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There Are an Estimated 1,320–6,630 Transgender Service Members in the Active Component, but Not All Will Seek Gender Transition–Related Treatment

• It is difficult to estimate the number of transgender personnel in the military due to current policies and a lack of empirical data. Applying a range of prevalence estimates, combining data from multiple surveys, and adjusting for the male/female distribution in the military provided a midrange estimate of around 2,450 transgender personnel in the active component (out of a total number of approximately 1.3 million active-component service members) and 1,510 in the Selected Reserve.
• Only a subset will seek gender transition–related treatment. Estimates derived from survey data and private health insurance claims data indicate that, each year, between 29 and 129 service members in the active component will seek transition-related care that could disrupt their ability to deploy.

The Costs of Gender Transition–Related Health Care Treatment Are Relatively Low

• Using private health insurance claims data to estimate the cost of extending gender transition–related health care coverage to transgender personnel indicated that active-component health care costs would increase by between $2.4 million and $8.4 million annually, representing a 0.04- to 0.13-percent increase in active-component health care expenditures.
• Even upper-bound estimates indicate that less than 0.1 percent of the total force would seek transition-related care that could disrupt their ability to deploy.

Previous Integration Efforts and the Experiences of Foreign Militaries Indicate a Minimal Likely Impact on Force Readiness

• The limited research on the effects of foreign military policies indicates little or no impact on unit cohesion, operational effectiveness, or readiness. Commanders noted that the policies had benefits for all service members by creating a more inclusive and diverse force.
• Policy changes to open more roles to women and to allow gay and lesbian personnel to serve openly in the U.S. military have similarly had no significant effect on unit cohesion, operational effectiveness, or readiness.