LGBTQ+ Advocacy

MMAA assists LGBTQ military and veteran community members with referral services and resources to support discharge upgrades, legal name changes, gender marker updates, and a wide range of other legal issues.

Thanks to modern science, there is no legitimate reason to deny service members living with HIV the ability to continue to serve their country without arbitrary restrictions on their assignments and ability to deploy. Major advances in the treatment of HIV have rendered the virus untransmittable. As the military struggles to meet recruiting goals, the last thing the Department of Defense should be doing is reinforcing harmful stereotypes and discharging highly trained service members based on outdated science.

Strategic Litigation

MMAA partners with law firms and legal service organizations to challenge discriminatory policies through legal action impacting the LGBTQ military and veteran community as well as service members living with HIV. Recent lawsuits include:

MMAA Advocacy Agenda

Only 1% of 334 million Americans serve in the military. The known LGBTQ+ community makes up more than 6.1% of actively serving members, more than one million veterans, and an estimated 50,000+ military-affiliated youth. This data is derived from 2014 RAND Corporation research that administered and analyzed a revised DoD Health Related Behaviors Study (HRBS) of active-duty personnel, including those in the U.S. Air Force, Army, Marine Corps, Navy, and Coast Guard. These numbers are thought to be significantly underestimated as the data does not reflect those serving in the Reserves or National Guard and it was collected just three years after the Don’t Ask, Don’t Tell (DADT) repeal during a time when openly transgender service members were still banned. Despite the LGBTQ+ community being well represented within military and veteran spaces, LGBTQ+ individuals still navigate unique challenges when accessing healthcare, employment, housing, becoming parents, or integrating into their communities. These challenges are amplified when considering intersecting factors related to military service and other personal identity traits.

In 2023, the 118th Congress forced more than 50 anti-LGBTQ+ votes on the House floor and filed more than 95 anti-LGBTQ+ amendments to bills going to the House floor. These efforts are a way for legislators to show they are taking a hardline stance on LGBTQ+ issues under the guise of keeping America’s youth “safe.”

  1. MMAA asks that Congress refuse to pass any bill that has attached anti-equality riders. Amendments ranged from:
    • Restricting and banning access to medically necessary care for transgender youth and adults, especially those who benefit from federally-funded programs like Medicare and Medicaid.
    • Targeting transgender youth by forcibly outing them to their parents, banning them from playing on sports teams, and banning transgender-inclusive books and study guides.
    • Empowering discrimination against LGBTQ+ people by preventing the federal government from adequately responding to discrimination against LGBTQ+ people by people and organizations that receive taxpayer funds.
    • Blocking access to housing programs and shelters funded by the Department of Housing and Urban Development (HUD) for transgender people
    • Blocking the Biden Administration from finalizing rules that explicitly clarify nondiscrimination protections for LGBTQ+ and intersex people in education and healthcare.
    • Preventing the Department of Justice (DOJ) from enforcing certain nondiscrimination protections and filing certain lawsuits to protect transgender people’s rights.
    • Blocking H.R. 4368, the 2024 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, funding from being used to implement several Executive Orders related to LGBTQ+ nondiscrimination protections and equality.
    • Instituting federal drag bans and limitations on flying Pride flags on federal property.

While many of these laws and appropriations bills ultimately did not pass the Senate and had the majority of anti-LGBTQ+ measures removed from them after they were sent to the Conference Committee, it takes an inordinate amount of time and people power to fight these amendments in each bill. MMAA and other LGBTQ+ military and veteran service organizations worked with both the House and the Senate to ensure no anti-LGBTQ+ legislation was passed.

MMAA’s previous advocacy stance prioritized supporting the creation and passage of a law to allow service members living with HIV the ability to serve their country without arbitrary restrictions on their assignments and ability to deploy. In April 2022, a federal court ruled that the DoD could no longer discriminate against servicemembers living with HIV and must allow them to deploy and commission as officers; MMAA, alongside Lambda Legal, filed the Roe and Voe v. Austin and Harrison v. Austin.

With the policy change, we remain vigilant in ensuring that the policy is implemented without restrictions on assignment and that people living with HIV are included on units that are eligible for deployment so that they are not denied opportunities, career milestones, promotions, or recognition. While the lawsuit ended the era of automatic non-deployability for people living with HIV, it still gives command leadership the ability to approve deployability status and prohibit consideration for some assignments which lends itself to potential implicit bias or discrimination.

  1. MMAA asks the DoD to change U.S. Military policy to allow people living with HIV to enlist or be appointed to the Armed Forces.
    • MMAA actively supports Lambda Legal and Minority Veterans of America lawsuit on behalf of three plaintiffs who were denied enlistment based on their HIV status.
  2. MMAA asks the DoD to ensure the continued implementation of an optimal HIV PrEP program to reduce PrEP accessibility barriers amongst deployed service members.
    • Currently the Navy and Marine Corps Sexual Health and Responsibility Program (SHARP) promotes PrEP prescriptions, however Sailors and Marines have experienced localized differences in the ability to access PrEP with servicemembers on larger bases, near urban areas, or with infectious disease specialists having an easier time accessing PrEP.
    • The Army, Air Force, and Coast Guard do not have a service-wide HIV prevention program that includes PrEP. Soldiers, Airmen, and Coast Guardsmen need to speak to their medical providers or seek an off-base medical provider which makes PrEP difficult to obtain.

In 2023, 85 anti-trans bills have already passed (15%) in 24 states of the 583 proposed across the country. To put that in perspective, in 2022, 26 bills passed (15%) out of 174 bills proposed. That is a 330% increase in proposed bills and a 320% increase in passed bills. These bills impact military service recruitment and retention efforts, particularly for service members with LGBTQ+ dependents. In Arkansas, Florida, Georgia, Iowa, Idaho, Indiana, Louisiana, Missouri, Mississippi, Montana, North Carolina, North Dakota, Nebraska, Oklahoma, Tennessee, Texas, Utah, Wisconsin, and West Virginia there are healthcare bills that prohibit gender-affirming care or medical intervention for transgender youth.

Of these states, Texas, North Carolina, Georgia, and Florida are among the top states with the most active duty U.S. Armed Forces personnel with almost 350,000 active duty troops (2021 data). Furthermore, these four states are among the top five states providing new recruits (2018 data).

Currently, the Biden Administration has defined Title IX protections to include gender identity but that may change with future administrations. MMAA’s goal is to ensure that transgender and nonbinary military dependents have access to affirming healthcare services and do not face discrimination in school. This includes:

  1. MMAA asks that the DoD ensure access to transgender healthcare services through Tricare and the Defense Health Agency (DHA) for service members’ family members in states with restrictive laws.
  2. MMAA asks that the DoD ensure that all military children can play sports or use the bathroom aligned with their gender identity in school, particularly in schools in states with restrictive laws.

Since 2016, transgender people have proven their ability to serve openly in our military. We are a stronger, more capable force with everyone included. Regardless of a person’s sexual orientation or gender identity, if they can meet military standards, their ability to serve should be enshrined in law. At present, there are more than 15,000 transgender people actively serving in the military and more than 163,000 transgender veterans.


The transgender veteran community has been waiting three years to access gender-affirming surgeries for transgender veterans since VA Secretary Denis McDonough announced that VA would cover the surgery. However, in 2023, Secretary McDonough said the holdup was with him, that “the policy is on his desk, and he is “not yet ready” to roll out the rule under the federal regulatory process that would create the benefit.” In January 2024, VA asked a federal appeals court to dismiss a lawsuit brought by Transgender American Veterans Association (TAVA) regarding delays in rulemaking saying “it is working to make such offerings available, but wasn’t prepared to finalize rules on the issue.”

  1. MMAA asks Congress to codify transgender service in DoD policies to ensure that it cannot be reversed by future executive orders.
    • Defining the standards for service eligibility: Any qualifications established or applied for eligibility for service in an armed force shall take into account only the ability of an individual to meet gender-neutral occupational standards for military service generally and the military occupational specialty concerned in particular, and may not include any criteria relating to race, color, national origin, religion, or sex (including gender identity, sexual orientation, or sex characteristics) of an individual.
  2. MMAA asks the DoD to ensure access to transgender healthcare services through Tricare and the Defense Health Agency (DHA) for service members in states with restrictive laws as well as making it unlawful to discriminate against an individual who is transitioning, has transitioned, or is perceived to be transitioning so they may live in accordance with their gender identity.
  3. MMAA requests that VA prioritize suicide prevention efforts for the LGBTQ+ community, with a particular focus on transgender veterans.
  4. MMAA requests VA immediately provide the promised gender-affirming surgery and accompanying care. Congress can help by passing legislation that requires VA to provide the promised gender-affirming surgery.

Top leadership purports VA is committed to creating a welcoming environment and improving healthcare for everyone, including LGBTQ+ veterans. In reality, VA has inconsistent policy implementation, non-standardized staff disciplinary actions for discriminatory actions, and organization-wide LGBTQ+ affirmative care competency training is not prioritized.

Already in 2024, several anti-LGBTQ+ incidents occurred within VA, which directly conflicts with VA leadership’s promise to make the agency more welcoming to all veterans. In the Portland VA Medical Center serving Oregon and SW Washington, a flier was posted in the elevator mocking VA’s diversity efforts claiming that leaders only want to help veterans of “approved minority groups.” Signs stating “We serve all who serve” were torn down and handouts with LGBTQ+ specific suicide prevention resources were thrown into the trash.

Although VA has developed programs such as PRIDE in All Who Served to improve health equity and access to care for LGBTQ+ military veterans, research finds its success is heavily related to individual VHA facility settings including leadership support for LGBTQ+ affirming programming, access to LGBTQ+ affirming care training, and facility culture (such as systemic anti-LGBTQ+ stigma).

To rebuild trust with LGBTQ+ veterans, MMAA is asking VA to:

  1. Issue a public statement identifying standardized actions and what follow up VA takes to hold providers and employees accountable for gender identity and sexual orientation discrimination, harassment, and bias.
  2. Create a policy that informs patients who identify as LGBTQ+ if their care provider is reprimanded for gender identity and sexual orientation discrimination, harassment, and bias with an option to transfer care if they feel unsafe.
  3. Provide a timeline and detailed outline of the measures VA intends to take to create systemic cultural change to support and protect LGBTQ+ veterans.
  4. Commit to creating an LGBTQ+ Veterans Advisory Committee to advise VA on the administration of benefits and provision of healthcare, benefits, and services to LGBTQ+ veterans.
  5. Release current data on incidents of discrimination at VA facilities as well as encourage LGBTQ+ veterans to report discrimination in VA facilities through a reporting tool that allows for intersectional analysis and tracking of individual, interpersonal, and institutional-based issues.

The passage of the Deborah Sampson Act (H.R. 3224) was a tremendous milestone to ensure that women veterans no longer receive substandard care at VA. The act eliminates barriers to care and services that many women veterans face and helps ensure VA addresses the needs of women veterans who are more likely to face homelessness, unemployment, and go without needed health care.

Much like women veterans, LGBTQ+ veterans face substandard VA care. However, they also face bigotry and inaccurate portrayals of sexual assault statistics to build fear of transgender individuals and portray women veterans as vulnerable. In reality, the 2022 U.S Trans Survey Early Insights reveal that nearly one-quarter of LGBTQ+ people (24%) report they did not see a doctor when they needed to in the last 12 months due to fear of mistreatment. Forty-four percent (44%) of LGBTQ+ people experienced serious psychological distress in the previous 30 days. Of those who saw a healthcare professional within the last 12 months, nearly one-half (48%) reported having at least one negative experience because they were transgender, such as being refused health care, being misgendered, having a provider use harsh or abusive language when treating them, or having a provider be physically rough or abusive when treating them.

  1. MMAA asks for an expansion of the Deborah Sampson Act that includes provisions to:

    • Eliminate barriers to care by staffing every VA health facility with a dedicated LGBTQ+ healthcare coordinator and training clinicians and direct service providers in LGBTQ+ competent care and service.
    • Expand the Deborah Sampson Act policy to include LGBTQ+ harassment and assault and provide publicly available annual reporting. The discrimination report must provide intersectional analysis and tracking as LGBTQ+ harassment often goes hand in hand with racial and gender bias.
    • Require the intake process for veterans at VA facilities to include survey questions about whether the veteran feels safe in the facility.
  2. MMAA asks Congress to direct VA to establish anti-discrimination (including gender identity, sexual orientation, or sex characteristics) regulations already defined under Section 1557 of the Patient Protection and Affordable Care Act for federal healthcare programs administered and funded by VA.

It’s been 13 years since DADT’s repeal but the trauma of these policies live on for LGBTQ+ veterans whose other than honorable discharges have yet to be corrected. There is a pending class action lawsuit by LGBTQ+ plaintiffs v. U.S. Department of Defense seeking redress for violations of the Fourteenth and Fifth Amendments to the U.S. Constitution. The five plaintiffs, on behalf of thousands more, ask that the government be ordered to remove the narratives and separation codes identifying their sexual orientation from their discharge forms and upgrade their discharge statuses as needed.

We are pleased that the DoD has taken a critical first step to presumptively review records and increase outreach efforts to those discharged under this discriminatory policy. While the DoD has acknowledged it has begun the process of reviewing records of approximately 2,000 veterans for potential discharge upgrade eligibility there are more than 29,000 LGBTQ+ veterans who were denied honorable discharges. Furthermore, the military used a range of charges to remove LGBTQ+ people from service, some of which resulted in a court-martial conviction and some with incarceration. The DoD says it has no means by which it can administratively set aside a conviction once appellate review is complete.

Rep. Robert Garcia and other Democratic lawmakers wrote a letter in January 2024 requesting answers to questions to allow oversight of the implementation of these efforts. Undersecretary of Defense Ashish Vazirani sent a response indicating the majority of the questions would be answered by May 31, 2024.

Also in January 2024, MMAA signed on to a letter with nine other VSO and LGBTQ+ organizations requesting a meeting to discuss concerns about the process eliminating many veterans from the process, including 1) veterans separated with Entry Level or Uncharacterized discharges, as well as those with Honorable characterizations whose DD214s reflect codes or language indicating the discharge was due to sexual orientation; 2) veterans with “aggravating factors”—such as misconduct—in their records, even when the misconduct is minor or unconnected to the discharge; 3) veterans who were subjected to non-judicial punishment under regulations, which no longer exist, that policed sexual orientation and same-sex sexual conduct; 4) veterans who were discharged due to suspected or presumed sexual orientation but whose records do not reflect sexual orientation as the basis for discharge, including those discharged under the pretext of misconduct; 5) veterans who were court martialed, or discharged in lieu of court martial, for alleged conduct that is no longer considered a violation of the U.C.M.J.; and 6) veterans who were discharged under policies that existed before DADT. The coalition has yet to receive a formal response to the letter or meeting with the DoD’s Office of Personnel and Readiness.

  1. MMAA asks that the DoD respond to both Rep. Garcia’s letter and the coalition letter to discuss how to better serve veterans who are currently left out of the presumptive discharge upgrade process.

As active service military members, veterans, military family members, and organizational allies serving the military community, we urge the Pentagon to engage publicly and meaningfully to address the decision to ban drag events from DoD facilities. This decision sends an exclusionary message to LGBTQ+ military families and ignores the reality that drag performances have long been a part of military history, tracing back to WWI and WWII.

Given the increasingly politicized nature of these events, the DoD must support the LGBTQ+ community against unwarranted attacks and bans on family-friendly, non-partisan, and privately funded activities. We know some LGBTQ+ friendly events are arbitrarily being canceled under the undefined drag ban.

  1. MMAA asks the DoD to issue a public statement from Secretary Austin to reverse the policy banning drag shows and story hours followed by:
    • Sharing clarified guidance immediately regarding what is “allowable” and “banned” as part of federally and privately funded events on DoD facilities.
    • Publicly denouncing any attempts to politicize LGBTQ+ issues so service members, veterans, and their families feel part of an inclusive and welcoming military system.
    • Acknowledging the anti-LGBTQ+ bias that has increased on military installations in direct response to the drag ban policy.