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The thin evidence behind Trump’s new ban on trans service members

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Activists participate in a rally at the Reflecting Pool of the US Capitol on April 10, 2019. | Alex Wong/Getty Images

President Donald Trump issued an executive order on Monday barring transgender people from openly serving in the military. He claims that the ban, which discriminates against potential service members based on their gender identity, will support military preparedness and reduce taxpayer costs — but the evidence behind it remains as thin as it was when Trump instituted the same policy during his first administration.

The executive order bans trans service members from using sleeping, changing, or bathing facilities that align with their gender identity. It claims that trans people “cannot satisfy the rigorous standards necessary for military service” because of the “medical, surgical, and mental health constraints” they face and asserts that their use of pronouns other than those assigned at birth “conflicts with a soldier’s commitment to an honorable, truthful, and disciplined lifestyle.”

A White House fact sheet on the executive order further claims that paying for gender-affirming surgeries for service members and their dependent children came at the “cost of millions to the American taxpayer.” 

The Department of Defense is coming up with a plan to implement the order, which will involve determining whether the ban will apply to existing service members or just those seeking to join the military going forward, according to a White House spokesperson. For now, current service members can still access gender-affirming care, but that could change imminently.

Despite these claims, it’s not clear that trans service members are any less capable than others. While it’s true that the federal government has subsidized gender-affirming surgeries, the costs associated with those surgeries are not unusual compared to other health care costs typically incurred on behalf of service members and their dependents.

Two organizations that promote LGBTQ rights — Lambda Legal, which sued over a previous iteration of the ban in 2017, and the Human Rights Campaign — announced Monday that it will challenge the executive order in court. The 2017 ban was blocked in court until the Supreme Court allowed a revised version of it, narrowed to cover only new recruits, to briefly go into effect. The justices, however, never reached a final determination on its legality before former President Joe Biden rescinded it in 2021.

“The justifications that are being provided here are the same ones they provided in 2017,” said Sasha Buchert, legal counsel for Lambda Legal. “None of the courts bought them, and I don’t believe they’ll buy it moving forward.” 

What we know about transgender service members, their readiness, and cost of care

Trans people have long served in the military, but it wasn’t until June 2016, under former President Barack Obama, that they were first allowed to do so openly without being discharged or denied reenlistment as a result. This mirrored policies in other countries, including Australia, Canada, Israel, and the United Kingdom.

Today, thousands of trans people serve in the military, though exact estimates vary based on how service members are surveyed and whether nonbinary individuals, people who transition before service, or people who haven’t yet started transitioning are included. Trans personnel are represented across roles, from cooks to musicians to fighter pilots to intelligence officers, Buchert said. Billions have already been invested in their training, she added. 

There is little evidence that trans service members have any significant impact on military readiness, cohesion, and costs. A 2016 report by the RAND Corporation, a nonpartisan policy think tank, found “minimal impact on readiness and health care costs” to allowing transgender personnel to serve openly, in part because only a small fraction of service members would likely even seek medical treatments related to transitioning that would impact their deployability or health care costs. 

A more recent report from the Congressional Research Service found that, from 2016 to 2021, $15 million went to expenditures for surgical and nonsurgical gender-affirming care. Those costs are in line with other routine medical costs for cisgender service members, according to Buchert, and represent just a small share of the overall military health system budget, which was $60.2 billion in fiscal year 2024.

“The amount spent over five years for gender-affirming care is negligible compared to overall costs,” said Jody Herman, a senior scholar of public policy at the Williams Institute, a think tank at UCLA School of Law focused on sexual orientation and gender identity law.

When service members do undergo gender-affirming surgeries (a category that can include surgeries ranging from bottom surgery to facial feminization surgery), the procedure is scheduled in advance. It doesn’t impact deployments or mission readiness and patients are typically back on full duty in four to eight weeks, said Sue Fulton, an army veteran and senior adviser to Sparta, an advocacy group for trans service members. That contradicts a claim in the White House factsheet that it can take a “minimum of 12 months for an individual to complete treatments” before they can meet readiness requirements.

“They give the impression that procedures that transgender folks might have are exotic and burdensome and expensive, which is simply not true,” Fulton said. “It’s not much different than, say, nonemergency minor knee surgery. … The readiness and physical capabilities of transgender service members are not different from that of other service members.”

As for the White House’s concerns about “mental health constraints” on trans service members, it is true that trans people experience higher rates of anxiety, depression, and attempted suicide, though those rates are significantly lower among those who undergo the gender-affirming surgery that trans service members can access.

Guidance from the American Psychological Association suggests that Trump’s executive order may actually contribute to mental health challenges faced by trans people in the military by discriminating against them and preventing them from accessing treatment. In a statement Friday, the APA warned that “research consistently shows that stigma and lack of treatment for transgender and gender nonconforming individuals have significant negative effects on mental and physical health.” 

The “flimsiness,” as Buchert put it, of the justifications for the ban reveals what she identified as the real motivation behind it: “For all the lip service about meritocracy, this is clearly not about merit. It’s about identity and clearly targeting transgender people in particular.”

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