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Donald Trump recently said on Twitter that the US

... cannot be burdened with the tremendous medical costs and disruption that transgender in the military would entail.

What are the medical and disruption costs of having transgender people in the military?

I am not talking just about the much-quoted Rand study, since that talks about the current costs, but naturally those costs will increase once more and more transgender people "come out" or join the military in later years due it becoming more accepted.

Kip
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Imean H
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    Related at politics.SE: [What medical costs burden the military enough to warrant banning all transgender people?](https://politics.stackexchange.com/questions/23135/). And please do not add attempts at an answer to your question (not even partial answers), as it discourages actual answers, and also opens your answer up to discussion in other answers, which isn't really the format that is encouraged here. – tim Jul 26 '17 at 18:12
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    "Economically justified" is a political opinion, not an empirical question. If a transgendered person costs just $1 more per year [and I shouldn't even assume the amount is positive without evidence, but moving on], whether that is "justified" to be paid by the military is still a political question. – Oddthinking Jul 27 '17 at 00:33
  • @Oddthinking A question like, "Is it worth taking this medicine for this disease" sounds like a personal or subjective question; but it can be answered with relevant facts (e.g. about efficacy). Similarly this question sounds political, but I think it too can be answered with relevant facts: the claim in question is that "medical costs" would be "tremendous", which can be answered by a good quantitative estimate of the "medical costs". After an answer says what the costs are, then it's up to the reader to decide whether to characterize those costs as "tremendous" or as "justified" or whatever. – ChrisW Jul 27 '17 at 00:46
  • @ChrisW: Agreed. Let's fix the question to ask that. – Oddthinking Jul 27 '17 at 00:48
  • I think he added 'medical costs' to divert focus, when it's disruption he's attempting to stop. I can think of some fairly major disruption caused by a transgender soldier relatively recently. – mcalex Jul 27 '17 at 02:33
  • Is the actual reason to ban them due to medical costs? I was under the impression that Gender-Identity Disorder(GID), Body Dysmorphia, etc were all considered 'mental illnesses' in the books. Which would label them unqualified or unsafe to serve. – knocked loose Jul 27 '17 at 13:10

1 Answers1

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There's a Scientific American article, Cost of Medical Care for Transgender Service Members Would Be Minimal, Studies Show, which cites two studies:

  • One from the RAND Corporation:

    The study also estimated that the cost associated with medical care for gender transition would only increase military health care expenditures by between $2.4 million and $8.4 million each year — an increase of between 0.04 and 0.13 percent.

  • Another published in the New England Journal of Medicine:

    A September 2015 study published in the New England Journal of Medicine reached similar cost estimates.

The summary of the RAND report includes the estimated number of transgender service members (1,320–6,630), the estimated number per year of those who would seek transition-related healthcare treatment (129 or 2%): from which one can determine their estimated cost per treatment (I reckon about $60K), and average cost per transgender service member (I reckon about $1200).

The corresponding estimates from the New England Journal of Medicine article are:

  • Number of transgender service members (who are eligible for health care): 12800
  • Number who would seek transition-related treatment: 188
  • Cost per treatment: $30K over 6.5 years

It says,

Having analyzed the cost that the military will incur by providing transition-related care, I am convinced that it is too low to warrant consideration in the current policy debate. Specifically, I estimate that the provision of transition-related care will cost the military $5.6 million annually, or 22 cents per member per month. Of course, the cost will depend on how many transgender personnel serve and utilize care, and estimates are sensitive to certain assumptions, such as the expectation that the military will not become a “magnet” employer for transgender people seeking health care benefits. Though my utilization and cost estimates are quite close to actual data provided by an allied military force, it seems clear that under any plausible estimation method, the cost amounts to little more than a rounding error in the military's $47.8 billion annual health care budget.

... the "actual data" being data from Australia:

As an accuracy check, consider the Australian military, which covers the cost of transition-related care: over a 30-month period, 13 Australian troops out of a full-time force of 58,000 underwent gender transition — an average of 1 service member out of 11,154 per year.3 If the Australian rate were applicable to the U.S. military, the Pentagon could expect 192 service members to undergo gender transition annually.

Incidentally it also says (and includes as a factor in its estimate) that,

However, transgender persons are overrepresented in the military by a factor of two

In other word, transgender persons are already more likely than average to volunteer for service.

Another article Inside Trump’s snap decision to ban transgender troops claims that the real cost was that the issue was (for political reasons) threatening funding for the border wall with Mexico:

House Republicans were planning to pass a spending bill stacked with his campaign promises, including money to build his border wall with Mexico.

But an internal House Republican fight over transgender troops was threatening to blow up the bill.

It quotes a Republican congressman as saying,

“It’s not so much the transgender surgery issue as much as we continue to let the defense bill be the mule for all of these social experiments that the left wants to try to hoist on government,”

Rep. Trent Franks (R-Ariz.), a conservative supporter of the Hartzler proposal, said last week.

... so perhaps their motive too wasn't that the economic cost is significant.

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ChrisW
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    The studies only seem to look at the cost of the medical care for the transition, but they don't consider the possibility of those people feeling better and as such performing better. Which in turn could lead to less costs as well. Possibly the studies didn't consider it because it is hard to estimate? Still, seems like an oversight to me. – stijn Jul 26 '17 at 19:42
  • @stijn If you exclude trans people outright, that really doesn't matter (unless you consider the lost talent, but that can probably be ignored because of the low percentage of trans people in the population). – tim Jul 26 '17 at 19:46
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    It seems odd that, if it was just an issue with paying for 'gender transition' procedures, the best solution would be to get rid of transgender servicemen, rather than just not paying for the transition. Not an issue with your answer, the argument just doesn't seem to make sense. – DaaaahWhoosh Jul 26 '17 at 20:26
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    @DaaaahWhoosh Based on the linked article, simply not paying for such transitions was the goal. Trump, however, will be Trump. – JAB Jul 26 '17 at 21:54
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    Indeed, the White House today described the decision as necessary for "military readiness and unit cohesion," which has nothing to do with cost of medical care. So yes, there's ample reason to doubt it's about costs. – Zach Lipton Jul 27 '17 at 00:09
  • @tim Presumably there's a cost to recruiting new service members to replace those kicked out for being trans? I'm seeing some widely varying numbers, but it seems clear it costs at least thousands to recruit someone and get them through training. – Zach Lipton Jul 27 '17 at 00:11
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    It's worth noting that at 6 million dollars per year, paying medical services for transgender servicepeople amounts to about a nickel per taxpayer. – Russell Borogove Jul 27 '17 at 03:01
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    Since the stated rationale is already changing, it's pretty obvious that the goal here is to make trans people a wedge issue on the left. – Russell Borogove Jul 27 '17 at 03:02
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    @Russel Borogove If the right succeeds with transgender people, the women in the military will be next – RedSonja Jul 28 '17 at 12:28
  • While I find the later half of your answer quite informative, i don't think this answers the OP question. He explicity asked about the costs to the military, not what trumps real motivations may be, and asked for information other then the RAND report. You have no information about costs to the military other then the excluded RAND report in this answer. – dsollen Jul 28 '17 at 12:45
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    @dsollen I don't consider myself obliged to answer the OP's question (e.g. I don't consider myself obliged to ignore the RAND report). I consider myself obliged to address the portion of the notable claim which the OP identified, which in this case is a claim that there are "tremendous medical costs". – ChrisW Jul 28 '17 at 12:48
  • @RussellBorogove while I don't approve of trumps statement at all as a skeptic I'm forced to play devils advocate. Rather or not the cost per taxpayer is minimal if the cost is going to a trivial number of individuals the cost could be deemed too high per person helped. To give an extreme example imagine a single goverment employee decided he needed a new mansion to be the best soldier he could be it it would only cost 6 million dollars. The cost is still trivial per tax payer, but most would agree that doesn't mean it's worth 6 mil to help one person. – dsollen Jul 28 '17 at 12:49
  • @RussellBorogove Having said that the cost isn't that high, and there is the obvious alternative of simply not covering transition surgery if it costs too much without banning all transgender, even those not planning to transition or who already transitioned just to avoid paying for surgery. I still strongly disapprove of the whole tweet, just pointing out that it's fallacious to make an argument about costs that only considers cost relative to total expenditures and not benefit per dollar spent. – dsollen Jul 28 '17 at 12:52
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    @dsollen No, actually, no one's forcing you to play devil's advocate. No one's forcing you to make up silly slippery slope arguments. – Russell Borogove Jul 28 '17 at 13:57
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    I think the estimation of cost is dishonest as it counts it on the whole and not how much more expensive a trans soldier is compered to a normal soldier, by just takes the total cost of military health care expenditures with is obviously going to be low, given how few trans people there are in the mitlitary currently. Something that can change at any time. – Icy Creature Jul 29 '17 at 19:40
  • @Frozendragon I added the estimated cost per soldier to the answer. – ChrisW Jul 29 '17 at 21:24
  • @Frozendragon Fair point, but considering transitions cost a couple thousand $, the per-soldier cost is frankly also not that high compared to salary, equipment and other miscellaneous costs (including medical). – Cubic Jul 31 '17 at 13:32
  • "In other word(s), transgender persons are already more likely than average to volunteer for service." it might not be more people volunteering, instead it could be something causing people to become transgendered while in the army, such as artificial hormone use - steroids. The way they put it is more correct. – daniel Aug 04 '17 at 12:19
  • I suspect that it's not about "how much does it cost compared to other things" as much as "it's an additional cost burden that doesn't need to be there" since it's controversial medical treatment in the first place. – MetaGuru Aug 04 '17 at 16:33