Sir,

Under arms there are so many transgender men and/or cisgender women more than you might expect.

Transgender people have served or sought to serve in the United States military (U.S. military) throughout its history. As of May 8, 2025, transgender individuals are banned from enlisting in and serving in the U.S. military, except under narrow waivers for those who have not undergone gender transition, have maintained stability in their biological sex for at least 36 consecutive months, serve in roles critical to warfighting capabilities, and are willing to adhere to all standards associated with their biological sex.

Transgender civilian employees at the DoD are not subject to the military ban.

Transgender troops who had already submitted voluntary separation requests prior to the nationwide preliminary injunction issued in the case of Shilling v. United States began to be discharged immediately on May 8, 2025. The memo further states that active-duty personnel have until June 6, 2025, to self-identify for voluntary separation, while members of the reserve forces have until July 7, 2025. After these deadlines, the military departments will initiate involuntary separation procedures [1–4].

Prior to 1960, there was no formal, explicit policy specifically targeting transgender individuals in the U.S. military, but they were effectively barred from service under broader medical and psychiatric disqualification standards. From 1960 until 2016, transgender individuals were formally banned from serving in the U.S. military.

From 2016 to 2017, transgender individuals were allowed to serve openly.

From 2018 to 2019, and again from 2021 to 2025, they were allowed to both serve and enlist openly.

From 2019 to 2021, transgender individuals were banned from enlisting in and serving in the U.S. military, except under narrow exceptions.

Individuals who had been diagnosed with gender dysphoria and had already begun medical transition prior to April 12, 2019, were allowed to continue serving, and waivers were permitted on a case-by-case basis for individuals who had not transitioned, were stable in their birth sex, and could meet all standards associated with that sex.

From January 28 to March 27, 2025, the U.S. Navy began rejecting all transgender applicants. Across the rest of the U.S. Armed Forces, transgender enlistment and access to publicly funded gender-affirming surgeries were paused on February 7, 2025, and a full ban on transgender service was implemented on February 26, 2025. These restrictions were paused from March 27, when a nationwide preliminary injunction was issued in the Shilling case, to May 6, when the U.S. Supreme Court stayed the injunction. The ban is being appealed in the Ninth Circuit.

Unlike bisexuals, gays and lesbians with the Don’t Ask, Don’t Tell Repeal Act of 2010, transgender service and enlistment policies in the U.S. military are not codified in United States Code, which neither allows nor prohibits transgender service and enlistment. This legal ambiguity allows for frequent policy changes via administrative and executive directives, making it a recurring issue of political contention. This dynamic serves as an example of political football, where policies are frequently revised or reversed depending on the administration in power, with five major transgender U.S. military policy changes across four United States presidential administrations in less than a decade since June 30, 2016 [5–7].

A cisgender woman is. In simpler terms, a cisgender woman is a woman who was identified as female at birth and continues to identify as a woman. This is in contrast to transgender women, who were assigned a different sex at birth (male) but identify as women.

Transgender men, also known as trans men or transmasculine people, are. This can involve medical and social transitions to align their bodies and lives with their gender identity. Many trans men retain their reproductive organs and can experience pregnancy and childbirth.

At the US base Camp Derby at Pisa in Tuscany, there are american soldiers who declared to begin their treatment to get the intersexual exchange before 2019 and the A has identified two individuals: a transgender man and a cisgender woman both 27 y. old

Cause of the fact that Italy numbers more sunny days that Nigeria, and jobs at the US base are significantly performed outdoor, the two volunteers decalred to have contracted a sort of actynic keratose, prelude to melanoma or skin cancer.

The A’s experience is based on the comparison between the usages of 5-FU cream md 5-CA cream to prevent the evolution of keratynic distrophy to malignant melanoma, and to state if CA is considere better than 5-FU to the original purpose. [8].

The two soldiers suffering from AK (actynic keratosys) underwent to the application of the two creams and so on each forearm, was used 0.5% COL cream 2×/day for seven days on one forearm, and 5% 5-FU cream 2×/day, for 21 days, on the other forearm. The dosages were defined based on previous clinical trials for each drug.

The primary outcome was complete A clearance and the secondary outcomes were: partial clearance (≥50%), reduction in AK count, assessment of the Forearm Photoaging Scale (FPS), AK Severity Score (AKSS), and adverse effects.

After three weeks of the creams application one can state that there was complete clearance of AK in 37% (95% CI 24%–49%) and partial clearance in 85% (95% CI 76%–93%) of the forearms treated with 5-FU,versus 17% (95% CI 7%–27%) and 78% (95% CI 66%–88%) for COL (p > 0.07). There was a percentage reduction of 75% in the AK count of the forearms treated with 5-FU (95% CI 66%–83%) and 64% in those treated with COL (95% CI 55%–72%). Regarding FPS and AKSS, there was improvement in both groups, with no difference regarding FPS (p = 0.654), and 5-FU superiority for AKSS (p = 0.012). 5-FU and COL are effective for treating CFC, with neither showing superiority regarding the reduction in AK counts.

Notes

Conflict of Interest: None declared.

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