Posted on Aug 12, 2015
SPC Angela Burnham
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How much will it cost us to let trans people serve openly? It's a valid question and I worked out some of the math down below. Some things to take into consideration before though, there are only around 15,000 trans people currently serving, we don't know how many veterans but it's probably around 75,000. Not all trans people get "the surgery" for various reasons, and the recovery time is typically 3 months. If half the current trans .mil population had sexual reassignment surgery, it would cost around $150,000,000 (assuming the cost for surgery remains around $20,000, which around North America is usually the case).

Now, the average length of enlisted service in the U.S. is around 7 years rounded up, and an average of 188,000 people join every year. Trans people make up .6% of the military population (rounded up), and therefore we could expect another 1,128 transgender recruits to join every year. Again, lets say half have SRS, the total estimated annual cost would be around $11,280,000. If we say 50,000 (66%) trans vets want the surgery (a very liberal estimate), that would be around $1,000,000,000. We might expect half the recently separated trans vets who didn't get it while in to get it through the VA while out.

Lets just assume for the sake of convenience that the same number of trans people that enter each year also leave (actually more people have been leaving than joining lately but w/e). So a quarter of those might want SRS (remember half would have already got it while in). That number is 282, and the cost would be $5,640,000 a year.

So to recap:
Initial wave of surgeries for active duty under Tricare - $150,000,000
Initial wave of surgeries for veterans/retired personnel - $1,000,000,000
Annual cost of surgeries for active duty under Tricare - $11,280,000
Annual cost of surgeries for veterans/retired personnel - $5,640,000

Sounds like allot of money, but how much will it increase our budget? In 2012, the DoD spent $52,000,000,000 on healthcare for service members. The Department of Veteran Affairs spends 42% of it's budget on healthcare, and it's budget was $168,800,000,000, with $70,896,000,000 spent directly on healthcare.

If we spend $150,000,000 more dollars in the initial wave of providing service members with SRS, it would reflect an overall budget increase of .3% (rounded up). The annual cost spent providing new recruits with SRS would be $11,280,000, which would reflect an overall annual budget increase of around .022% (rounded up).

If we spend $1,000,000,000 on the initial wave of surgeries for veterans (again a very very liberal estimate), it would reflect an overall budget increase of 1.4%. If we spend around $5,640,000 annually on surgeries for new veterans, it would reflect an increase of .008% (rounded up).

One more fun figure:
The total initial cost between both the DoD and DVA would be around $1,150,000,000. Out of the total amount of national debt, $18,342,202,555,158, this would reflect an overall increase of .0063% (rounded up).

My personal opinion is slanted on whether or not trans people should serve openly (I'm trans myself, left the service 4 days ago). So with the above numbers in mind, I'd love to hear from you. Do you support allowing transgender people to serve openly?
Posted in these groups: 9ed82c1 TransgenderMoney budget Budget
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Responses: 23
COL Jean (John) F. B.
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SPC Angela Burnham - This should be considered "elective surgery" and disallowed. If a person enlisted as "male", that is what he should serve as. If he wants to change his body to resemble a female, he should bear the costs. If not having the surgery creates mental anguish that affects his ability to perform his duties, he should be discharged, not provided surgery. (Note - The same is true for female to male, since I was chastised once for only discussing "M2F" and not "F2M", as it was put to me.)
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Capt Jeff S.
Capt Jeff S.
>1 y
I'd take it a step further and all you bleeding hearts can downvote me for being a "bigot" and telling it like it is. If someone enlists as a male, then they should be obligated to remain a male for the rest of their career. PERIOD. And nobody whose chromosomes are XX should be allowed to enlist as a male, and vice versa XY > female. The ONLY exception to that would be those rare unfortunates that have extra chromosomes and have the plumbing of both sexes at which point the doctor had to decide what sex they would be and this was done shortly after birth... But even in that case, their situation should be evaluated. Do they need a constant supply of drugs to maintain their health? If so, they're disqualified. Life isn't always fair, you have to deal with it. I know that sounds harsh but that's the reality of it. There are other places and other ways people can serve our country.
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SrA Michelle Black
SrA Michelle Black
>1 y
Capt Jeff S. - EXACTLY! Fair and equal treatment across the board--disqualified as unfit just like anyone else who couldn't serve for mental illnesses (GID or comorbid depression, anxiety, etc...all mental illnesses, so UNFIT!) or other physical ailments.
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MSgt Kerry Lundy
MSgt Kerry Lundy
6 y
Col Jean F Burleson I agree with you whole heartedly!! Born a boy you are a boy! Born a girl you are a girl. End of discussion. You want a change you pay for it and all follow up treatments! I and the rest of the tax payers are not responsible to pay for your dreams and desires. Who do you think should do your job while you under go surgery and three (3) months of follow ups and you do this before you enlist. THE COLONEL is right.
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MAJ Javier Rivera
MAJ Javier Rivera
>1 y
100% agreed!
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Cpl Software Engineer
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That sounds like an awful lot of money to support an extreme minority of people while the DoD is cutting in all areas including troop numbers. IIRC some of us have been saying that TG's would join for no other reason than to get the surgery. Personally, I see this as a huge waste of defense dollars.
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MSG Mitch Dowler
MSG Mitch Dowler
>1 y
TG people have a very, very high rate of STD's and also various mental health problems such as depression. It is not a valid assumption to blame TG suicide rates on discrimination when these suicide rates hold true across the nation even in very politically correct and accepting places such as Capitol Hill in Seattle. It is much more likely that the depression is linked to the same mental health issues that caused confusion the person's sexual plumbing and the promiscuity associated with the STD's. I have estimates as high as 50% for HIV transmission in studies of TG people.
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MSgt Kerry Lundy
MSgt Kerry Lundy
6 y
SPC Angela Burnham - Explain so this old veteran can understand why gender reassignment surgery is a necessary medical treatment. Is this a medical or psycological problem when a man thinks he should be a woman and a woman thinks she should be a man.
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SPC Angela Burnham
SPC Angela Burnham
6 y
MSgt Kerry Lundy -
Hello Master Sergeant, thanks for pulling me back to Rallypoint! I'll do my best to explain things to you from my perspective. From WebMD:
"People who have gender dysphoria feel strongly that their gender does not match their biology. Gender dysphoria used to be called 'gender identity disorder.' But the mismatch between body and internal sense of gender is not a mental illness. Instead, what needs to be addressed are the stress, anxiety, and depression that go along with it."

The above statement that gender dysphoria itself is not a mental disorder is backed up by the World Health Organization, the American Academy of Pediatrics, and the American Psychiatric Association (among others). Furthermore, there is substantial medical evidence that transgender people are transgender from birth, such as the below study with compared transgender brains to the brains of cisgender (normal) individuals:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5953012/

So now that we've established that gender dysphoria itself isn't an illness, we can begin to treat the real problems, and their symptoms. Gender Confirmation Surgery often reduces dysphoria in transgender people by bringing their physical bodies in line with their gender identity, leading to less anxiety over the incongruency. However, it's important to note that many transgender people don't need or want surgery. The reasons can vary, but around 67% of transgender people are content with hormone replacement therapy, with replaces testosterone in the body with estrogen, or vice versa.

The second way we can eliminate the stress, anxiety, and depression associated with gender dysphoria is to reduce the social stigma associated with being transgender. Transgender people are subject to discrimination and violence on a nearly daily basis. When something as simple as using the bathroom can get you killed, you start to (understandably) stress the hell out.

At the end of the day, we can't throw all transgender people out of the military, it's just not feasibly going to happen. There are bare minimum 10,000 troops serving right now who are transgender, and maybe 10% of them are out and open. You can locate and throw out that ten percent, but it's literally just the tip of the iceburg. My opinion, which I recognize is biased, is that if these individuals can't be removed then we should at least do what we reasonably can to ensure that they can devote themselves to their missions instead of having to look over their own shoulders constantly.
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SGT Tim. Wilson
SGT Tim. Wilson
>1 y
Cpl (Join to see) Talk about misuse of Military Budget ... What about taking part of the Military Budget to build a WALL????? That isn't complete, doesn't stay up AND has been proven that it can be climbed, tunneled under and through!!!!
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1SG Civil Affairs Specialist
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SPC Angela Burnham, there are not 15,500 Transgender persons serving in the US Armed Forces. I pulled the study that has been cited as showing that figure and debunked it on another thread for it's obviously flawed methodology. Short version is the sampled population were from LGBT Community Centers, and they filled out a survey that among other things asked them if they were current or prior service military and if they were discharged due to DADT. They then projected onto the general population based on survey responses and viola! Three whole aircraft carrier crew are transgender! Or three Army brigades. Or half of the entire US Coast Guard. On its face, this is preposterous. I would estimate the number as closer to 1000.
Having said that, I think that covering this surgery under Tricare would be a grievous mistake costing a fortune per Soldier with no benefit to the readiness of the armed forces. I can't think of a more compelling case than that for not doing it.
If people identifying as another gender want to serve, fine. Make the change on your own dime. I am supportive of you finding your own way and making a change like that is hugely important to you personally. But that is not why the military medical system exists.
I wish them well as I do any of my comrades in arms.
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SGT Tim. Wilson
SGT Tim. Wilson
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LTJG (Join to see) I'm late to this discussion but wanted to thank you for posting this article. It was a very interesting and informative read!
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SGT Tim. Wilson
SGT Tim. Wilson
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MSG Mitch Dowler Those thing's are authorized now, IF, they are a MEDICALLY necessary!
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SGT Tim. Wilson
SGT Tim. Wilson
>1 y
Capt Jeff S. Right, the country that does such a great job taking care of it's Vets! Give me a break! If you were more accepting you wouldn't have a problem with this.
So tell me, if your son or daughter has gender dysphoria what will you say then? No you can't serve your country because I can't accept you?
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MSgt Kerry Lundy
MSgt Kerry Lundy
>1 y
SGT Tim. Wilson - Can you explain to us how a sex change surgery is medically necessary as opposed to a personal choice? What makes it medically necessary? What percentage of those who are surgically sex changed seek a discharge after healing from the surgery?
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