President Trump Blamed the Transgender Military Ban on an Inaccurate Cost for Surgery

President Donald Trump blamed the cost of gender-transition surgeries for his Administration’s policy barring transgender people from serving in the military, citing a figure experts said was inaccurate.

In an interview with British commentator Piers Morgan on Tuesday, Trump claimed that the costs of gender transition surgeries were behind his decision to bar transgender military service, first announced in a series of tweets in July of 2017.

“Well, it is what it is,” Trump said. “Also massive amounts of people going in and then asking for the operation, and the operation is $200,000, $250,000.”

That number is incorrect, however.

According to widely cited figures by the Philadelphia Center for Transgender Surgery, male-to-female transition surgeries are usually around the ballpark of $25,600. Meanwhile, a standard female-to-male bottom surgery is around $24,900 at the facility. And while the center’s price sheets include several other gender-affirming surgeries — like facial reconstruction and calf augmentation — that can make total costs near the $100,000 to $140,000 range, even those total costs are substantially less than the figures Trump cited.

“I don’t know where the $200,000 to $250,000 range comes from. The high end for costs relating to genital reconstruction surgery for transgender individuals is less than half that,” said Dr. Joshua Safer, the executive director at Mount Sinai’s Center for Transgender Medicine and Surgery, who estimates ballpark ranges are more like $25,000 at the low end to as much as $100,000, depending on the type of operation.

Dr. Amy Weimer, the founder and co-director of UCLA’s Gender Health Program, also said usual costs “reach nowhere near the amount stated by Trump.” She added that many transgender individuals do not desire or get gender-affirming surgeries, and for those that do desire it, having access to the surgeries is linked to cost savings in the long-term by reducing other health conditions, such as depression and substance use.

Trump also blamed the transgender military policy on Defense Department rules regarding prescription drug use.

“Because they take massive amounts of drugs,” Trump explained. “They have to, and also — and you’re not allowed to take drugs. You’re in the military, you’re not allowed to take any drugs,” adding that members can take aspirin.

This is also untrue. While some individuals with conditions like asthma and diabetes are restricted from enlisting, many service members can and do take prescription drugs.

For example, a 2013 Military Times report estimated at least one in six service members takes some kind of psychiatric drug. Further, the Department of Defense spends approximately five times as much on erectile-dysfunction drugs like Viagra than it would on medical care for transgender troops, according to a Washington Post analysis.

A 2016 report from nonpartisan think-tank Rand estimated that providing gender-affirming care to transgender troops would cost between $2.4 million and $8.4 million annually. In comparison, total Defense Department spending on erectile dysfunction medications exceeds $80 million each year.

Morgan also asked Trump what he thought of transgender military members who have received honors for their service during the interview, which took place during Trump’s three-day state visit to Great Britain.

“I’m proud of them. I think it’s great,” he said. “But you have to have a standard and you have to stick by that standard. We have a great military and I want to keep it that way. Maybe they’d be phenomenal. I think they probably would be. But again, you have very strict rules and regulations on drugs and prescription drugs and all of these different things, and they blow it out of the water.”

The Department of Defense finalized Trump’s guidance on the matter in April 2019. It effectively bars transgender individuals who have transitioned from enlisting in the military, and prohibits already-enlisted troops from undergoing hormone therapy or gender transition surgeries.