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RTTUZYUW RHOIAAA0001 1541312-UUUU—RHSSSUU 
ZNR UUUUU 
R 031311Z JUN 21 MID200000908383U 
FM CNO WASHINGTON DC 
TO NAVADMIN 
INFO CNO WASHINGTON DC 
BT 
UNCLAS
NAVADMIN 112/21
MSGID/GENADMIN/CNO WASHINGTON DC/N1/JUN//
SUBJ/INTERIM GUIDANCE FOR SERVICE OF TRANSGENDER NAVY PERSONNEL//

REF/A/EXECUTIVE ORDER/PRESIDENT/25JAN21// 
REF/B/MEMO/SECDEF/29JAN21// 
REF/C/DOC/SECDEF/DODI 1300.28/30APR21// 
REF/D/DOC/SECDEF/DODI 6130.03 VOL 1, CHANGE 2/30APR21// 
REF/E/DOC/SECNAV/4NOV16// 
REF/F/ALNAV/SECNAV WASHINGTON DC/271843ZAPR21// 
REF/G/DOC/COMNAVPERSCOM/7NOV16// 
REF/H/DOC/SECDEF/DODI 1332.45/30JUL18// 
REF/I/DOC/COMNAVPERSCOM/2FEB19// 
REF/J/DOC/COMNAVRESFOR/23MAR20// 
REF/K/DOC/BUPERS/7SEP17// 
REF/L/DOC/SECDEF/DODI 1332.14/27JAN14// 
REF/M/DOC/SECDEF/DODI 1322.22/24SEP15// 
REF/N/DOC/SECDEF/DODI 1215.08/19JAN17// 
REF/O/DOC/OPNAV/16JUL12// 
REF/P/DOC/OPNAV/4JUN09// 
REF/Q/DOC/OPNAV/24JUL17// 
REF/R/MSG/CNO WASHINGTON DC/071827ZNOV16// 
REF/S/MSG/CNO WASHINGTON DC/192009ZMAR19// 
REF/T/SECDEF/DODI 1350.02/4SEP20//
NARR/REF A IS EXECUTIVE ORDER (EO) 14004, ENABLING ALL QUALIFIED AMERICANS TO 
SERVE THEIR COUNTRY IN UNIFORM.   
REF B IS SECRETARY OF DEFENSE MEMO, MILITARY SERVICE BY TRANSGENDER PERSONS 
AND PERSONS WITH GENDER DYSPHORIA.   
REF C IS DEPARTMENT OF DEFENSE INSTRUCTION (DODI 1300.28, IN-SERVICE 
TRANSITION FOR TRANSGENDER SERVICE MEMBERS.   
REF D IS DODI 6130.03 VOL 1, CHANGE 2, MEDICAL STANDARDS FOR MILITARY 
SERVICE: APPOINTMENT, ENLISTMENT, OR INDUCTION.   
REF E IS SECRETARY OF THE NAVY INSTRUCTION 1000.11, SERVICE OF TRANSGENDER 
SAILORS AND MARINES.   
REF F IS ALNAV 031/21, MILITARY SERVICE BY TRANSGENDER PERSONS AND PERSONS 
WITH GENDER DYSPHORIA INTERIM GUIDANCE.   
REF G IS MILPERSMAN 1000-131, MEMBER GENDER MARKER CHANGE PROCEDURES.   
REF H IS DODI 1332.45, RETENTION DETERMINATIONS FOR NON-DEPLOYABLE SERVICE 
MEMBERS.   
REF I IS MILPERSMAN 1001-150, NAVY RESERVE PARTICIPATION REQUIREMENTS.   
REF J IS RESPERSMAN 6000-010, RESERVE MEDICAL.   
REF K IS BUPERSINST 1001.39F, ADMINISTRATIVE PROCEDURES FOR NAVY RESERVISTS.  
REF L IS DODI 1332.14, ENLISTED ADMINISTRATIVE SEPARATIONS.   
REF M IS DODI 1322.22, SERVICE ACADEMIES.   
REF N IS DODI 1215.08, SENIOR RESERVE OFFICERS TRAINING CORPS (ROTC) 
PROGRAMS.   
REF O IS OPNAVINST 3120.32D CH-1, STANDARD ORGANIZATION REGULATIONS OF THE 
U.S. NAVY.   
REF P IS OPNAVINST 5350.4D, NAVY ALCOHOL AND DRUG ABUSE PREVENTION AND 
CONTROL PROGRAM. 
REF Q IS OPNAVINST 5354.1G, THE NAVY EQUAL OPPORTUNITY PROGRAM.   
REF R IS NAVADMIN 248/16, INTERIM GUIDANCE FOR SERVICE OF TRANSGENDER NAVY 
PERSONNEL.   
REF S IS NAVADMIN 070/19, INTERIM GUIDANCE FOR SERVICE IN THE NAVY BY 
TRANSGENDER PERSONS AND PERSONS WITH GENDER DYSPHORIA.   
REF T IS DODI 1350.02, DOD MILITARY EQUAL OPPORTUNITY PROGRAM.//
RMKS/1.  Consistent with policies and procedures set forth in references (a) 
and (b), all transgender persons who wish to serve in the United States Navy 
and can meet the appropriate standards shall be able to do so openly and free 
from discrimination.  The Navy remains committed to treating all persons with 
dignity and respect. No person, solely on the basis of gender identity, will 
be denied accession, involuntarily separated or discharged, denied 
reenlistment or continuation of service, or subjected to adverse action or 
mistreatment.  References (r) and (s) are cancelled.
2.  Purpose
    a.  This NAVADMIN provides interim guidance in line with reference (c) 
for policy, regulations and procedures related to the service of transgender 
Navy personnel, in anticipation of an update to reference (e).  This policy 
applies to Navy military personnel, including those serving in the Reserve 
Component (RC).
    b.  For the purpose of this NAVADMIN, the term *Service Member* includes 
midshipmen in a contracted Reserve Officer Training Corps (ROTC) status and 
those at the military service academies.  This NAVADMIN does not apply to 
individuals participating in ROTC programs in a non-contracted volunteer 
status.
3.  Accessions.  Reference (d) establishes physical and medical standards for 
appointment, enlistment, or induction into the military services.
4.  Service
    a.  Consistent with references (a) through (f), transgender individuals 
shall be allowed to serve openly in the Navy.
    b.  Reference (e) remains in effect, but where it conflicts with 
reference (c), reference (c) takes precedence.
    c.  The Navy recognizes a Service Members gender by the Service Members 
gender marker in the Defense Enrollment Eligibility Reporting System (DEERS).  
When a standard, requirement, or policy depends on whether the individual is 
male or female (e.g., medical fitness for duty, body composition assessment 
(BCA), physical readiness testing (PRT), Military Personnel Drug Abuse  
Testing Program (MPDATP) participation, berthing, head, shower facilities and 
uniform and grooming standards) all Service Members will be subject to the 
standards, requirements, or policies associated with their gender marker in 
DEERS.
5.  Medical
    a.  Service Members with a diagnosis of gender dysphoria, for which a 
military medical provider (MMP) has determined that gender transition is 
medically necessary, will receive associated medical care and treatment.
    b.  Service Members must maintain their health and fitness and meet 
individual medical readiness requirements.
    c.  Each Service Member in the Active Component (AC) or in the Selected 
Reserve (SELRES) will, as a condition of continued participation in military 
service, report significant health information that may affect their 
readiness to deploy or fitness to continue serving to their chain of command.  
Service Members who have or have had a medical condition that may limit their 
performance of official duties must consult with an MMP concerning their 
diagnosis and proposed treatment, and must notify their commanders.
    d.  A MMP may determine certain medical care and treatment (e.g. cross-
sex hormone therapy) is medically necessary even after a Service Members 
gender marker is changed in DEERS.  A gender marker change does not preclude 
such care and treatment.  If additional care and treatment that were not part 
of an original treatment plan are required after a gender marker change, and 
that additional care and treatment may impact the Service Members fitness for 
duty, the Service Member must provide medical documentation to the commander 
identifying the additional care, treatment, and projected schedule for such 
treatment.
6.  In-Service Transition
    a.  Starting Gender Transition.  Gender transition begins when a Service 
Member receives a diagnosis of gender dysphoria from a MMP or a confirmation 
of a diagnosis received from a civilian medical provider indicating the 
Service Members gender transition is medically necessary.  In consultation 
with the Service Member, the provider will develop a medical treatment plan 
for gender transition to obtain stability in the self-identified gender.  If 
a treatment plan is developed by a civilian provider, the plan will be 
subject to review and validation by a MMP and the MMP will validate any 
associated duty limitations.  Following receipt of their diagnosis and 
medical treatment plan, prior to starting their care, the Service Member will 
request commanding officer (CO) approval of the timing of their request to 
transition gender.  The CO, in coordination with the MMP, the Navy Service 
Central Coordination Cell (SCCC), and others as appropriate, will develop a 
Cos transition plan that approves the timing of the transition process. 
The CO is the final approval authority for the transition plan.
    b.  COs Action on the Request.  The CO will respond to the request within 
a framework that ensures readiness by minimizing impacts to the mission 
(including deployment, operational, training, and exercise critical skills 
availability), as well as to the morale, welfare, good order and discipline 
of the command.  When approving the transition plan, the CO should also take 
into account the Service Member planned rotation date (PRD) and potential 
impacts on major career milestones of the Service Member.  As directed by 
reference (c) and this NAVADMIN, the CO will:
        (1) Promptly respond to any request for medical care, as identified 
or validated by the MMP, and require that such care is provided consistent 
with applicable regulations.
        (2) Respond to any request for medical treatment or an exception to 
policy (ETP) associated with gender transition, as soon as practicable, but 
not later than 90 days after receiving a request determined to be complete as 
directed by reference (c) and this NAVADMIN.  A request that, upon review by 
the CO, is determined to be incomplete, will be returned to the Service 
Member with written notice of the deficiencies identified, as practicable, 
but not later than 30 days after receipt.
            (a) An approved transition plan, signed by the CO and the Service 
Member, will be provided to the Service Member and the MMP.
            (b) Upon submission of an ETP request seeking a Service policy 
waiver under paragraph 6g of this NAVADMIN, the CO will provide a written 
endorsement with recommendation and route via the first flag officer in the 
chain of command to Deputy Chief of Naval Operations (Manpower, Personnel, 
Training and Education) (DCNO (N1)).
    c.  Completing Transition.  Gender transition concludes when the Service 
Members gender marker in DEERS is changed, upon which the Service Member is 
recognized in their self-identified gender.  Care and treatment may still be 
received after the gender marker is changed in DEERS as described in 
reference (c) and paragraph 5d of this NAVADMIN.  At this point, the Service 
Member must meet all applicable military standards in the self-identified 
gender.
       (1) Once the Service Members MMP has documented that the Service 
Member has completed the medical care identified in a medical treatment plan 
as necessary to obtain stability in the self-identified gender, the MMP will 
provide the Service Member with a memorandum to the CO recommending the 
Service Members gender marker in DEERS be changed to their self-identified 
gender.
       (2) When the Service Member has received the recommendation from their 
MMP and obtained the appropriate documentation pursuant to paragraph 6d 
below, they will submit a written request to their CO to have their gender 
marker changed.  The CO will approve, in writing, the change of a Service 
Members gender marker in DEERS, after receipt of the Service Members request, 
including associated MMP recommendation and appropriate documentation.
       (3) Service Members shall submit the required documentation and the 
COs written approval, as directed by reference (g), to Navy Personnel 
Command.  Once the gender marker is changed in DEERS, the Navy will recognize 
the Service Member in their self-identified gender, to include uniform and 
grooming standards, BCA standards, PRT standards, MPDATP standards, and other 
standards applied with consideration of the Service Members gender as 
reflected in DEERS.
The Service Members gender marker in DEERS determines the head, shower, 
locker room and berthing that will be utilized in facilities that are subject 
to regulation by the Navy.
    d.  Documentary Evidence Required.  Service Members are responsible for 
obtaining one of the following federal or state documents as legal proof of 
gender change.  No documents other than (1) through (3) below are acceptable:
       (1) A certified true copy of a State birth certificate reflecting the 
Service Members self-identified gender.
       (2) A certified true copy of a court order reflecting the Service 
Members self-identified gender.
       (3) A United States passport reflecting the Service Members self-
identified gender.
    e.  Return to Previous Gender.  A Service Member who has completed a 
gender transition but has not resolved their gender dysphoria should consult 
with their MMP and commander.  If a return to their previous gender is 
medically required, the Service Member is to use the procedures outline in 
reference (c) and paragraph 6 of this NAVADMIN.
    f.  Real-Life Experience (RLE).  RLE is the phase in the gender 
transition process during which the individual begins living socially in the 
gender role consistent with their self-identified gender.  RLE may or may not 
be preceded by the commencement of cross-sex hormone therapy, depending on 
the medical treatment associated with the individual gender transition.  The 
RLE phase is also a necessary precursor to certain medical procedures, 
including gender transition surgery.  RLE generally encompasses dressing in 
the new gender, as well as using self-identified gender berthing, head, and 
shower facilities.  RLE normally occurs in an off-duty status prior to the 
gender marker change in DEERS.  If it is recommended in a Service Members 
medical treatment plan that RLE occur in an on-duty status, the Service 
Member must submit an ETP in line with paragraph 6g.  Without an ETP, RLE is 
to take place in an off-duty status.  In the absence of an approved ETP, 
Service Members will utilize the shower, locker room and berthing facilities 
that correspond to their current DEERS gender marker in facilities that are 
subject to regulation by the Navy, including during off-duty RLE.
        (1) For off-duty RLE in foreign locations, Service Members and 
commands need to be cognizant of host-nation laws and social norms.  Travel 
warnings, the State Departments country-specific website, the Department of 
Defense (DoD) Foreign Clearance Guide, and any U.S. regional military 
commander directives should be reviewed and heeded.
        (2) For off-duty RLE in the United States, Service Members who do not 
have an ETP for on-duty RLE may transit to and from their place of work in 
RLE attire at their discretion.
    g.  ETP During Transition.  For on-duty RLE, Service Members may request 
an ETP via their CO and the first flag officer in the chain of command to 
DCNO (N1) as part of an approved transition plan as directed in this NAVADMIN 
and references (c) and (e).  ETP requests should include the CO approved 
transition plan along with the Service Members medical treatment plan.  
Examples of ETPs requiring DCNO (N1) approval prior to a gender marker change 
in DEERS include grooming, uniform and appearance standards, change of 
berthing, head and shower facilities, and urinalysis observation.
       (1) ETPs to adhere to a Service Members self-identified gender BCA and 
PRT standards may be submitted for PFA cycles commencing in calendar year 
2022.  If a Service Member is requesting an ETP for the BCA and PRT, they 
must submit, along with their package, an endorsement from their MMP or, if 
they are a Reservist, the Regional Medical Director.  The endorsement should 
state that the Service Member can no longer meet the standards of their 
current DEERS gender marker for the BCA and/or PRT as a result of the medical 
treatment associated with their gender transition.  If an ETP for the BCA and 
PRT is approved, the Navy SCCC will submit the approval letter to OPNAV N171 
for action.  OPNAV N171 will ensure PRIMS-2 reflects the gender scoring 
identified in the ETP.  Such a change is for PFA calculation purposes only 
and not for a change in the official gender marker, reported by DEERS, in the 
Navy Physical Readiness Information Management System.
       (2) ETPs apply only to the current command-approved transition plan.  
If any circumstances change, (i.e., operational deployment, permanent change 
of station (PCS), transfer of command not requiring a PCS, change of medical 
status, etc.), the Service Member will need to seek a new ETP.
       (3) When a Service Member, with a previously approved ETP, is in the 
process of transferring commands it is recommended to reach out to the new 
command prior to arriving in order to submit a new ETP to allow for 
continuity of on-duty RLE.  If the ETP request has not yet been approved by 
the time the Service Member has arrived to the new command, the CO may honor 
the previously approved ETP while the new ETP request is being processed for 
adjudication.
       (4) If a Service Member is ordered to temporary duty (TDY) or 
temporary additional duty (TAD), the CO of the temporary command may, if 
requested, agree to honor the ETP approved for the Service Members parent 
command, in part or in whole.  A signed memorandum by the CO will be provided 
to the Service Member and the SCCC.  COs are strongly encouraged to honor 
ETPs of TDY and TAD personnel any time operational circumstances allow.
       (5) All ETPs will be submitted to the Navy SCCC via encrypted email or 
DoD Secure Access File Exchange (DoD SAFE).  COs may contact the SCCC with 
questions regarding ETPs.
7.  Navy Policy
    a.  All Service Members will continue to treat each other with dignity 
and respect.  There is zero tolerance for harassing, hazing, or bullying in 
any form.
    b.  Privacy considerations in berthing and shower facilities can be found 
in reference (o).
        (1) Berthing
            (a) COs are expected to implement appropriate policies that 
ensure privacy protection of individual Sailors out of courtesy to all, as 
the tactical situation allows in order to maintain good order and discipline.
            (b) No person will sleep fully unclothed.  Clothing items 
considered to be appropriate sleepwear include undergarments, PT/gym shorts 
and shirts, pajamas and sweat suits.
            (c) No person will transit through spaces unclothed. Sailors 
shall maintain a minimum standards of coverage out of courtesy to all, for 
personal privacy and to foster good order and discipline.
       (2) Crews Heads and Washrooms.  As in the case of berthing spaces, no 
person will transit through head or washroom spaces unclothed.  Service 
Members shall maintain a minimum standard of coverage out of courtesy to all, 
for personal privacy and to foster good order and discipline.  Clothing items 
considered to be appropriate include shirt, shorts, robe or PT gear.  If a 
robe is worn, appropriate garments shall be worn underneath.
    c.  MPDATP.  Reference (p) requires that all Service Members be subject 
to urinalysis and that an observer be of the same gender as the observed 
Service Member during urinalysis.  The observed Service Member may request an 
ETP to be observed by someone of his or her self-identified gender.  Service 
Members are required to adhere to urinalysis policies and procedures when 
selected to observe.  Cos shall ensure dignity and respect is maintained for 
Service Members selected to provide a sample as well as for observers.  COs 
have the discretionary authority to assign observers in order to preserve the
dignity and respect of both parties.
    d.  Equal Opportunity.  Reference (q) clarifies that it is Department of 
Navy policy to prohibit harassment and unlawful discrimination against 
persons or groups based on race, color, religion, sex, national origin, or 
sexual orientation.  Department of Defense policy in reference (t) further 
provides that members will be afforded equal opportunity in an environment 
free from prohibited discrimination on the basis of race, color, national 
origin, religion, sex (including pregnancy), gender identity or sexual 
orientation.
    e.  Pronouns/Names:
        (1) Prior to a gender marker change in DEERS, a transgender Service 
Member is required to adhere to the policies, standards and regulations 
associated with their current DEERS gender marker unless the Service Member 
has an approved ETP to adhere to the standards associated with their self-
identified gender in line with paragraph 6g of this NAVADMIN.  If the Service 
Member has neither their gender marker changed nor an ETP granted for on-duty 
RLE, natal gender (assigned sex at birth) pronouns will be used.  Once the 
gender marker has changed or an ETP for on-duty RLE has been approved, 
preferred gender pronouns will be used.  Intentional misuse of transgender 
Service Member pronouns is inappropriate and inconsistent with the Navy zero 
tolerance policy on harassment.
        (2) As a Service Member transitions to their self-identified gender, 
they may change their name in their official Navy record. If the Service 
Member has changed their name officially, intentional misuse of the Service 
Members birth or other former name is generally considered disrespectful and 
may constitute conduct inconsistent with the Navy zero tolerance policy on 
harassment.
    f.  Assignments:
        (1) All Service Members are worldwide assignable as their medical 
fitness for duty permits.
        (2) The Navy will detail Service Members in line with their gender 
marker recorded in DEERS.
        (3) Assignment or continued service within a military occupational 
specialty, community or designator will be in line with the Navy Bureau of 
Medicine (BUMED) standards for service or retention within that designator.  
Some medical or surgical treatments for gender transition can make a Service 
Member temporarily or permanently incompatible with continued service in a 
special duty community.  In this situation, the member may be placed in a not 
physically qualified (NPQ) or grounded status based on their community 
medical guidelines and referred for consideration of a waiver or 
redesignation.  Case specific questions should be discussed with the Navy 
SCCC and special duty community medical representative.
    g.  Deployability:
        (1) Transgender Service Members may deploy if, like all Service 
Members, they meet all requisite deployability criteria.
        (2) If a Service Member is undergoing gender transition, they may 
have periods of non-deployability based on the care needed. Availability for 
deployment and any anticipated duty limitations will be considered by medical 
providers when developing a medical treatment plan with the Service Member 
and this information will be shared with the Service Members CO.  Medical 
recommendations concerning unanticipated deployments will be made in the same 
way as other medical conditions and as part of the pre-deployment process.
        (3) Service Members who are considered non-deployable for a period of 
12 consecutive months will be evaluated for a retention determination in line 
with reference (h).
    h.  Security Clearances.  Any change in a Service Members demographic 
status is reportable to the command security manager in order to maintain a 
national security clearance.  This includes changes to name and gender.  A 
Standard Form 86 Certification (SF 86C) allows reporting of changes in 
previously reported information on the Questionnaire for National Security 
Positions (SF 86).
8.  RC.  All DoD and Navy policies regarding accessing and retaining 
transgender personnel are applicable to both AC and RC Service Members.  
Selected Reserve and Full-Time Support personnel will follow the gender 
transition approval process described in paragraph 6 of this NAVADMIN.  
Individual Ready Reserve Service Members must report changes in medical 
conditions as outlined in reference (i).
    a.  Medical Diagnosis and Treatment Plan.  A civilian medical provider 
normally provides a medical diagnosis of gender dysphoria and medical 
treatment plan for RC Service Members.  When this occurs, the diagnosis and 
all relevant medical information must be reported and submitted to their Navy 
Reserve activity (NRA) medical duty representative (MDR), in addition to 
informing their reserve unit leadership.  The MDR will forward the medical 
treatment plan to the Navy SCCC medical representative and the regional 
medical representative for validation.  The SCCC medical representative will 
facilitate validation of the diagnosis and review of the medical treatment 
plan.  Once the diagnosis is confirmed and the medical treatment plan is 
finalized, a transition plan can be developed. 
The NRA CO shall coordinate with the Navy Reserve Force Surgeon, the Reserve 
unit CO, and the Service Member to develop the transition plan.  The NRA CO 
with administrative responsibility for mobilization readiness is the approval 
authority for SELRES transition plans.
    b.  Manpower Availability Status (MAS) Codes.  Once the NRA CO receives a 
gender transition request, the Service Member initially becomes temporarily 
not physically qualified (TNPQ) and the temporarily not physically qualified 
for mobilization (MPQ) MAS code will be applied to the Service Member as 
directed by reference (j).
This appropriately identifies the member as having an acute medical condition 
and supports documentation of readiness in the same manner as other medical 
conditions.  The Service Members mobilization status will be reviewed monthly 
to determine whether they are physically qualified for mobilization during 
their transition.  The MPQ MAS code indicates that the Service Member is 
awaiting validation of diagnosis and undergoing a treatment plan that 
precludes mobilization during the acute phase.  If the member’s condition is 
not considered stable or resolved after the first period of TNPQ, TNPQ may be 
renewed for a second period.
    c.  Medical Retention Review (MRR).  As directed in references (j) and 
(k), if it is determined that the medical condition is deemed chronic in 
nature, and will likely prevent the member from safely and effectively 
fulfilling duty responsibilities, or interfere with mobilization, a MRR 
package will be submitted to BUMED to evaluate medical retention as outlined 
in the Manual of the Medical Department, chapter 15.  If the Service Member 
is retained and needs a medical waiver for deployment due to ongoing 
treatment or therapy, the Member will be placed into an MNN MAS code to 
signify that the Member is deployable with limitations.  If the condition is 
resolved and the Member has no lasting restrictions, the Member should be 
reevaluated for removal of medical MAS codes.
SELRES serving on active-duty orders (e.g., active-duty for training, active-
duty for special work, mobilization, definite recall) for a finite period 
will generally be precluded from beginning the gender transition process 
during that period.
9.  Considerations Associated with the First Term of Service.  As directed in 
reference (c), a blanket prohibition on gender transition during a Service 
Member first term of service is not permissible.
    a.  Recruit Training Command.  A Service Member is subject to separation 
in an entry-level status during the period of initial training (defined as 
180 days in line with reference (l)) based on a medical condition that 
impairs the Service Members ability to complete such training.
    b.  U.S. Naval Academy (USNA) and Naval Reserve Officer Training Corps 
(NROTC).  Midshipmen must continue to meet medical accession standards in 
reference (d) or meet criteria for a medical waiver while at USNA or enrolled 
in NROTC.  If identified to have a medical condition or incapacity that 
impairs the individual ability to complete training or receive an appointment 
into the U.S. Military Services, a medical leave of absence (MLOA) may be 
warranted while undergoing treatment for up to 1 year, as determined by the 
Secretary of the Navy.  
When MLOA is recommended, a medical record review will be conducted to 
determine whether there is clear evidence that, following medical treatment, 
the midshipman will be unable to meet the standards for appointment into the 
Navy within a reasonable period of time.  
Midshipmen who will be unable to meet standards or receive a waiver for 
appointment may be dis-enrolled from USNA in line with reference (m) or dis-
enrolled from NROTC in line with reference (n).  Midshipmen who desire a 
gender transition while enrolled in USNA or NROTC will be evaluated under the 
same terms and conditions applicable to participants in these programs with 
medical conditions that are not related to gender transition or gender 
dysphoria.  Each situation is unique and will be evaluated based on its 
individual circumstances; however, all midshipmen will be required to meet 
medical accession standards in line with reference (d), or receive a medical 
waiver of those standards, as a prerequisite to appointment in the Navy.
    c.  A Service Member is subject to administrative separation for a 
fraudulent or erroneous enlistment or induction when warranted and, in line 
with reference (l), based on any deliberate material misrepresentation, 
omission or concealment of a fact, including a medical condition that, if 
known at the time of enlistment, induction, or entry into a period of 
military service, might have resulted in rejection.
    d.  If a Service Member requests non-urgent medical treatment or an ETP 
associated with gender transition during the first term of service, including 
during periods of initial entry training in excess of 180 calendar days, the 
commander considering and balancing the individual need associated with the 
request and the needs of the command may give the significant weight to the 
All-Volunteer Force readiness model, as discussed in reference (c), along 
with any other facts and circumstances related to the individual Service 
Member that impact that model, in determining when such treatment may 
commence and whether to approve or positively endorse the ETP request.
10.  Resources
    a.  COs with questions or concerns may contact the SCCC at  
(703) 604-5084/DSN 664 or via e-mail at usn_navy_sccc(at)navy.mil.
    b.  Service Members diagnosed with gender dysphoria or who identify as 
transgender should work with their medical provider and chain of command 
before contacting the SCCC.
    c.  The COs toolkit and additional resources may be found on the MyNavyHR 
web site under mynavyhr.navy.mil/Support-Services/21st-Century-Sailor/LGBT-
Resources.
11.  Members of other services are subject to Navy policy as outlined in this 
NAVADMIN with regard to usage of heads, showers, locker rooms and berthing 
facilities on Naval vessels.
12.  This NAVADMIN remains in effect until superseded or cancelled, whichever 
comes first.
13.  Released by Vice Admiral John B. Nowell, Jr, N1.//
BT 
#0001 
NNNN 
UNCLASSIFIED//

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      U.S. Navy's Afloat Accident Rate Hits Decade High, Led by MSC

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