A top Air Force official seemingly reassured military medical officers that they’d be immune from lawsuits over child sex-change procedures during the Biden administration, documents obtained exclusively by the Daily Caller News Foundation show.
Lt. Col. Josh Smalley, who is currently a physician at the taxpayer-funded Uniformed Services University, shared a series of attachments in March, May and July 2023 that members of the U.S. military and civilian employees should not fear legal action when providing “gender-affirming care” to minors. During the Biden administration, the Department of Defense rolled back restrictions on transgender military personnel.
The documents were provided to the DCNF by the Center to Advance Security in America (CASA), a “nonpartisan organization dedicated to improving the safety and security of the American people.” CASA acquired the documents during a lawsuit against the U.S. Air Force under the Freedom of Information Act.
Smalley, an openly pro LBGT advocate, has published papers such as “Navigating Transgender Healthcare in the Uniformed Services,” “Fit Transitioning: When Can Transgender Airmen Fitness Testin Their Affirmed Gender” and “Transgender and Gender Diverse Health Care in the US Military: What Dermatologists Need to Know.”
Smalley, the White House and Department of War didn’t respond to a request for comment.
‘Indemnify
The emails, although heavily redacted, contain subject lines and attachments titled “IP Care for Transgender Children in Europe” and “Questions from the field on minor gender affirming care.”
“The Department’s ability to carry out its functions depends on the willingness of our personnel to make decisions and take actions that are consistent with their official duties but may nevertheless expose them to personal civil or criminal liability,” a memo, dated Feb. 13, 2023, which Smalley shared with an unknown recipient states.
In a memo titled “Questions from the field on minor gender affirming care,” an attachment appears to explain how members of the U.S. military and civilian employees may be immune from legal action
“Upon request, the Department of the Defense may indemnify, in whole or in part, a Department civilian employee or Service member,” the email attachment states. Moreover, “Upon request, the Department of Defense may pay for all or part of the settlement or compromise of a claim against a Department civilian employee or Service member at any time, provided the Secretary or his or her designee determines that… [redacted].”
In another correspondence, Smalley referenced a 5-hour “symposium/roadshow” for the “Buckley MTF,” though the details surrounding the event itself are unclear.
“Military hospitals and clinics are also referred to as direct care, military treatment facilities or MTFs,” according to the health.mil website.
In Executive Order 14183, the Trump administration cracked down on the LGBT policies favored in the Biden era.
One of Smalley’s papers, “Fit Transitioning: When Can Transgender Airmen Fitness Testin Their Affirmed Gender,” is notable because it may affect training in the U.S. Air Force. If upheld, the policy recommendation would allow men in the U.S. Air Force to lower their fitness requirements to those of women.
“The major components of gender-affirming care include hormone therapy, gender confirmation surgery, and mental health care, if needed. These are covered by TRICARE, the health care program for military service members,” one of Smalley’s papers, published by MDedge.com in July 2024, titled Transgender and Gender Diverse Health Care in the US Military: What Dermatologists Need to Know, states.
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