Starting the first week of October, the government will pay for gender reassignment treatments and surgeries for eligible soldiers — an estimated expense between $2.4 million to $8.4 million per year.
There are between 1,320 and 6,630 transgender troops in the active-duty force of 1.3 million, according the RAND Corp. which conducted a study for the Pentagon. Of those troops, RAND estimates that between 30 and 140 would like hormone treatment, and 25 to 130 would seek surgery.
The Defense Department policy states if a service member’s ability to serve is hindered by a “medical condition or medical treatment related to their gender identity,” they will be treated. When an active duty service member receives approval from a military medical provider to undergo gender transition, the commander must approve the timing of medical treatment.
Defense Department spokesman Air Force Maj. Ben Sakrisson said starting Oct. 3, the military health program will cover therapy and hormone treatments for Tricare beneficiaries with gender dysphoria. According to Sakrisson, gender reassignment surgeries for active-duty personnel will be conducted at either a military hospital or, if qualified care is unavailable at a military facility, at a private hospital paid by Tricare.
Ron Crews, executive director of Chaplain Alliance for Religious Liberty, said this is not the best use of government money, because soldiers undergoing treatments or surgeries will be unqualified for deployment for extended periods of time.
"I think this is a gross misuse of military medical dollars that should be used to make our military forces deployable or to help those who are wounded or injured while they are deployed," Crews, a veteran, said.
The military is also spending "tremendous amounts of training" on transgender education — time, Crews said, could be devoted to "better equip" soldiers to fight wars.
Hormone therapy doesn’t require designated recovery time, but reassignment surgeries require up to 21 days medical leave plus up to 90 days medical disability, according to RAND. Male-to-female genital surgery, which requires the longest recovery, leaves soldiers nondeployable for 135 days. The study says some might suffer from postoperative complications that would “render them unfit for duty” – for example, 6 to 20% of people who have a vaginoplasty have complications.
Aaron Belkin, director of the Palm Center, a public policy think tank that focuses on LGBT issues, said the actual cost of caring for these troops could be lower than anticipated because "transition-related care has been proven to mitigate serious conditions including suicidality that, left untreated, impose costs."
According to a USA TODAY report on Sept. 16, at least five transgender troops are pursuing treatment outside the military health care system, including one seeking sex-reassignment surgery.
Three are sailors or Marines and the other two are airmen, according to the report.
The Army recently assured Pvt. Chelsea Manning, who is serving a 35-year prison sentence for leaking national security secrets, it would pay for gender reassignment surgery while she’s in prison. The American Civil Liberties Union, which represents Manning, said she will meet with a team of doctors in coming weeks to talk about surgery preparations.
The U.S. Department of Defense has resources and information on its website about the new transgender policy and will be distributing a handbook on the policies to commanders next week.