This interview was conducted by Emma Smith (she/her), a licensed professional counselor and doctoral candidate who specializes in gender and identity. A long time advocate of military families and LGBTQ+ rights, Emma asked to partner with Sparta to fulfill the advocacy domain of her program by completing a series of interviews through the lens of a mental health professional, highlighting some of the challenges our transgender service members face, and their incredible resiliency. As such, these interviews have a different style and tone than other SOS postings. We hope that these stories can be of use not only to other service members, but also service providers who need to better understand the lived experience of transgender service members.
Kora Delta (she/her) is an E-4, Command and Control Battle Management Operator in the United States Air Force.
Military Service Questions
Kora joined the Air Force because, to her, “it seemed like the smartest, most advanced in policy and technology, and it agreed the most with what I liked when choosing branches.”
Question: What is the most important lesson you’ve learned over your career?
Kora was quite clear that she has learned that she is the most powerful and influential factor in her own life. “No one will care more about your health, career, finances, or body than you,” she explained. “Sure, there is a supervisor, a PCM, or a fitness rep who can help, but people PCS people move, and so do you.” She also shared that while there can be barriers that service members face, there are often workarounds to be found – if you know how to ask and what resources to use.
“Did someone say no? Depending on what it is, there could be someone who can help navigate or find an alternative path to achieve similar results.” However, she does caution that finding workarounds is a unique skill and that folks need to learn how to balance completing their mission without stepping on people’s toes. Being able to strike that balance, however, opens up opportunities. “Know what you are doing and have the confidence to make sure you get what you want,” she encouraged.
Question: In your opinion, what is the most important personality trait/strength someone would need to work in your industry/be successful in your job?
“Communicate.” According to Kora, the key to success in her job is communication. She explained that some people have a vague communication style, so she has found the need to be patient and ask clarifying questions. On the other hand, she also recognizes that brevity can be valuable in communication. “Getting the right message to the right people in the right context makes processes and mission execution faster. Some people need more or less explanation, and a strong communicator knows the signs and says the right things to ensure everyone is on the page.”
What is one piece of advice you’d give to a person who is transgender or nonbinary and wants to join the military?
As much as Kora feels strongly about her role in the Air Force and is confident about navigating the system, she is less enthusiastic about recommending military service to other transgender or nonbinary individuals. According to Kora, the processes of accessing transition-related care are the main reasons she hesitates to encourage others. The process of navigating Tricare, getting signatures and maintaining communication with PCMs and Case Managers (who often PCS), and then booking the appointments within reasonable timeframes on base were her main concerns. According to Kora, she’s often been forced to wait months for signature, only to start over because a provider PCSed or paperwork got lost along the way.
As a provider, hearing about the unnecessary barriers and inefficiencies in the system is heartbreaking. Systemic inefficiencies across the military healthcare system have been long-standing complaints among service members and their families; however, it seems particularly important to highlight them in the context of transgender care. Some of the most malicious and blatantly false arguments we’ve heard from those who oppose transgender service are that people join to transition. Once you understand the challenges of navigating transition-related care within the military system, that argument sounds more absurd than ever. If you have no desire to serve in the military beyond accessing transition-related healthcare, Kora is clear -- this is not the path to take. “If it’s not about service, you would be better off working at Starbucks or a place with good insurance. It will save you the months or years of paperwork and having so many unnecessary people in your medical business.”
Question: What was coming out to yourself like for you?
“The process of coming out to myself was a very long and soul-searching process. I knew. I always knew I had a unique diversity in my mind, body, and spirit. But I didn’t know what the word was. I didn’t have a proper vocabulary word to associate with it.”
“Once I knew, I was terrified,” Kora explained. “I had to keep to myself.” Kora shared how she tried “killing it” by leaning into hypermasculinity and joining the military. She also tried to find other outlets: church, nature, fostering relationships with others, and meditation, to name a few. “There was one thing left I had to confront and address.” Kora worked with multiple private mental health professionals, some unaffiliated with the military to process; to process what has been going on and find language that better fits her experiences. “Throughout all the healing and discovery, I shed a lot of hate, prejudices, judgment, and old beliefs. I became more content with the human race. Throughout the process, I became okay with the possibility that I always was and will always identify as trans. I was okay with confronting my identity. I was also ready to start the process of transition. As I delved more into actually starting, I truly accepted myself, and my whole identity was blossoming, and I knew I was becoming someone truly unique.”
Question: What was it like coming out while in the military?
“I probably, unofficially, came out at the worst time was in the middle of a deployment.” According to Kora, people knew something different about her, and it made sense when she finally told them. “So, for some people, it wasn’t as much of a surprise. And at the end, no one cared– that’s actually the perfect way to say it– no one cared.”
While grateful she was not facing blatant opposition, Kora felt like she would be facing a significant life change on her own. “Now [lack of opposition] can be a good thing, but it can also be bad. The only thing worse than something negative is something indifferent. Because no one cared, there wasn’t anything really negative, but there wasn’t really anything positive either….”
Additionally, Kora felt like those around her didn’t know how to be engaged, even if they wanted to care. She explained, “No one knew how to come to me and have a conversation. No one knew what to do. For many people, I was the first person they ever met who was transgender. No one wanted to ask any questions that could be possibly uncomfortable or impede on protected health information.” For a culture that relies so heavily on teamwork and taking care of one another, it is jarring to think of someone being left to manage a major life event like this essentially alone. “They just didn’t know what to do [work leadership, medical providers, etc.],” she explained. “So I just did my own thing. And that’s how it was with the military community.”
Question: Now that you’re out, what is it like navigating the process of transition as a service member?
“It’s such a nightmare… It is so frustrating to have to restart the whole process,” Kora shared, referring again to lost paperwork and maintaining continuity across her ever-changing care team. But for her, the pain of the experience has more to do with the human element than systemic inefficiencies. According to Kora, even when she was able to “assist” her medical providers by bringing them the right policies and guidelines, and references, providers’ perceived lack of comfort or awareness with trans-related healthcare meant that she could not get the paperwork in place start hormone replacement therapy (HRT) and seek Gender Affirming Surgeries (GAS).
One of the issues was a lack of understanding and awareness about how trans-related care can impact someone’s ability to perform their assigned tasks and what care can be handled locally versus referred out to a higher level. “At first, they said they did not want to start local treatment for HRT until I had gone to an MTDY [essentially a temporary duty location, like a work trip] that ended up being delayed by a year. In the meantime, they also coded me on a restriction waiver that didn’t allow me to PCS to Korea. Upon attending my MTDY, I brought up my issues and learned that I could have started HRT sooner and still gone to Korea and expanded my military knowledge.”
“I don’t think I can even express just how frustrated and disappointed and wounded I was when I had people who did not care about me, to essentially be neglected,” she says flatly. “The lazy answer is no.” Speaking of which, of all the words that someone could use to describe Kora, lazy would not be one of them. Throughout this entire time that Kora was, is, and has been waiting… on paperwork, appointments, a delayed PCS, and medically necessary healthcare, she continues to do her job and exceed the expected standards.
If you worked with a therapist, what was your experience like with them?
Regarding therapists, Kora shared that she has mixed experiences, although she is a strong proponent of mental health care and therapy. Specifically around trans-related concerns; however, her first therapist was not very knowledgeable about the issues and problems she was dealing with. Additionally, she found that when she paid out of pocket, she could access more competent care than when using providers on base. This, too, however, was largely dependent on location.
At her new duty station, she has found that providers are generally more knowledgeable. However, due to a shortage of providers, at the time of our interview (February), Kora has only been able to see a mental health provider once since arriving in November 2022. And because of the way the mental health care system works, it’s a toss-up whether or not the provider you get to see is knowledgeable about your concern.
What does a mental health provider need to know about working with transgender folks, especially military ones?
“One piece of advice is just to learn– research, research, research. At least learn about what it’s like to be trans and the transition processes. Read the policies, and ensure everyone in the treatment team is on the same page.” Kora also mentioned that SPART*A and THMEU are great resources to know about and refer clients for accurate information.
Question: What can the military due to take care of trans servicemembers?
“Just make processes smoother. I have had to re-ask questions so many times. Policy and guidance are pretty vague. It’s very ambiguous. There was a policy that came out on April 30, 2021. And it says that the next version will be available in a year –so April 30, 2022. We’re almost to April 30, 2023. There’s still not a new version.”
Sparta Rapid-fire Questions
Q: What are your career goals?
A: Get a degree in organizational leadership
Q: How do you stay resilient?
A: Perspective. I am grateful for the things that have gone right, but we can do better.
Q: What’s one thing you want people to know about transgender military members?
A: There’s so much more to us than being trans.
Q: What can allies do to support the transgender military community?
A: Take an interest and ask, “How can I help?”
Q: Anything else you want people to know?
A: I want people to know my story.
Emma’s Reflection
Something that Kora reminded me of in our interview that feels important to mention is that some people still believe the myth that trans-related healthcare is a drain on our medical resources. In reality, however, the data is precise that trans-related healthcare makes up a tiny portion of the Department of Defense’s budget for healthcare. An article from 2021[1] reported that The Pentagon spent just over $15 million over five years between 2016 and 2021 on transition-related healthcare for service members. For the same period, the Pentagon’s annual medical budget for healthcare programs ranged between $33.5 billion and $35.6 billion. That means that, on average, trans-related healthcare took up 0.0084% of The Pentagon’s annual spending on healthcare. I will avoid comparing other medical conditions and their costs because that’s not the point. The point is that we have proud, dedicated, and profoundly capable service members who require medical care for a known and treatable medical issue – the treatment of which seems to improve not only the quality of their lives but also the quality of their service.
Open almost any book, podcast, speech, or article published in the last ten years on leadership and organizational success strategies. You will consistently hear the need to invest in your people. Those people are going to be the key to a successful organization. Kora is a great example. She is a powerhouse, gets the job done, and will move mountains to make things happen. Kora is intelligent and resourceful; she knows how to think through complex problems to arrive at a workable solution. Kora isn’t a drain on the system; she’s one of the keystones crucial to its success. And from what I can tell, while Kora is extraordinary– she is not unbeknownst that investing in our service members and empowering them to be their best and fullest selves means they can go out into the world and truly make a difference.
About Emma Smith
Emma Smith, M.S., LPC (she/her) is a queer therapist in private practice in Washington, DC; specializes in sexual and gender identity, and holds advanced certifications in clinical trauma and transgender healthcare. She has a long-standing passion for LGBTQ+ rights and has participated in publicity campaigns and lobbying days specifically in support of transgender service members since 2017. Emma is a doctoral candidate in Counselor Education and Supervision from Walden University in Minneapolis, MN. She is also a graduate of the University of Scranton.
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[1] https://www.military.com/daily-news/2021/06/18/heres-how-much-pentagon-has-spent-so-far-treat-transgender-troops.html
