Gay military doctor now fights for trans troops, LGBT health equity

Jesse Ehrenfeld testifies for trans military service. (Blade file photo by Michael Key)

Six months ago, five service members made history on Capitol Hill by becoming the first openly transgender witnesses to testify before Congress.

Alongside them was another witness who wasn’t transgender, but a member of the LGBT community who presented expert testimony affirming their capacity to serve as President Trump threatened to expel them from the military under his proposed ban.

Jesse Ehrenfeld, an anesthesiologist and expert in LGBT medical issues, said otherwise qualified individuals shouldn’t be barred from military service simply because they’re transgender.

“I would like to say unequivocally for the record that there is no medically valid reason, including a diagnosis of gender dysphoria, to exclude transgender individuals from military service,” Ehrenfeld told the House Armed Services Personnel Subcommittee.

In an interview Tuesday with the Washington Blade, Ehrenfeld acknowledged his personal experience helped influence his advocacy for transgender people in the military.

After all, he’s a gay man who’s able to serve as a commander in the Navy and be open about his sexual orientation thanks to repeal of “Don’t Ask, Don’t Tell,”

“Being an LGBTQ person, you know, I have faced discrimination at various points in my life,” he said. “Certainly the ability to stand up for what is right, I think, in part comes from those experiences growing up as a gay person, and certainly, as a physician, I have certain opportunities to try to stand up for the community.”

Ehrenfeld, 40, has a long record prior to his congressional testimony of being on the forefront of advocating for transgender people in the military — both in the Obama and Trump administrations.

A crucial moment came in 2015, when Ehrenfeld as a commander in the Navy, was deployed to Afghanistan where he provided care at the NATO Role III Multinational Medical Unit.

Then-Defense Secretary Ashton Carter, newly confirmed in his role as defense chief, took questions from service members at a military town hall in Kandahar about their concerns in the field.

Ehrenfeld’s question: Do you support allowing otherwise qualified transgender people to serve openly in the armed forces?

At the time, transgender people were barred from service as a result of a medical regulation instituted in the 1980s that was based on an outdated understanding of individuals with gender dysphoria.

“I don’t think anything but their suitability for service should preclude them,” Carter replied, adding he hasn’t studied the issue a lot since he became secretary of defense, but was “open-minded” about “what their personal lives and proclivities are, provided they can do what we need them to do for us.”

Days later during the White House news conference, the Washington Blade took the opportunity to ask whether President Obama shared Carter’s views on transgender service. Then-White House Press Secretary Josh Earnest affirmed that was the case.

“I can tell you the president agrees with the sentiment that all Americans who are qualified to serve should be able to serve, and for that reason, we here at the White House welcome the comments of the secretary of defense,” Earnest said.

Thinking back on that moment, Ehrenfeld said he was “frankly very nervous” to speak out but was “delighted” with Carter’s response.

“His message that fitness for duty should be the primary driver of the ability to serve is one that I think serves our military well,” Ehrenfeld said.

What motivated Ehrenfeld to ask the question? Ehrenfeld said it was based on his experience serving with Air Force Staff Sgt. Logan Ireland, a transgender service member who was deployed with him in Afghanistan. Since that time, Ireland has been at the forefront of advocacy for transgender people in the military.

The two met, Ehrenfeld said, shortly after he arrived in Afghanistan and Ireland sought medical care at the facility where Ehrenfeld was working.

“Frankly, I was a bit shocked to meet this person because I knew of the restrictions on transgender service and the last place I expected to find a transgender person was deployed with me in Afghanistan,” he said.

An estimated 14,700 transgender people are now serving in the military. Although the Obama administration would shortly after change the policy to allow transgender service, Trump would change that months after taking office and institute a ban.

“There are mountains of transgender troops and even more transgender veterans who are able to and have done that job quite well,” Ehrenfeld said. “It’s unfortunate that we have discriminatory policies that are preventing them from doing their job.”

After the exchanges at the military town hall and the White House, the wheels were in motion for a year-long study at the Defense Department on transgender military service.

For the Obama administration study, Ehrenfeld said he provided input based on his medical expertise and had conservations with defense officials as the process was happening.

On June 30, 2016, Carter announced at the Pentagon the ban would be lifted. Ehrenfeld said he was present at the Defense Department and it was among the “proudest moments” of his career.

“I understand how we’ve taken a few steps backwards since but at the time it represented such progress with incredible ramifications for transgender people and LGBTQ people all across our nation, not just those serving,” Ehrenfeld said.

Ehrenfeld, who earned his medical degree from the University of Chicago and his master’s in public health at Harvard University, bolsters his advocacy with his impressive credentials in medicine.

Motivated to enter the field of medicine at an early age, Ehrenfeld said in his college days at Haverford College he sought to shadow physicians in their work.

“I love taking care of patients in the operating room, getting them through complex surgeries, watching them walk out of the hospital is one of the most fulfilling things that I get to do on a weekly basis,” he said.

A researcher in the field of biomedical informatics, Ehrenfeld is a professor at Vanderbilt University Medical Center, where he serves as director for the Center for Evidence-Based Anesthesia.

His LGBT work in the medical field goes beyond transgender military service. Nine years ago, he co-founded the Program for LGBTI Health at Vanderbilt for work on health disparities facing LGBT people.

The research, Ehrenfeld said, seeks to modify and improve electronic health records to serve the needs of LGBT patients and care protocols for transgender people.

“A lot of that work is ongoing,” Ehrenfeld said. “We continue to partner with colleagues, not just at Vanderbilt but across the country to help advance the evidence base that can lead to the best practice for LGBTQ patients.”

Sean Cahill, director of health policy research at the Boston-based Fenway Institute, said he worked with Ehrenfeld on LGBT data collection in health care.

“Jesse Ehrenfeld has been an effective advocate for LGBT health equity within the American Medical Association and the broader health professional sector,” Cahill said. “Jesse has helped enlist broad, mainstream support for sexual orientation and gender identity data collection in Electronic Health Records, for SOGI nondiscrimination in health care and for coverage of transgender health care needs.”

In 2018, Ehrenfeld was given the inaugural NIH Sexual & Gender Minority Research Award for that work.

Now chair of the Board of Trustees for the American Medical Association, Ehrenfeld also works on behalf of U.S. physicians to conduct medical advocacy, which he said includes reducing HIV/AIDS stigma and working to ensure all Americans, including LGBT people, have access to affordable health care.

“We’re committed to helping to achieve equity through health care, and that has to be done by raising awareness about the importance of health equity to patients and communities but also working at the system level to identify and eliminate those disparities,” he said.

With all those hats, Ehrenfeld said a typical week consists of seeing patients in the operating room — mostly for anesthesia for non-surgical procedures — as well as being active in Vanderbilt’s LGBT health programs, where he researches information technology to reduce health care disparities.

“I never know exactly what’s going to happen,” he said. “I have some vague idea of what might transpire, but it’s that variety that kind of keeps me going.”

Other work in LGBT advocacy includes appearing with his partner in a 2015 TV ad produced by Freedom to Marry promoting same-sex marriage and being a former chair of the Massachusetts Log Cabin Republicans from 2009-2010.

One other distinction pops out on his list of accolades. In 2016, Ehrenfeld won an Emmy nomination for “TransMilitary,” a film directed by Fiona Dawson that documents the lives of transgender people in the military, including Ireland.

“I’m very proud of that particular nomination because of what it represents,” Ehrenfeld said. “It represented work and ideas on the film ‘TransMilitary’ trying to capture authentically the lives of deployed and actively serving transgender service members. And I was able to work with a production team to capture a lot of footage and photos.”

Meanwhile, anti-LGBT groups continue their work seeking to undermine transgender people, such as by stating — contrary to evidence — transgender identity isn’t based on science and biological sex is the only reality.

One such mailing came this week from the National Organization for Marriage, a group formed to fight same-sex marriage.

Under the subject line “Science Deniers,” the e-mail compares biological characteristics, between men and women, such as differences in sensory abilities, and behavioral differences to conclude transgender advocates are promoting a “completely false ideology.” The National Organization for Marriage then asks for donations to allow the group to continue its message.

Ehrenfeld said his affirmations of transgender people are based on science.

“I think when we have individuals that try to bend facts, we point them back to what the evidence speaks to and we know, acknowledging that individuals gender and sexual identities don’t always fit neatly into binary paradigms,” he said.

Likely as a result of anti-transgender sentiments such as these, the change allowing transgender people to serve openly in the military wouldn’t last. In 2017, President Trump announced via Twitter after meeting with unnamed military experts he’d ban transgender people from the armed forces.

“I was actually seeing patients that day,” Ehrenfeld said. “Unfortunately, it’s been a continuous fight ever since to regain the ground that has been lost.”

Although defense officials were reportedly surprised by the tweets, then-Defense Secretary James Mattis was concurrently conducting a study at the Pentagon re-evaluating transgender military service. Months later, Mattis produced an implementation plan severely restricting the ability of transgender people to serve in the armed forces.

Unlike the Carter study, Ehrenfeld said he didn’t provide input for the Mattis study, nor was he asked for his expertise.

The courts initially blocked the Trump administration’s policy, but the U.S. Supreme Court lifted those orders, essentially allowing the ban to go into effect. The Pentagon implemented its restrictions on transgender military service on April 12.

With the ban in place, transgender advocates continue the battle for a change to allow service members once again to serve regardless of their gender identity. At the top of their list to make that happen is removing Trump from the White House when he seeks re-election in 2020. 

Ehrenfeld, however, cautioned restoring transgender military service might not be as simple as electing a having a new president.

“I don’t think it is necessarily,” Ehrenfeld said. “There are legal challenges that are a part of the equation and certainly, there’s no guarantee a new administration would change the policy or change course. Again, I don’t have a crystal ball to be able to predict what it would take to get us to a better policy position, but certainly those are the kinds of things that I think are in the mix.”

Gal Mayer, president of GLMA: Health Professionals Advancing LGBTQ Equality, called Ehrenfeld a “national leader” for LGBT health whose rise coincides with the medical field’s growing support for policies addressing LGBT health equity.

“Jesse Ehrenfeld is a national leader for LGBTQ health who embodies the qualities GLMA hopes to foster: A health professional who dedicates their practice and academic research to advocating for the health and well-being of LGBTQ people,” Mayer said.

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