Exclusive: Pentagon spent nearly $8 million to treat 1,500 transgender troops since 2016

WASHINGTON – The Pentagon has spent nearly $8 million to treat more than 1,500 transgender troops since 2016, including 161 surgical procedures, according to data obtained by USA TODAY.

As of Feb. 1, 1,071 service members have been diagnosed with gender dysphoria in the Army, Navy, Air Force, Marine Corps, Coast Guard and Public Health Service on active duty and in the reserve force.

Most of them are senior enlisted personnel, but there are 20 senior officers – majors and lieutenant commanders and higher – as well.

Overall, the troops represent a fraction of the total force of 2.1 million. The number of transgender troops serving who have not sought treatment through the military is not known.

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Transgender troops and their medical and psychological treatment has been a flash point for controversy since President Donald Trump tweeted in July 2017 that he wanted to ban them from the military. In January, the question reached the Supreme Court, which ruled that a modified ban could take effect while lower court challenges continued.

On Wednesday, the House Armed Services Committee will hear testimony on the military's policy, which bans most troops with a diagnosis of gender dysphoria.

Democrats, including House Speaker Nancy Pelosi, have blasted the Pentagon policy as bigoted. She invited transgender troops to Trump's State of the Union address this month.

Data on the population of transgender troops have been closely held at the Pentagon. The most definitive estimates of the population of transgender troops have come from a Defense Department-commissioned report in 2016. The non-partisan RAND Corp. report estimated as many as several thousand among the 1.3 million service members on active duty in the Air Force, Army, Marine Corps and Navy. RAND researchers determined that their treatment would have negligible effects on military readiness.

The data obtained by USA TODAY show in greater detail the number and rank of troops receiving treatment, the type of therapy and the cost.

Gender dysphoria is a condition recognized by the medical and mental health community. The American Medical Association, American Psychiatric Association and American Psychological Association oppose the Pentagon's ban, noting that there is no medically valid reason to exclude those with the diagnosis of gender dysphoria from military service. 

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The Pentagon data date to July 1, 2016, when the Obama administration lifted the existing ban on service for transgender troops and allowed them to seek treatment. Since then, 1,524 troops have been diagnosed with gender dysphoria. In the active-duty force there were 500 in the Army, 442 in the Navy, 354 in the Air Force, 101 in the Marine Corps, 33 in the Coast Guard and four in the uniformed Public Health Service. And 90 service members served in the reserves.

Through Feb. 1, the cost of treating troops with the diagnosis of gender dysphoria has totaled $7,943,906.75. That included 22,992 psychotherapy visits, 9,321 prescriptions for hormones and 161 surgical procedures. Surgeries performed included 103 breast reductions or mastectomies, 37 hysterectomies, 17 "male reproductive" procedures and four breast augmentations. Psychotherapy sessions cost nearly $5.8 million and surgery cost more than $2 million, according to the data.

The Pentagon's budget this year is $716 billion.

Brad Carson, the Pentagon's former top personnel official and one of the architects of the Obama-era policy, said Wednesday that the number of transgender troops is smaller than anticipated, as is the cost of treating of treating them. He noted that the Pentagon spends about $50 billion per year on health care.

"A few million spent here is dwarfed by the treatment cost of virtually any ache and pain you can think of," said Carson, who is now a professor of public policy at the University of Virginia.

The relatively small number of transgender troops also indicates that recruits are not joining the military to receive medical treatment, Carson said.

"We need every qualified patriot willing to serve in our armed forces," said Air Force Lt. Col. Carla Gleason, a Pentagon spokeswoman. "The 2018 update to the 2016 policy is not a ban on transgender service members; it is a policy on gender dysphoria. Any currently serving transgender service member with a diagnosis of gender dysphoria will remain under the 2016 policy. Any new policy will not apply to those individuals."

Wednesday's hearing is scheduled to be held before the House Armed Services Committee's panel on personnel, chaired by Rep. Jackie Speier, D-Calif. She has been a vocal critic of the Trump administration's efforts to exclude transgender people from serving in the military.