US military families with transgender children stationed in Europe faced a lack of specialized sex hormone therapy options due to a shortage of qualified clinicians. In mid-2010s reporting, it was noted that gender-affirming hormone therapy for minors was included in military health coverage, and by 2017 a significant number of young service members had sought care to transition.
Several families relocated to Europe seeking treatment, yet only a single Landstuhl facility handled such care, and that clinic had stopped accepting new patients because of demand and capacity constraints. Reports at the time highlighted gaps in counseling and screening services for transgender youths in military families, even as mental health risks such as depression and suicidality were acknowledged as elevated concerns.
Observers pointed out that the availability of endocrine and related services near U.S. bases in Europe was limited, with only a couple of clinics within a reasonable distance to provide hormone therapy and other necessary care for transgender children. The demand from local residents across Europe was described as substantial. European clinicians argued that complex work in this area should occur in the patient’s native language to ensure clear, sensitive communication.
Experts emphasized that gender-identity care requires in-depth conversations about identity, sexuality, and related issues, all ideally conducted in the patient’s mother tongue. They noted that a thorough process—often at least a dozen consultations—precedes any hormonal intervention according to European practice standards, underscoring the need for time, careful assessment, and experienced clinicians.
Additionally, clinicians warned that hormone therapies, such as those affecting puberty, carry potential consequences like infertility and long-term physical changes. They called for comprehensive psychotherapeutic evaluation before initiating treatment to ensure well-supported decisions by young patients and their families.
In discussions with clinicians, it was reported that the past decade saw around two hundred young patients seeking gender-affirming care from a single European provider, with a substantial share presenting in the last two years. Space limitations forced the clinic to turn away two transgender youths connected to American military families in Germany, illustrating the scale of unmet need in this region.
Statements from the military health administration indicated that addressing these gaps would require increased funding for medical care in Europe to meet the needs of transgender children across the force deployed there.
Earlier political debates surrounding service by transgender individuals in the U.S. military included proposed legislation aimed at restricting or prohibiting service of those with gender dysphoria. The proposed act would ban service for people identifying as transgender, unless they described themselves in official documents in accordance with their birth sex, and it was projected to affect a significant portion of transgender military personnel, particularly those nearing or having completed educational paths inside the service. The policy discourse highlighted the tension between medical access abroad and military readiness in regard to transgender service members, as lawmakers weighed potential impacts on personnel and family wellbeing.