Dear Senate Leaders Thune and Schumer, and House Speaker Johnson and Leader Jeffries,

We, the 58 undersigned organizations, urge you to reject any legislation that further restricts access to essential health care, including abortion, contraception, fertility, and gender-affirming medical care, whether delivered in-person or via telehealth for military service members, veterans, and their families. We are united in our belief that all people—including those who serve and their families—should be able to access the care they need, wherever they live, and to make informed decisions about their own bodies and lives.

Our country is facing a reproductive health care crisis, one that has only become worse in the wake of the devastating and erroneous Supreme Court decision in Dobbs v. Jackson Women’s Health Organization. Currently, 12 states have total abortion bans; in many more, abortion is almost entirely inaccessible. The combination of abortion bans and restrictions and cuts to funding for contraception and other family planning care all compound to make it at best, difficult, and at worst, extremely dangerous to access needed reproductive health care. The impact could mean lifelong harms to people’s well-being, health, and financial stability, plus alarming rates of death due to pregnancy and birth, including exacerbating the already high maternal mortality rates for Black women.

These obstacles are especially burdensome for cisgender women and transgender and nonbinary people who serve in the military or depend on the Military Health System (MHS). Women represent 17.5 percent of active duty service members and nearly 20 percent of all active duty officers. The MHS serves approximately 1.62 million women of reproductive age (15-45), including service members, retirees, and their dependents. Just last year, Congress took critical action to increase access to birth control and ensure that TRICARE offers contraception to all beneficiaries without out-of-pocket costs. However, we are concerned that the ongoing attacks on reproductive health care access across our nation will continue to make access to abortion, fertility care such as IVF, and maternal health care more difficult, especially for veterans, military service members, and their families who are often stationed in a state or country that bans or restricts abortion and other types of care.

Additionally, half of U.S. states have passed laws banning best practice medical care for youth, and anti-trans lawmakers have increasingly turned their attention to restricting care for adults. A large body of scientific evidence compiled over the last five decades illustrates that gender-affirming medical care is safe, effective, lifesaving care that improves the physical and mental health of transgender people. In fact, every major medical and mental health association in the country—representing more than 1.3 million doctors—supports individualized, age-appropriate gender-affirming medical care to promote the health and well-being of transgender people. For transgender adults, access to hormone therapy reduces the risk of depression, while trans adults not using hormone therapy were almost four times more likely to have depressive disorder. For transgender youth, access to age-appropriate hormone therapy and puberty blockers can be lifesaving. Studies have consistently found that transgender youth who are able to access the gender-affirming medical care they need have substantially improved mental health outcomes, including lower rates of anxiety, depression, and suicidality. And yet, we have seen efforts by Congress to deny this care to service members, veterans, and their families. The burdens of those attempts fall hardest on those who are stationed in states that have enacted their own bans on care.

Our country promised service members and veterans comprehensive health care without barriers when they signed up to serve — but that promise continues to be broken. Extremists have attacked both reproductive health care and gender-affirming medical care, threatening our fundamental rights and targeting those who serve, veterans, and their loved ones. There is no greater example of this than the cruel and senseless purge of transgender people from our military. The discriminatory removal of transgender service members by the Trump administration has led to heartbreaking consequences and threatened readiness and morale among the ranks. Despite their desire to bravely serve, transgender service members now face a world where their civil rights, indeed their very existence, are under unrelenting attack, and, as veterans, their health care is in jeopardy once again — to say nothing of our service members who are parenting transgender children where this care has already been banned.

Attacks on women, transgender, and non-binary people at home and abroad are attacks on the same basic rights to self-determination and bodily autonomy. Many of the medical providers who offer abortion and other reproductive health services also offer gender-affirming medical care, as this care is part of the full spectrum of essential health services our communities need. Policies attempting to prevent people from receiving either form of health care obstruct and deprive many of our most vulnerable communities of time-sensitive, life-saving care.

We, the undersigned 58 organizations, urge you to oppose any legislation, including appropriations bills and the National Defense Authorization Act (NDAA), containing language that restricts or bans access to reproductive health or gender-affirming medical care.

It is the responsibility of Congress to protect the health of its constituents and our nation’s troops, veterans, and military families. No one should be left behind; despite that, the safety and well-being of our military service members, veterans, and their families are under enormous threat. We cannot and should not jeopardize the health of our communities for political gain.

Find the full letter here.