united states coast guard

R 131404 MAR 19
ALCOAST 077/19
A. Secretary of Defense Directive-type Memorandum (DTM)-19-004, “Military Service by Transgender
Persons and Persons with Gender Dysphoria”
B. Military Transgender Service, COMDTINST M1000.13
C. Coast Guard Recruiting Manual, COMDTINST M1100.2 (series)
D. Coast Guard Medical Manual, COMDTINST M6000.1 (series)
E. Military Separations, COMDTINST M1000.4
F. Medical Standards for Appointment, Enlistment, or Induction in the Military Services,
DoDI 6130.03
1. This ALCOAST announces upcoming changes to military service by transgender persons and persons
with gender dysphoria as outlined in REF (A).  These changes are effective on 12 APR 2019 and are
in alignment with recent changes to Department of Defense policy.
2. All persons shall be treated with dignity and respect. No person shall be denied accession,
involuntarily separated or discharged, denied reenlistment or continuation of service, or
otherwise subjected to adverse action or treatment solely on the basis of gender identity.
3. On or after 12 APR 2019, applicants for Coast Guard military service will continue to be
accessed or commissioned per REFS (C) through (F). In addition, the following medical standards
will also apply:
   a. An applicant with a history or diagnosis of gender dysphoria is disqualified unless:
     (1) They are stable for 36 consecutive months in their biological sex immediately prior to
application as certified by a licensed medical provider; and,
     (2) They have not transitioned to their preferred gender and a licensed medical provider
has determined that gender transition is not required to protect their health; and,
     (3) The applicant is willing and able to adhere to all standards associated with their
biological sex.
   b. An applicant with a history of cross-sex hormone therapy, sex reassignment or genital
reconstruction surgery is disqualified.
4. On or after 12 APR 2019, military members diagnosed with gender dysphoria may be retained if
   a. Do not require a gender transition to protect their health, as certified by a military
medical provider; and,
   b. Are willing and able serve in their biological sex and comply with all associated standards.
5. Exemption Criteria: Individuals will be considered exempt from the new policy announced in this
message and will continue to be subject to the previous accession and retention standards if, prior
to 12 APR 2019, they:
   a. As an applicant, entered into a contract for enlistment (including the Delayed Entry Program
(DEP)) or were selected for entrance into an officer commissioning program through a selection
board or similar process and were medically qualified for accession in their preferred gender; or,
   b. As a military member, received a diagnosis of gender dysphoria from, or had such diagnosis
confirmed by, a military medical provider.
6. Exempt individuals may continue to receive all medically necessary treatment, obtain a gender
marker change in DEERS per REF (B), and serve in their preferred gender or pursue gender transition.
7. Any member who receives a diagnosis of gender dysphoria will receive appropriate medical care.
8. On or after 12 APR 2019, REFs (B) though (E) will be updated to reflect these changes.
9. On or after 12 APR 2019, waivers and exceptions to policy will be considered on an individual
basis. Waiver and policy exception guidance will be provided in the update to REF (B).
10. Information on the Coast Guard’s transgender policy including FAQs can be found at
11. Members with medical concerns about gender dysphoria should seek the counsel of a military
medical provider.
12. Questions regarding transgender and gender dysphoria policy should be directed to
the Service Central Coordination Cell at This inbox provides privileged
conversations with a team of experts on transgender policy and other concerns.
13. Released by RADM W. G. Kelly, Assistant Commandant for Human Resources.
14. Internet release is authorized.