Congress enacted FY2025 NDAA provision barring TRICARE coverage of gender-affirming care for military dependents under 18

On December 23, 2024, President Joe Biden signed H.R. 5009, the "Servicemember Quality of Life Improvement and National Defense Authorization Act for Fiscal Year 2025," into law as Public Law 118-159. Section 708 of the enacted act amends 10 U.S.C. 1079(a), the statute governing TRICARE's health-benefit program, to prohibit TRICARE from covering "medical interventions for the treatment of gender dysphoria that could result in sterilization" — a category that includes hormone therapy and puberty blockers — for TRICARE beneficiaries under 18 years of age. TRICARE covers roughly 9.5 million beneficiaries, including the minor dependents of servicemembers and military retirees.

Section 708 originated as a House Republican-inserted rider (House-passed H.R. 8070, Section 709) during conference negotiations and was adopted, with an amendment, into the final enacted NDAA text; the House passed the underlying bill December 11, 2024, and the Senate followed one week later. The provision is narrower than a House-passed companion measure (Section 713 of H.R. 8070) that would have barred TRICARE and the Supplemental Health Care Program from covering gender-affirming surgical care and hormone therapy for all beneficiaries; that broader ban was not included in the final law. TRICARE was already statutorily barred from covering gender-affirming surgical care for beneficiaries under 10 U.S.C. 1079(a)(11), so Section 708 extends the exclusion specifically to nonsurgical hormone-based treatment for minors.

In his signing statement, Biden said his administration "strongly opposes" Section 708, writing that it "inhibits the Department of Defense's ability to treat all persons equally under the law, no matter their gender identity," compels DOD "to contravene clinical practice guidelines and clinical recommendations," and "targets a group based on that group's gender identity." Biden signed the underlying bill despite this objection because it is "must-pass" annual defense authorization legislation funding the entire military for fiscal year 2025. Military families of transgender adolescents told reporters the provision forced abrupt disruptions in ongoing medical care as TRICARE coverage lapsed.