Posted on Aug 12, 2015
How much will it cost the U.S. military to allow transgender service members to serve?
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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?
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: 
Transgender
Budget
Transgender Budget
Posted >1 y ago
Responses: 23
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SPC Angela Burnham,
Thank you for posting sources, I'll get into them when I have some time.
I personally don't believe the Army is responsible for providing surgery. When you enlist you come "as is", i.e. the Army agrees to enlist you with proper disclosure of all preexisting medical conditions and a thorough medical exam. When you ETS the Army is liable for any damages incurred to your health due to your time in service. Transgender recruits are opting to enlist and serve which I find admirable and brave, but why is the Army responsible to discharge them in any shape or form other than that in which they enlisted? I'm not even sure budgetary considerations enter into the conversation.
You mentioned that "SRS is an appropriate method of reducing the effects of gender dysphoria", which I take to mean that the Soldier enlisted with a preexisting condition (gender dysphoria) which was not discovered or properly disclosed during the enlistment process. Doesn't that make the recruit ineligible for service? Is it grounds for fraudulent enlistment? I'm just throwing ideas out there. The LGBT community still has an uphill battle in all facets of our society, and I do not envy your struggle.
Thank you for posting sources, I'll get into them when I have some time.
I personally don't believe the Army is responsible for providing surgery. When you enlist you come "as is", i.e. the Army agrees to enlist you with proper disclosure of all preexisting medical conditions and a thorough medical exam. When you ETS the Army is liable for any damages incurred to your health due to your time in service. Transgender recruits are opting to enlist and serve which I find admirable and brave, but why is the Army responsible to discharge them in any shape or form other than that in which they enlisted? I'm not even sure budgetary considerations enter into the conversation.
You mentioned that "SRS is an appropriate method of reducing the effects of gender dysphoria", which I take to mean that the Soldier enlisted with a preexisting condition (gender dysphoria) which was not discovered or properly disclosed during the enlistment process. Doesn't that make the recruit ineligible for service? Is it grounds for fraudulent enlistment? I'm just throwing ideas out there. The LGBT community still has an uphill battle in all facets of our society, and I do not envy your struggle.
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AMA Journal of ethics article estimated that there are 134,000 Armed Forces veterans in the United States with gender dysphoria. The article also
estimated that 0.6 percent of the US population—roughly 1.4 million people—self-identify as transgender, not .6 percent of the military.
Your numbers of currently serving is grossly different.
Veterans Health Administration (VHA) Health Benefits, VHA Directive 2013-033 specifically prohibits gender-affirming surgery within Veterans Affairs (VA) facilities or using VA funding. Likewise, TRICARE has similar restrictions on covering the surgery, and only covers conditions present at birth.
Serving openly, and the costs of surgery are not one and the same.
estimated that 0.6 percent of the US population—roughly 1.4 million people—self-identify as transgender, not .6 percent of the military.
Your numbers of currently serving is grossly different.
Veterans Health Administration (VHA) Health Benefits, VHA Directive 2013-033 specifically prohibits gender-affirming surgery within Veterans Affairs (VA) facilities or using VA funding. Likewise, TRICARE has similar restrictions on covering the surgery, and only covers conditions present at birth.
Serving openly, and the costs of surgery are not one and the same.
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SPC Angela Burnham
You're absolutely right, but keep in mind my numbers were both 4 years old, and calculated on the back of a napkin so to speak. Thanks for the updated information.
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While I do not have a vote regarding who serves, as a taxpayer I would say that this should be treated as elective, as that is my view, therefore should not be paid for by the military. We could go back and forth all day as to whether it is elective. As a tax payer I do not believe this is partly my responsibility. If that is the case then everyone who wishes the surgery in the nation should have it covered by someone. I will say that if someone is authorized service and has previously had the suregery then all medical, including any complications should be covered, as the individual is who they are.
There are othe factors that broaden this topic that relate to competitive edges for promotion etc. such as PT scores which Cary a lot of weight in ones career. Under what category is it fare to compete, male or female, for obvious reasons. We are dealing with this very issue today in HS sports and competing for collegiate scholarships. Anyway, as I stated this could go on all day. In the end the military will adapt and overcome all and any issues associated with any changes as it always has. Thank you for your service.
There are othe factors that broaden this topic that relate to competitive edges for promotion etc. such as PT scores which Cary a lot of weight in ones career. Under what category is it fare to compete, male or female, for obvious reasons. We are dealing with this very issue today in HS sports and competing for collegiate scholarships. Anyway, as I stated this could go on all day. In the end the military will adapt and overcome all and any issues associated with any changes as it always has. Thank you for your service.
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SGT Tim. Wilson
CSM Darieus ZaGara CSM you brought up good points when it comes to the PFT, etc and that is something that needs to be considered.
As for being a taxpayer, I don't think my tax dollars that are supposed to be supporting the Military should be diverted to pay for a wall but I don't get a say in that either!
As for being a taxpayer, I don't think my tax dollars that are supposed to be supporting the Military should be diverted to pay for a wall but I don't get a say in that either!
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That money could be used else where for service members, as in better rec facilities, funding for college courses, etc. The transition surgery is not mission imperitive and thus should be treated as stated before, an elective surgery.
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SGT Tim. Wilson
Following your train of thought, rec facilities and college courses are not "mission imperative" either. But then again neither is building a wall!
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I love the fact that this question was asked though I'm able to get shot down possibly. Let's take money into perspective yes the average is 20000 dollars. Now remember this will probably be done by military doctors which brings the cost down. Now put in the perspective the fact is all 15000 (estimated) soldiers leave. My reserve says between 50-70000 dollars that's nine hundred million dollars as apposed to if you go with the surgery which with your 20000 dollars would be 3 hundred million. That's 1/3 of the price to train new soldiers. As for the comment below on it being elective that's a great idea. Until you think about this. People come in with glasses make them pay for those. Make them pay for lasik if they want that also. Charge for birth control. Being transgender is not a choice but the military banning good soldiers is a choice.
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We dont currently hire folks with the intent to surgerize them as part of the condition that they serve. There are several physical disable individuals that would honorably serve if they had surgery paid for by the military as a condition that they serve. The only surgeries I know of that are offered to ADSM are for injuries illnesses that primarily occured while serving, with the exception of eye surgery for vision improvement. How do you convince the American people to invest money in this effort? What benefit does it offer them or the DOD? The argument that if you dont get the surgery will increase the chance of suicide is a defensive argument and paints the picture of stereotypical mental instability based off not receiving a surgery vs. spending money on preventing and enforcing discrimination against folks, as that is the main cause of the suicide... Descrimination right? Or is it the depressing physical appearance and lack of acceptance of the actual individual?
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CSM Michael Chavaree
There are stipulations to the surgeries you mentioned, they are not elective surgeries any active duty Soldier can take advantage of, not sure where you got your information.
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SGT Tim. Wilson
CSM Michael Chavaree Actually there is a Interesting article by linked in the early part of this discussion that shows a lot of "elective" cosmetic surgeries being done on the militaries (taxpayer) dime. A couple higher ranking doctors also basically said it was done so the surgeon's could keep up with their skills and certifications. The article was old so not sure what happened with the investigation.
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SGT Tim. Wilson
CSM Michael Chavaree For heterosexual patients not looking for reassignment surgery.
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SPC Burnham-I'm not qualified to comment on what you're experiences have been, so all I can offer is that for better, or worse, these are costly questions in both dollars, and the far reaching effects on the services. It would be lacking in integrity for me to offer counterpoints without admitting that my opinion is also formed by my personal feelings. I've yet to be convinced that the process of questioning one's gender is wholly without external influences...neither have I been convinced that it is the best course for the individual to follow towards a complete life. However, I hope you have people in your life who can help you on that individual journey.
What I "may" be qualified to add is that the service, like any other profession, has to balance investments to returns. I believe the central concern most of us in disagreement are offering is that there may be some who would join, at a later date request this assistance, then leave the service after incurring extensive medical costs and absences from duty. No "trick" question...but a sincere thought, what are your opinions on the military requiring an extension of service commitment upon completion of this process should it ever be offered?
What I "may" be qualified to add is that the service, like any other profession, has to balance investments to returns. I believe the central concern most of us in disagreement are offering is that there may be some who would join, at a later date request this assistance, then leave the service after incurring extensive medical costs and absences from duty. No "trick" question...but a sincere thought, what are your opinions on the military requiring an extension of service commitment upon completion of this process should it ever be offered?
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SPC Angela Burnham
Thanks for the response Commander,
This was also a point of contention in the Canadian armed forces. What they found after implementing the program was the opposite of what many thought. Transgender people actually serve longer than their cisgender counterparts. Even in the U.S., transgender people are twice as likely to serve as cisgender ones, and the only thing we ever give them is a general discharge with no benefits. The reasons are manyfold; the hyper masculine environment of the military gives transgender men (ftm) a more friendly environment to live in than the civilian world offers. Likewise, it offers transgender women (mtf) not "out" yet an ideal place to hide from suspicion.
This was also a point of contention in the Canadian armed forces. What they found after implementing the program was the opposite of what many thought. Transgender people actually serve longer than their cisgender counterparts. Even in the U.S., transgender people are twice as likely to serve as cisgender ones, and the only thing we ever give them is a general discharge with no benefits. The reasons are manyfold; the hyper masculine environment of the military gives transgender men (ftm) a more friendly environment to live in than the civilian world offers. Likewise, it offers transgender women (mtf) not "out" yet an ideal place to hide from suspicion.
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In the grand scheme of things, $1.2B is chump change compared to what the military has spent buying oceanfront property in Afghanistan. That being said, I'm interested in hearing your thoughts as a transgender person on some of the costs that have nothing to do with money:
1. Man(person?)hours it takes to create policy to address transgender specific issues when we need all available minds to solve how the military should properly downsize
2. Confusion in the ranks on how to treat the now openly transgender person (when to switch APFT scales, EO complaints filed if a person is offended by being addressed as the wrong gender, who to assign as a urinalysis observer etc.)
3. Is transgender-ism fluid? Is there a possibility that the military will be required to pay for reverse surgery and treatment if a person no longer wants to be the gender they switched to?
I'll be the first to plead complete ignorance about transgender issues. If you can shine some light on these, I'll use the knowledge gained when interacting with transgender people in future units.
1. Man(person?)hours it takes to create policy to address transgender specific issues when we need all available minds to solve how the military should properly downsize
2. Confusion in the ranks on how to treat the now openly transgender person (when to switch APFT scales, EO complaints filed if a person is offended by being addressed as the wrong gender, who to assign as a urinalysis observer etc.)
3. Is transgender-ism fluid? Is there a possibility that the military will be required to pay for reverse surgery and treatment if a person no longer wants to be the gender they switched to?
I'll be the first to plead complete ignorance about transgender issues. If you can shine some light on these, I'll use the knowledge gained when interacting with transgender people in future units.
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MSgt (Join to see)
So you would force a biological female to watch a m2f transgender (no surgery) unrinalysis? How about the biological female's rights in this? You would have a biological female share a room the size of a closet with a m2f transgender (no surgery)? I have no problems with transgender serving once they have completed the surgery as the gender they chose. I have no problem with them serving before that if they serve as the gender of their birth. (What they do on their off time is their own business). I wouldn't even mind if the airman took a year break from the service to go and get the surgery on their own dime then came back and picked up their career where they left off as the opposite gender. I just don't want to be be a watcher at operation golden flow and see the next airman in line whip out a penis. That would make me feel very uncomfortable. I would also be uncomfortable if I'm sharing a very small room in a deployed location with someone with a penis. I have no problem with bathrooms. I have no problem with locker rooms as long as every shower and changing area is separated. Can a compromise be reached on this where one groups rights to feel secure and feel good about who they are doesn't trample on another groups rights to do the same?
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SGT Tim. Wilson
MSgt (Join to see) Okay I'm not transgender but I know a few of both the m2F and f2M variety.
You talk about one groups rights to feel secure, etc., not trampling on another groups rights. Now I understand that position, but I would ask you what would you suggest to accomplish this? How would you go about making it work?
I think too many people take the approach that this is abnormal to what I was raised with or my belief so it is wrong. PERIOD! Instead of looking at the person and the accomplishments they have already achieved, even through their struggles. People need to walk a mile in each other's shoe's instead of just spouting off some hateful rhetoric. We have enough of that already and no I'm not saying you were hateful.
But think of ways that you could be a benefit to both sides of this situation and bring those ideas to the table for discussion.
And I'm sure if it came to pass, they would ask for a volunteer for a roommate if one was needed or for a UA monitor.
Just a thought!
You talk about one groups rights to feel secure, etc., not trampling on another groups rights. Now I understand that position, but I would ask you what would you suggest to accomplish this? How would you go about making it work?
I think too many people take the approach that this is abnormal to what I was raised with or my belief so it is wrong. PERIOD! Instead of looking at the person and the accomplishments they have already achieved, even through their struggles. People need to walk a mile in each other's shoe's instead of just spouting off some hateful rhetoric. We have enough of that already and no I'm not saying you were hateful.
But think of ways that you could be a benefit to both sides of this situation and bring those ideas to the table for discussion.
And I'm sure if it came to pass, they would ask for a volunteer for a roommate if one was needed or for a UA monitor.
Just a thought!
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MSgt (Join to see)
SGT Tim. Wilson - there are many females who have experience MST and would feel very uncomfortable when put into a close situation such as rooming with a trans female. Why victimize the female service member again by putting them through that? There mare more MST survivors in the military than transgenders that want to serve. Bathrooms with floor to ceiling doors, ok. Open changing rooms, not ok until full surgical transition is done. Putting a transgender female that has not had the full surgical transition with a biological female in a small room in a deployed location, not ok. They should have had the full transition first.
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SGT Tim. Wilson
MSgt (Join to see) That's why I suggested volunteer's. I sure there would be those that would.
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The question has been answered. 3yrs 0.0003 percent of the Medical budget. Less then (non airforce) coffee cups.
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Always nice to switch to percentages when you can reflect millions of dollars as a tiny little fraction....whatever...who even cares about the money? Mentally ill people are not fit for military service.
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SGT Tim. Wilson
At one time WOMEN were not fit for Military Service or to Vote! Should we revert to those day's?
And, in my time in service, I met a lot of people that were unfit for Military Service but had NO mental illness! I also met those that were great soldiers but not all there, some would say they had a Mental Defect.
And there 1000's of AD and Veterans who suffer and fight with PTSD which is considered a Mental Illness!
Maybe you should educate yourself on what is and isn't a mental illness before you go spouting it off all over the place, especially on something you obviously have no idea what you are talking about since that is the only comment you seem to be able to make on the subject!
And, in my time in service, I met a lot of people that were unfit for Military Service but had NO mental illness! I also met those that were great soldiers but not all there, some would say they had a Mental Defect.
And there 1000's of AD and Veterans who suffer and fight with PTSD which is considered a Mental Illness!
Maybe you should educate yourself on what is and isn't a mental illness before you go spouting it off all over the place, especially on something you obviously have no idea what you are talking about since that is the only comment you seem to be able to make on the subject!
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