By DAVID KLEPPER, Associated Press

WASHINGTON (AP) — People with congestive heart failure, undergoing treatment for schizophrenia or who have a history of paraphilic disorders will no longer be eligible for a medical waiver to serve in the military, according to new rules issued by the Pentagon on Tuesday.

The guidance signed by Defense Secretary Pete Hegseth updates a list of conditions that disqualify potential recruits from serving in the armed forces. The decision comes after the Pentagon announced earlier this year that it would ban transgender troops and review other medical conditions that are currently eligible for a waiver.

“America’s warfighters must be physically and mentally capable of performing their duties in the harshest of conditions,” Hegseth wrote in the memo announcing the changes. “Severe underlying medical conditions introduce significant risks on the battlefield and threaten not only mission priorities, but also the health and safety of the affected individual and their fellow service members.”

Waivers have long been used to enlist young people who might otherwise be unqualified for military service due to a wide array of medical, conduct or other reasons.

Most waivers are issued for medical conditions ranging from asthma, eyesight problems or skin disorders to more complex health conditions, such as past psychological illness or previous sports injuries that may have healed but still must be evaluated.

Prior to the new rules, heart failure, current treatment for schizophrenia and a history of paraphilic disorders — defined as a persistent sexual interest in atypical objects or activities — were among a long list of physical and mental health conditions in which waivers were allowed.

Multiple sclerosis, a history of cystic fibrosis, past organ transplants or a suicide attempt within the past 12 months also will be considered disqualifying conditions that make a person illegible for service.

The new rules list several conditions in which a waiver may only be granted by the secretary of a military branch. Those conditions include a missing eye, hand or foot, past corneal transplants, liver failure, kidney disease, past psychotic disorders or the presence of an implanted pacemaker or defibrillator.

The detailed rules governing which medical conditions quality for a waiver have come under greater scrutiny amid the Trump administration’s ban on transgender troops.

New rules required active duty troops as well as National Guard and Reserve troops to identify themselves as transgender and voluntarily leave the service or face involuntary separations.