“After consultation with my Generals and military experts, please be advised that the United States Government will not accept or allow Transgender individuals to serve in any capacity in the U.S. Military,” Trump said in a series of morning Twitter posts. “Our military must be focused on decisive and overwhelming victory and cannot be burdened with the tremendous medical costs and disruption that transgender in the military would entail. Thank you.”
But a 2016 RAND study commissioned by the Pentagon itself contradicts the President’s rationale, finding that the medical costs for transgender military members would be an “exceedingly small portion of active-component health care expenditures.”
By analyzing private health insurance data on gender transition-related expenditures, (such as hormone therapy or surgical treatment, for instance), researchers found that Military Health System costs could increase by $2.4 million and $8.4 million per year if it were extended to cover the estimated 1,320 to 6,630 transgender people in the military. This amount pales in comparison to the Department of Defense’s $49.3 billion health care expenditures in 2014, for example, and would represent between 0.005% to 0.017% of the department’s overall health care costs, according to the study.
Overall, the study estimated that only 29–129 service members would seek gender transition–related care per year, and 30 to 140 personnel would seek hormone therapy. Another 25 to 130 personnel would seek surgical treatment.
Trump’s sweeping decision comes after former defense secretary Ashton Carter ended the U.S. ban in 2016, thus allowing transgender troops to serve openly, receive medical care, and change their gender identity in the Pentagon’s personnel system. The President’s announcement also comes after a report last week that House Republicans are working to revive an amendment that would ban the Pentagon from funding sex reassignment surgeries and hormone therapies. The initial amendment failed earlier in July, meaning that for the first time, the military health care system could be called on to provide these services.
Trump also said that allowing transgender service members would cause “disruption.” He did not elaborate on this, but the RAND study concluded that “evidence from foreign militaries and the U.S. military has indicated no significant impact on unit cohesion or operational readiness as a result of allowing transgender and gay and lesbian personnel to serve openly.”
In 2016, 18 countries — Australia, Austria, Belgium, Bolivia, Canada, the Czech Republic, Denmark, Estonia, Finland, France, Germany, Israel, the Netherlands, New Zealand, Norway, Spain, Sweden, and the United Kingdom — allowed transgender military personnel to serve openly.