person will transit through spaces unclothed.
Sailors shall maintain a minimum standard of coverage out of courtesy to all, 
for personal privacy and to foster good order and discipline.
            (b) Crews Heads and Washrooms.  No person will transit through 
spaces unclothed.  Sailors shall maintain a minimum standard of coverage out 
of courtesy to all, for personal privacy and to foster good order and 
discipline.  Clothing items considered to be appropriate include:  shirt, 
shorts, robe or PT gear.  If a robe is worn, appropriate garments shall be 
worn underneath.
        (2) Navy Alcohol and Drug Abuse Prevention and Control Program, 
OPNAVINST 5350.4D, requires that all Service Members be subject to urinalysis 
and that an observer be of the same gender as the observed Service Member 
during urinalysis.  Language will be incorporated into the updated 
instruction to adjust for the comfort level of the observer and the Service 
Member being observed.  The integrity of the urinalysis program will be 
maintained at all times.
Service Members are required to adhere to urinalysis policies and procedures 
when selected to observe.  COs shall ensure dignity and respect is maintained 
for Service Members selected to provide a sample as well as for observers.  
COs have the discretionary authority to assign observers in order to preserve 
the dignity and respect of both parties.
        (3) Physical Readiness Program, OPNAVINST 6110.1J, delineates fitness 
standards for male and female Service Members.
There are no separate or distinct standards for transgender Service Members.  
Service Members and MMPs must carefully consider the time required to adjust 
to new physical fitness assessment (PFA) standards as part of the medical 
treatment and transition planning process.
            (a) Service Members must adhere to applicable fitness program 
standards commensurate with the gender marker currently reflected in DEERS.
            (b) Upon gender marker change in the Navy Personnel 
Administrative Systems/DEERS, Sailors will be required to meet the PFA 
standards of their preferred gender.
            (c) The MMP may determine if a medical waiver is 
required/justified for the body composition assessment and PFA during and 
upon completion of transition, consistent with OPNAVINST 6110.1J.
        (4) Military Equal Opportunity Policy, OPNAVINST 5354.1F, is being 
updated to clarify that discrimination based on gender identity is a form of 
sex discrimination.
    c.  Facilities.  Service Members will use gender-specific berthing, head, 
and shower facilities according to the gender reflected in Navy Personnel 
Administrative Systems/DEERS.
    d.  Assignments
        (1) All Service Members are world-wide assignable as their medical 
fitness for duty permits.  Timing of a transition plan should include 
consideration of a Sailors PRD and planned deployment/operational 
requirements.  When possible, Service Members will normally attempt to 
finalize transition during one tour to avoid interrupting medical treatment 
and having to coordinate a new transition plan at the next command, where 
operational requirements may be different.
        (2) The Navy will detail Service Members in accordance with their 
gender marker recorded in the Navy Personnel Administrative Systems/DEERS.
        (3) Community assignment restrictions will be in accordance with the 
Navys Bureau of Medicines (BUMED) current assessment of disqualifying medical 
statuses.  Individuals undergoing medical or surgical treatment may be 
restricted from flight duty and diving operations and the Personnel 
Reliability Program if medically appropriate.  Case specific questions should 
be discussed with the Navy SCCC medical experts.
    e.  Security Clearances.  Any change in a Service Members status (e.g., 
marriage, divorce, addition of dependents) is reportable to the command 
security manager in order to maintain a national security clearance.  This 
includes changes to name and gender.  A Standard Form 86 Certification (SF 
86C) allows reporting of changes in previously reported information on the 
Questionaire for National Security Positions (SF 86).

6.  Reserve Component (RC).  All DoD and Navy policies regarding accessing 
and retaining transgender personnel are applicable to both AC and RC Service 
Members.  Full-Time Support personnel will follow the policy and procedures 
as described in the preceding paragraphs.
The following additional guidance applies to Selected Reserves (SELRES).
    a.  Reporting Requirement.  Gender transition begins when a Service 
Member receives a diagnosis indicating that gender transition is medically 
necessary.  The diagnosis must be reported and submitted along with relevant 
medical information to their Navy Reserve Activity (NRA) Medical Department 
Representative, in addition to informing their reserve unit leadership.
    b.  Manpower Availability Status (MAS) Codes.  Once the NRA CO receives a 
gender transition request, the Service Member initially becomes Temporarily 
Not Physically Qualified (TNPQ) and the temporarily not physically qualified 
for mobilization (MPQ) MAS codes will be applied to the Service Member as 
directed by reference (g).  This appropriately identifies the member as 
having a medical condition and supports documentation of readiness in the 
same manner as other medical conditions.  The Service Members mobilization 
status will be reviewed monthly to determine whether they are physically 
qualified for mobilization during their transition.  The MPQ MAS code 
indicates the Service Member is awaiting validation of the diagnosis and 
treatment plan and precludes mobilization.
    c.  Medical Diagnosis and Treatment Plan.  The medical diagnosis and 
treatment plan will normally be provided by a civilian medical provider, but 
must be forwarded for validation to the BUMED Medical Support Cell that 
services the Navy SCCC.  Once the diagnosis is confirmed and medical 
treatment plan is finalized, a transition plan can be developed.  The NRA CO 
shall coordinate with the Navy Reserve Force Surgeon, the Reserve unit CO, 
and the Service Member to develop the plan.  The NRA CO with administrative 
responsibility for mobilization readiness is the approval authority for 
SELRES transition plans.
    d.  Individual Medical Readiness (IMR).  IMR status will be determined on 
a case-by-case basis as dictated by the transition plan.  Generally, the MPQ 
MAS code will remain in effect until the reserve Service Members transition 
plan is completed, or if at any time during the transition a medical 
condition arises to warrant change in medical status.  Transitioning Service 
Members may have periods of ineligibility for participation due to planned 
medical procedures and in accordance with the approved treatment plan, which 
shall be treated as directed in references (g) and (h).  SELRES serving on 
active-duty orders (e.g., Active-Duty for Traing, Active-Duty for Special 
Work, mobilization, definite recall) for a finite period will generally be 
precluded from beginning the gender transition process.

7.  Initial Entry Education/Training.  As directed in reference (a), a 
blanket prohibition on gender transition during a Service Members initial 
term of service is not permissible.  However, gender transitions will often 
not be sustainable during entry-level training due to the rigorous military 
requirements and schedule associated with such training.
    a.  Recruit Training Command.  A Service Member is subject to separation 
in an entry-level status during the period of initial training (defined as 
180 days per Enlisted Administrative Separations, DoDI 1332.14) based on a 
medical condition that impairs the Service Members ability to complete such 
training.
    b.  U.S. Naval Academy (USNA) and Reserve Officer Training Corps (ROTC).  
Midshipmen must continue to meet medical accession standards while at USNA or 
enrolled in ROTC.  If Midshipmen do not maintain the standards for 
appointment into the U.S. Military Services, a one-year medical leave of 
absence (MLOA) may be warranted as determined by the Secretary of the Navy.  
When an MLOA is recommended, a medical record review will determine whether 
the health-related incapacity or condition presents clear evidence that, 
following medical treatment, the Midshipman will be able to meet the physical 
standards for appointment into the Navy within a reasonable period of time.  
USNA Midshipmen who cannot meet medical accession standards and become 
medically disqualified may be disenrolled as directed by reference (i).  
Midshipmen who desire to begin a gender transition while in the ROTC Program 
or at USNA will be evaluated under the same terms and conditions applicable 
to Midshipmen in comparable circumstances not related to transgender persons 
or gender transition.  This will be based on a determination there is a 
medical condition that impairs the individuals ability to complete such 
training or to access into the Armed Forces.  Each situation is unique and 
will be evaluated based on its individual circumstances.

8.  Medical.  BUMED issued guidance in reference (e) on the provision of 
necessary medical care and treatment of transgender Service Members.  BUMED 
established Regional Transgender Care Teams
(TGCT) staffed at select military treatment facilities to facilitate the 
appropriate diagnosis and referral of transgender personnel to necessary 
specialists, ensuring the most effective treatment plans.
TGCT staff will act as consultants and advisors to any military health 
providers who seek consultation regarding a Service Member seeking 
transgender related care.

9.  Resources
    a.  COs with questions or concerns may contact the Navy SCCC through Navy 
311 at:  Navy311(at)navy.mil or (855) 628-9311 or 
http://www.navy311.navy.mil.  The SCCC may also be contacted directly via 
email at:  usn_navy_sccc(at)navy.mil
    b.  Service Members who desire to transition or are presently 
transitioning should work with their medical provider and chain of command 
before contacting the SCCC.
    c.  The COs toolkit and additional resources may be found on the Navy 
Personnel Command web site under
http://www.public.navy.mil/bupers-
npc/support/21st_Century_Sailor/lgbt/Pages/default.aspx
    d.  DoD has created a webpage located at 
http://www.defense.gov/News/Special-Reports/0616_transgender-policy
where Service Members can find a copy of the references (a) and (b) and the 
DoD Handbook. The website also has information to support commands, members, 
and medical personnel.  Through a Common Access Card - enabled link, Service 
Members and commands may submit questions to the DoD SCCC at 
https://ra.sp.pentagon.mil/DoDCCC/sitepages/homepage.aspx.

10.  Marines embarked on Navy Vessels are subject to Navy policy as outlined 
in this NAVADMIN.

11.  This NAVADMIN remains in effect until superseded or cancelled, whichever 
comes first.

12.  Released by Vice Admiral R. P. Burke, N1.//

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