When Dwayne Villanueva joined the Army at 17, he thought it would help to overcome his nagging desire to become a woman.

"It's a hypermasculine environment and I thought that by joining the military it would make me more masculine," Villanueva recalled in a recent interview. "I thought joining the military would help suppress those feelings or take them away, as far as wanting to be a female.

"It didn't work."

Today, Villanueva, an Army corporal at Tripler Army Medical Center in Hawaii, identifies as a woman, having changed her name to Laila both legally and in official Army records.

Officially, the Army still considers Villaneuva a man, and expects adherence to male grooming and uniform standards.

But culturally and personally, Villanueva says, her colleagues accept her as a woman.

"Currently I present as male, but the patients and other workers, military and civilians alike, view me as female and use the female pronoun."

Villanueva acknowledged some difficulty in conforming to the military's male standards "when you have people referring to you as a female." Still, she said the transition is "exciting and liberating."

Stories like Villanueva's are likely to become more common and more widely shared across the military as the Pentagon begins to set in motion a plan to lift the longstanding prohibition on allowing transgender men and women to serve openly in the military.

Defense Secretary Ash Carter made the announcement July 13 and said that over the next six months, top military officials will hammer out details of a new policy to allow active-duty troops to transition from one gender to another.

That will force the Pentagon to tackle questions like these:

  • When do transgender troops begin adhering to a new dress code and grooming standards?
  • How will their fitness standards change?
  • How will billeting rules apply?
  • Will the military health care system provide them with hormone replacement therapy or gender reassignment surgery?

While the details remain unclear, Carter made apparent that Defense Department policy indeed will soon change.

"Current regulations regarding transgender service members are outdated and are causing uncertainty that distracts commanders from our core missions," Carter said in a statement July 13.

He has ordered the creation of a "working group" to study the issue over the next six months and identify any readiness implications of the policy change. The group will be led by Brad Carson, acting DoD personnel chief. acting Under Secretary of Defense for Personnel and Readiness Brad Carson.

"At my direction, the working group will start with the presumption that transgender persons can serve openly without adverse impact on military effectiveness and readiness, unless and except where objective, practical impediments are identified," Carter said.

Under current rules, transgender individuals are considered medically unfit for service and can be honorably discharged if diagnosed with "psychosexual conditions, including but not limited to transsexualism, exhibitionism, transvestism, voyeurism, and other paraphilias," according to DoD Instruction 6130.03.

For now, any administrative discharges for those diagnosed with gender dysphoria or who identify themselves as transgender will require approval from Carson, Carter said. That is likely to limit or effectively halt such discharges.

"At a time when our troops have learned from experience that the most important qualification for service members should be whether they're able and willing to do their job, our officers and enlisted personnel are faced with certain rules that tell them the opposite," Carter's statement said.

"Moreover, we have transgender soldiers, sailors, airmen, and Marines — real, patriotic Americans — who I know are being hurt by an outdated, confusing, inconsistent approach that's contrary to our value of service and individual merit."

The announcement comes nearly four years after the 2011 repeal of the don't ask, don't tell policy that barred gays from serving openly. In recent years, a small number of transgender troops have come forward to talk about the remaining prohibition.

Anecdotal reports suggest local unit-level commanders have begun making these decisions and allowing some transgender troops to publicly transition. For example, Senior Airman Logan Ireland, a transgender man, received permission to wear a man's uniform when he attended an LGBT reception at the White House in June.

In some cases, military treatment facilities have filled prescriptions for hormone-replacement therapy and rejected them in some cases, advocates say.

But the issues are too complex to leave to local commanders, said Allyson Robinson, a West Point graduate who is now policy director for SPARTA, an advocacy group for LGBT service members.

"There needs to be a DoD wide policy," she said. "That policy ought to set a date at which a gender transition will take place in the service member's official military records, and that decision should be made by the service member and their medical team and their unit commander."

The biggest sticking point may be fitness standards, but Robinson suggested the military could follow the lead of the National College Athletic Association, which requires transgender women to undergo hormone replacement therapy for 12 months before competing in women's athletics.

Transgender men are not permitted to compete as women after starting hormone therapy, according to NCAA rules.

Advocates estimate up to 15,000 transgender individuals may be among the 2.2 million active-duty and reserve troops serving today.

A 2014 study published by the Williams Institute at the University of California Los Angeles School of Law cited several data sources suggesting transgender people may serve in the military at higher rates than the general population. For example, a review of health records of all veterans receiving health care through the Veterans Health Administration from 2000 through 2011 found a prevalence of Gender Identity Disorder five times that of the U.S. general population.