The United States military once did not allow gay men, bisexuals, or lesbians to serve. In 1993, the United States Congress passed, and President Bill Clinton signed, a law called "Don't ask, don't tell" (DADT). This law let gay, lesbian, and bisexual people serve in the military as long as they did not share their sexual orientation. Even though some service members tried to end the ban through lawsuits, these efforts did not succeed at first.

In 2010, two federal courts said the ban on openly gay, lesbian, and bisexual service members was unconstitutional. On July 6, 2011, a federal appeals court stopped the DADT policy. In December 2010, the House and Senate passed, and President Barack Obama signed, the Don't Ask, Don't Tell Repeal Act of 2010. This law ended the restrictions on gay, lesbian, and bisexual service members starting September 20, 2011.

A 2015 survey by the RAND Corporation of more than 16,000 service members found that 5.8% identified as lesbian, gay, or bisexual. Among males, 1.9% identified as gay and 2.0% as bisexual. Among females, 7.0% identified as lesbian and 9.1% as bisexual.

In June 2024, U.S. President Joe Biden signed a "pardon proclamation" that officially affected thousands of military veterans who had past criminal records related to same-sex relationships.

History

General George Washington brought in Friedrich Wilhelm von Steuben to train the new American Army in the latest military drills and tactics. Von Steuben had been an officer on the Prussian General staff. He escaped Germany because he faced legal action for homosexuality. He joined Washington's army at Valley Forge in February 1778 with two young aides. Steuben became an American general and a senior advisor to Washington. There were rumors about his personal life, but no investigation was ever conducted. After the war, he received a Congressional pension.

The first known action against a homosexual person in the U.S. military happened on March 11, 1778. Lieutenant Frederick Gotthold Enslin was removed from the Continental Army after being found guilty of sodomy and lying in a court-martial.

Throughout the 18th and 19th centuries, the U.S. military expelled soldiers for homosexual acts, even before laws explicitly banned sodomy. In 1916, the Articles of War were created. They included a rule that punished anyone who committed "assault with intent to commit sodomy." This rule was changed in 1920 to make sodomy itself a crime. The new rule started in 1921 and was the first clear law against homosexuality in the U.S. military.

For most of its history, the U.S. military had no unified policy about homosexuals serving. Before 1949, each branch of the military charged soldiers caught in homosexual acts with sodomy, tried them in court-martial, and gave them dishonorable discharges. In 1940, psychiatrists Harry Stack Sullivan and Winfred Overholser created guidelines for military screening. They believed homosexuals should not be inducted, but they did not suggest banning all homosexuals from service. Other psychiatrists and military officials later used homosexuality as a key part of screening. In 1941, the U.S. Army Surgeon General’s office classified "homosexual proclivities" as a reason to disqualify someone from military service. The Navy, Selective Service, and Women’s Army Corps later adopted similar policies. The Women’s Army Corps used strict screening based on appearance and gender conformity to exclude lesbians. They also allowed heterosexual relationships with soldiers to discourage homosexual behavior.

During World War II, it became too difficult to hold court-martial trials for all soldiers accused of homosexual acts. Instead, commanders gave them "blue discharges," a type of administrative discharge. Blue discharge holders faced problems in civilian life because the discharge had a negative reputation. The Veterans Administration refused to give them benefits under the G.I. Bill. In 1944, a policy required homosexuals to be sent to military hospitals, examined by psychiatrists, and discharged under Regulation 615-360, section 8.

For example, Staff Sergeant Allen Irvin Bernstein was arrested in 1944 after a failed attempt to meet another soldier. He was sent to a psychiatric ward at Camp Lee, Virginia, and discharged in a month. He appealed his discharge and submitted a 140-page defense of homosexuality titled Millions of Queers (Our Homo America). His appeal was ignored. His book was forgotten until 2010, when a researcher found it in the National Library of Medicine. Bernstein was denied veterans benefits and kept appealing until 1981, when the Army changed his discharge to honorable.

Blue discharges ended in 1947 and were replaced with two categories: "general" and "undesirable." A general discharge was considered honorable but not as strong as a full honorable discharge. An undesirable discharge was not honorable but not as severe as a dishonorable discharge. The Army changed rules to ensure homosexuals could not get general discharges. Soldiers who identified as homosexual but did not commit acts received undesirable discharges. Those found guilty of homosexual acts were dishonorably discharged.

In 1945, four gay veterans who were honorably discharged formed the Veterans Benevolent Association, the first group for veterans. It was mostly social and had 100 members at its peak. The group ended in 1954, and some members later joined the New York chapter of One, Inc., a homophile advocacy group.

In 1949, the Department of Defense made anti-homosexual rules the same for all military branches: "Homosexual personnel, regardless of sex, should not be allowed to serve in any branch of the Armed Forces. Known homosexuals must be separated from the military immediately."

In 1950, President Harry S. Truman signed the Uniform Code of Military Justice, which started in 1951. It created a single justice system for the military. Article 125 banned sodomy among all soldiers, defining it as "unnatural carnal copulation with another person of the same or opposite sex or with an animal. Penetration, however slight, completes the offense."

From the 1940s through 1981, it is unclear how well the military kept gay and bisexual people out of service. During the Vietnam War, some men pretended to be gay to avoid the draft. However, many gay and bisexual people still joined the military and served, some with notable achievements.

For example, in the 1950s, Navy doctor Tom Dooley became famous for his work in Vietnam. He resigned in 1956 after being found involved in homosexual activities. The Navy did the first official study on sexual orientation and military rules. In 1957, the Crittenden Report found that gay individuals were not more likely to be security risks than heterosexuals. However, it still recommended excluding homosexuals from service, stating that homosexuality was "wrong, evil, and should be branded as such."

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Healthcare needs and provisions

In 2014, the U.S. Veterans Health Administration (VHA) provided healthcare services to about one million gay and lesbian veterans. After the rule called "Don't Ask, Don't Tell" was ended, more gay and lesbian veterans began seeking medical care. However, Sherman and her coauthors noted that many veterans are worried about whether they receive fair and equal healthcare from the VHA. They also found that veterans who do not get quality healthcare are more likely to have health problems and feel unhappy.

Sherman and her coauthors explained that in the past, many gay and lesbian veterans were afraid to tell their healthcare providers about their sexual orientation because they feared being discharged from the military. After the rule was ended, gay and lesbian veterans are now assured that their sexual orientation will not be used against them. However, because of past experiences, some still worry that sharing this information might harm their future careers. They also fear that societal prejudices might lead to being denied medical care, losing benefits, or receiving poor treatment.

Sherman and her coauthors studied how gay and lesbian veterans communicate with their VHA providers and their experiences with healthcare. Many veterans reported being unhappy with their medical care. They said they do not get the support they need from healthcare providers, and some providers do not ask about their sexual orientation. Many veterans feel uncomfortable with their providers. The study also found that some veterans avoid seeking care from the VHA, and others struggle to find fair healthcare services. These findings show that there are problems in how the VHA provides care to gay and lesbian veterans.

A 2011 report found that lesbian veterans often skip routine medical tests, and gay men are less likely to seek medical care than heterosexual men. This may lead to some health issues not being treated quickly enough.

Sherman and her coauthors pointed out that poor communication between patients and providers can lower the quality of care. A person’s sexual orientation and identity can affect their physical and mental health.

The authors noted that many healthcare workers are not comfortable discussing sexual orientation. However, if doctors start the conversation, veterans are more likely to share this information. If gay and lesbian veterans share details about their health, they may be more satisfied with their care. They may also receive better preventive care and screenings for health risks, such as sexually transmitted diseases. Complete medical records can help doctors provide better care and evaluate veterans’ fitness for duty.

To address concerns about discrimination and improve care, the VHA introduced new policies in 2013. For example, the VHA created the Office of Health Equity to focus on the healthcare needs of gay and lesbian veterans and reduce unfair treatment.

These changes mark an important step in improving healthcare for gay and lesbian veterans. The VHA now requires providers to treat all patients with respect and sensitivity. They also changed the definition of "family" to allow gay and lesbian veterans to decide who is considered part of their family. However, as of 2014, some medical records still contain incorrect or unclear information about veterans’ choices. The VHA also started training programs to help healthcare workers understand the challenges faced by gay and lesbian veterans.

Since medical forms do not ask veterans to share their sexual orientation, providers often do not know this information when making treatment decisions. To address this, the Institute of Medicine suggested that patients include this information in their medical records. This information would be kept private and used only to improve health. The VHA is working to keep this information from being shared with other groups. Experts like Sharpe and Uchendu recommend using open-ended questions to help veterans provide more details.

Healthcare for gay and lesbian veterans is still not fully meeting their needs. The VHA’s first goal is to create a welcoming environment for these veterans. Improving relationships between providers and patients and encouraging patients to share more personal information can lead to better health outcomes.

In March 2024, it was announced that the U.S. military will cover IVF treatment for single individuals and same-sex couples, not just heterosexual couples. In June 2024, President Joe Biden signed a pardon proclamation to formally clear the records of thousands of veterans who were historically charged with crimes related to same-sex relationships.