The Transgender Military Ban, Part 1: Costs to President Trump

President Donald J. Trump tweeted the following on July 26, 2017:

“After consultation with my Generals and military experts, please be advised that the United States Government will not accept or allow… Transgender individuals to  serve in any capacity in the U. S. Military.  Our military must be focused on decisive and overwhelming… victory and cannot be burdened with the tremendous medical costs and disruption that transgender in the military would entail. Thank you”

A History of Inclusion

The service of members of the LGBTQIA community in the US military has remained a highly contentious and passionately-fought issue on all sides of the political (and gender) spectrum.  The battle for inclusion in the American Armed Forces first involved inclusion along ethnic lines, then involving lesbians, gays, and bisexuals, and more recently the rights of transgender persons to openly serve.

On July 26^th, 1948 President Harry S. Truman signed into effect Executive Order 9981: Establishing the President’s Committee on Equality of Treatment and Opportunity in the Armed Services.  The order essentially desegregated the United States Armed Forces, stating “… there shall be equality of treatment and opportunity for all persons in the armed forces without regard to race, color, religion, or national origin”.  President Trump’s tweet banning the service of transgender American soldiers comes on the 69^th anniversary of President Truman’s executive order.  This Executive Order jumpstarted the battle for inclusion in the American Armed Forces, first included ethnic lines, then sexual orientation, and finally gender identity.

President Bill Clinton, in October of 1993, executed a new law known as “Don’t Ask, Don’t Tell, Don’t Pursue, and Don’t Harass”, though it’s commonly referred to as “don’t ask, don’t tell” (DADT).  DADT reversed the long-standing statutory ban on gay, lesbian, and bisexual individuals from serving in the United States military. Gay, lesbian, and bisexual individuals had long served in the US military with their sexuality largely kept secret.  DADT was first met by suspicion and hostility from many politicians and military personnel alike, citing fears of ‘undermining morale’ if gays, lesbians, and bisexuals were permitted to serve in any capacity.  Again, gays, lesbians, and bisexuals had long served the US military, but not to the explicit knowledge of their commanding officers or fellow servicemen and servicewomen.

President Barack Obama, in December of 2010, after both the House of Representatives and US Senate successfully voted to repeal the practice, signed into law a full reversal on DADT. The practice of forbidding gay, lesbian, and bisexual service-members to be ‘out’ about their sexuality and serve in the US military was effectively over.

Throughout the battles fought for gays, lesbians, and bisexuals to openly serve in the military, transgender individuals were explicitly told they must ‘pass’ as their biological sex if they wished to serve in the US military.  Transgender persons have myriad ways of expressing their sexual orientation, including: dressing in accordance with their gender identification, changing their name, hormone treatment, and medical procedures that alter their body to conform with their gender identity.  So far as the military was concerned, transgender individuals could be threatened with discharge for an enlistment violation if they did not ‘pass’ as their sex assigned at birth.  That is, until June of 2016, when Secretary of Defense Ash Carter lifted the ban on transgender individuals from openly serving.  In his public statement on the reversal, Carter explains:

“Our mission is to defend this country, and we don’t want barriers unrelated to a person’s qualification to serve preventing us from recruiting or retaining the soldier, sailor, airman, or Marine who can best accomplish the mission.  We have to have access to 100% of America’s population for our all-volunteer force to be able to recruit from among them the most highly qualified – and to retain them.”

Taking our lead from Carter, Obama, Clinton, and Truman, a question remains if military service is a civil right, civil liberty, or both.  The distinction between these terms can be found here.  Under current US federal law and military policy, American citizens over the age of 18 of sound body and mind can volunteer to serve in the US Armed Forces.  As it relates to transgender persons, the civil right to serve in the military without discrimination and the civil liberty to openly serve have been supported by legal precedents.  If President Trump’s blanket ban is codified in policy, any resulting legal action will clarify how civil rights and liberties are applied in the case of transgender Americans wishing to serve.

Trump’s Argument

President Trump’s transgender military ban was conveyed to the public via tweet, and tweets are not legally binding nor are they official US policy (though they have been ruled legal stream of consciousness).  The day after Trump tweeted on the issue, the Joint Chiefs of Staff General Dunford stated the Department of Defense was not changing policy on the President’s tweets alone- an official policy directive must be issued.

The President’s tweets may indeed be a precursor to an executive order (such as the case with President Truman and military desegregation), a bill-turned-law (Presidents Clinton and Obama with the creation and repeal of DADT), a policy change (Secretary Carter and the service of openly transgender soldiers), some other legally binding option, or it may remain what it is today: a tweet.  The likelihood of the president issuing a policy directive is arguably uncertain.  However, based on the information the American public has on President Trump’s proposed transgender military ban, we can make an educated analysis of his arguments for a ban.  A thorough and exhaustive examination of his full public statement (341 characters, not including spaces) reveals two justifications the president offers for his transgender military ban: “tremendous medical costs” and “disruption that transgender in the military would entail”.

In 2016, the RAND Corporation, a nonpartisan think tank offering research and analysis in operational strategy related to the US Armed Forces, published a report titled Assessing the Implications of Allowing Transgender Personnel to Serve Openly; the full text can be read here.  This report, commissioned in response to growing questions about the reality of allowing transgender individuals to openly serve in the military, assessed: 1) the health care needs of transgender individuals, 2) the population size of transgender individuals in the US military, 3) the likelihood & potential costs of gender-related healthcare services to the US military, and 4) the ‘potential readiness’ of the US military to allow transgender individuals to openly serve.  This report helped inform Secretary Carter’s decision to allow transgender individuals to openly serve.  This widely-respected and cited report directly addresses both of President Trump’s justifications for banning military service of transgender individuals: medical costs and “disruptions” to unit cohesion.

The medical cost President Trump is likely alluding to is the extension of healthcare coverage to transgender individuals in the US Armed Forces to cover gender-transition related treatment.  As previously stated, this includes procedures such as hormone treatment, surgeries such as hair removal or breast implantation, and gender reassignment surgery.  Given the ongoing and bitterly contentious debate in the US Congress on Obamacare repeal / reform, President’s Trump’s focus on costs accrued from health does make sense, given the current political climate.  Politicking aside, the RAND Corporation did indeed find an increase in costs to the military in extending healthcare to include gender-transition related treatments.  Using cost estimates based off public employers, private employers, and treatments likely to occur in transgender persons in the military, allowing the health extension would cost the military between $2.4million and $8.4million per year (by comparison, the US military spends $84million / year in treatment for erectile dysfunction for US servicemen- 10x the amount of gender-transition related treatment). The US military currently spends $6.2billion per year in healthcare-related costs.  Therefore, allowing transgender soldiers to have access to gender-transition related treatment would see a 0.13% or 0.0013 yearly increase in the US Armed Forces healthcare budget.  These specific estimates can be found between pages 33-37 of the RAND Report.  To put this in further perspective, one of President Trump’s foundational arguments against the military service of transgender individuals is an unwillingness to spend a potential $2.4m-$8.4m / year, for individuals committed to protecting the United States from enemies foreign and domestic, in healthcare procedures that are entirely optional and may or may not be utilized.  For the president, these “medical costs” are simply too high.

President Trump’s second and final argument against the military service of transgender individuals is the “disruption” they present to their fellow soldiers, sailors, airmen, and Marines.  This very argument has been used before, most notably in the follow-up to President Obama’s repeal of DADT.  Critics of the repeal feared if other members in the unit found out an individual was lesbian, gay, or bisexual, this would inhibit unit bonding, and therefore negatively impact unit cohesion and situational readiness.  This argument has long been dismantled, and data indicate this trend holds for transgender individuals serving in the military as well.  In fact, individuals with negative attitudes towards transgender individuals are more likely to change those attitudes towards a positive outlook, given more interactions with a transgender person.  This specific instance of Mere Exposure Effect (or as social psychologists would say, “Familiarity Principle”) has been found in militaries across the world, including in the US.  The RAND Report summarizes these studies (pages 39-47), stating the presence of one or more transgender individual in a military unit has no significant impact on cohesion, operational effectiveness, or readiness.  “[D]isruption that transgender in the military would entail”, cited by President Trump as a reason for the transgender military ban, is simply not supported by the evidence.

Reaction to President Trump’s tweet was mostly surprise. While conservative circles welcomed the move, news outlets, advocacy groups, members of the US Armed Forces and private citizens have all expressed their ire, frustration, and disbelief at the transgender military ban.  What is more disturbing than this sudden announcement are the potential effects of President Trump’s statement on the lives of transgendered Americans.  It serves as an illustration of discrimination and oppression of transgender people in general.  This attack and other attacks like it, while disguised in seemingly innocuous rationale such as “medical costs” and unit “disruption”, do real and tangible damage to transgender persons. Reaching equality for transgender persons has just become more difficult.