The Pentagon has spent $15 million in the past five years to treat 1,892 transgender troops, including $11.5 million for psychotherapy and $3.1 million for surgeries, according to Defense Department data provided to Military.com
Of the 243 gender reassignment surgeries performed on military personnel since 2016, 50 took place between Jan. 1, 2016 and Dec. 31, 2017, and 193 occurred from Jan. 1, 2018 to Dec. 31, 2019 -- the two years after President Donald Trump announced via Twitter that he would bar transgender individuals from serving in the U.S. military.
According to the Defense Health Agency, the surgeries were performed in military health facilities and included removal of breasts or testicles, hysterectomies and labiaplasty -- creation of or reshaping the flesh around a vagina.
The total number of transgender persons serving in the armed forces across all three components -- active-duty, Reserve and National Guard -- is not known as not all likely have sought treatment.
But as of May, 1,892 military personnel have been diagnosed and treated for gender dysphoria, including 726 Army soldiers, 576 Navy sailors, 449 Air Force airmen and 141 Marines, according to DHA spokesman Peter Graves.
The Palm Center, a public policy think tank that focuses on LGBT issues, estimated in 2018 that 14,707 transgender troops serve in the U.S. armed forces, including nearly 9,000 on active duty and 5,727 in the reserves.
In 2016, then-Defense Secretary Ash Carter announced that transgender people already serving in the military would be allowed to serve openly and transgender individuals were allowed to enlist as of July 1, 2017.
Trump announced via tweet in July 2017 that planned to ban transgender people from serving in the U.S. military, saying he consulted with military leaders and military experts before deciding that DoD did not need to be "burdened with the tremendous medical costs and disruption that transgender in the military would entail."
A policy was released by then-Secretary of Defense James Mattis in 2018 that prohibited individuals diagnosed with gender dysphoria from serving, with exceptions. It also said that transgender persons who didn't have the gender dysphoria -- defined as extreme anxiety or distress that may accompany a person's desire to be the opposite gender -- could serve, but only in their birth gender.
A number of lawsuits were filed over the policy, which was upheld by the U.S. Supreme Court in January 2019.
President Joe Biden reversed the policy on his fifth day in office, Jan. 25, 2021.
According to DoD, the department spent $11,582,262.99 on psychotherapy for service members with gender dysphoria from Jan. 1, 2016 through May 14, 2021. Within DoD, 637 service members received hormone therapy during the same time frame, at a cost of $340,000, and 243 surgeries were performed at a cost of $3.1 million.
The Pentagon's annual medical budget for health care programs in 2016 was $33.5 billion; the proposed fiscal 2022 budget calls for $35.6 billion in discretionary spending for health care.
The services have been rolling out branch-specific guidance regarding the treatment of transgender troops. The Air Force released its guidance on April 30, while the Navy issued a message June 3 stipulating its policy barring discrimination against any service members.
"The Navy remains committed to treating all persons with dignity and respect," the message read. "No person, solely on the basis of gender identity, will be denied accession, involuntarily separated or discharged, denied reenlistment or continuation of service, or subjected to adverse action or mistreatment."
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