Commanders have received notices that some members of their units may be covered by the policy and should begin separation procedures, according to the Transgender military advocacy group SPARTA Pride and Priya Rashid, an attorney with the National Institute of Military Justice. They say several hundred active-duty and Reserve troops, including cadets, have been identified in recent months. SPARTA estimates thousands have already been discharged or are in the process of leaving; the Defense Department has not provided a current count.

An internal Air Force email dated July 31 said the Office of the Secretary of Defense had identified service members whose electronic health records showed a current or past diagnosis of gender dysphoria, or symptoms consistent with it. The Defense Department, Defense Health Agency and military branches declined to answer questions, citing ongoing litigation.

The military’s MHS Genesis system holds health information for more than 9.5 million service members, relatives and children. Records may include diagnoses, prescriptions, mental health notes and documentation of care covered by TRICARE. Military health databases can be searched by diagnosis code, though policies and procedures differ among branches.

One service member facing separation said their referral included details from their medical history, including treatment dates, counseling sessions and medication. The airman said they had not been evaluated for the referral, no longer experienced gender dysphoria and had not shared their treatment history with colleagues.

A sailor who requested anonymity over fear of retaliation said the military had been central to their life and career and that separation would upend both. SPARTA executive director Kara Corcoran, an active-duty Army infantry officer also facing separation, said the policy penalizes people for having addressed a past medical issue.

The administration says a history of gender dysphoria is incompatible with military readiness. President Donald Trump issued directives forming the basis of the ban after returning to office in January 2025. An initial period for troops to leave voluntarily ended in July 2025, after which the Pentagon began involuntary separations.

The Department of Defense estimated about 4,200 troops with gender dysphoria were serving when the ban began. That figure is higher than a 2019 department estimate of about 1,000 troops with at least one related diagnosis. Estimates of the number of transgender people in the military vary, in part because the department does not maintain a definitive count of those who identify as transgender.

Rashid said she has recently heard from about 25 people a week seeking advice on involuntary separation. She said those contacting her include people who transitioned before enlisting and served under the rules then in effect, as well as people whose records mention treatment but who have not transitioned. She also said the search has flagged some people who are not transgender, including members who underwent certain surgeries or sought a diagnosis while pursuing care for other conditions.

The rules for disclosure of military health information are complex. Federal privacy protections allow some sharing with commanders for military purposes, and the Defense Department says records remain subject to the Privacy Act. A 2023 defense law also calls for protecting the confidentiality of mental health services, with exceptions for circumstances such as threats to safety or good order and discipline. Rashid argues those exceptions do not justify using past diagnoses to remove troops who are performing their jobs.

A confidential Army order issued in August bars commanders from broadly searching health or personnel records for soldiers with gender dysphoria or requesting lists of affected members from medical providers. It also limits ordering behavioral health evaluations to confirm a diagnosis, though the order allows action based on information commanders already know or receive from higher headquarters.

In the Air Force and Space Force, medical readiness boards assess cases before commanders refer them to a centralized legal team. Navy and Marine Corps procedures are similar; sailors have 10 days to request a separation board or waive that right. The boards are directed to determine whether a person has had a diagnosis or symptoms of gender dysphoria, while service secretaries make final separation decisions.

The policy is being contested in federal court. A federal judge allowed the case Talbott v. USA to proceed as a class action in June but has not determined who is covered. The administration has also asked the Supreme Court to consider the policy’s constitutionality before a key case is scheduled for trial in January. Lawyers for service members have warned that removals are accelerating while litigation continues.

The potential consequences are especially severe for junior enlisted troops. Corcoran said members with fewer than six years of service may be ineligible for separation pay, could have to repay enlistment bonuses and may have limited access to veterans’ benefits. SPARTA said it has provided more than $36,000 in assistance to 29 people this year, including four who used the support to move away from states with anti-transgender laws.