As the Department of Veterans Affairs (VA) moves to offer experimental transgender surgery to service members and veterans, VA Secretary Denis McDonough did not shy away from putting a price tag on the controversial “medicine.” He did not address the likelihood that many of the veterans who “transition” from their biological sex might regret their decisions and therefore return for medical care to detransition.
In an interview with NPR, Ari Shapiro asked McDonough to estimate how much taxpayers would have to pay for transgender surgery. Shapiro noted that there are an estimated 134,000 transgender veterans, with another 15,000 transgender troops actively serving in the armed forces.
McDonough estimated that the VA will take about two years to implement the rule and to get ready to perform the surgeries, which involve the removal of healthy sex organs to replace them with facsimiles of sex organs belonging to the opposite sex. He estimated that about 543 veterans will be eligible for the surgery every year. “So we think these are both important numbers but manageable numbers inside our current budget envelope,” the secretary said.
“The last push to reverse this ban in 2016 fell apart amid concerns about funding,” Shapiro noted. “Do you have an estimate of what the cost might be?”
“You know, the cost projection is from – anywhere from just over a million dollars a year to somewhere closer to $30 million a year,” McDonough explained. “We also assess it might get a little bigger than that because we assess that there may be as many as 3,000 veterans who would have this care if they could get it, those waiting for it. So if that’s the case, it could get up to as much as $71 million all in by 2028.”
The cost of transgender surgery varies. People without health insurance will likely pay an estimated $15,000 for genital surgery, an estimated $25,000 for both genital and chest surgeries, and $50,000 or more for both surgeries along with procedures to make facial features appear more masculine or feminine. It remains unclear exactly how far the VA will go in making taxpayers foot the bill for cosmetic changes.
While the condition of gender dysphoria (the painful and persistent discomfort with one’s own body that comes from identifying with the opposite sex) is real, there is no conclusive evidence that transgender surgery improves the mental health outcomes of gender dysphoric people. Many observers have compared transgender surgery to anorexia because it involves extreme measures to alter an otherwise healthy body to appease a disturbed mental state.
Men and women who formerly identified as transgender and underwent surgery have grown to reject transgender identity and lament the damage they did to their own bodies. A man who formerly identified as a woman and got his male genitals removed described the female facsimile that replaced them as a “Frankenstein hack job.”
Doctors have warned that even “puberty-blockers” and cross-sex hormones give healthy people a disease. Research shows that there are significant risks with sex-reassignment surgery, including heart conditions, increased cancer risk, and loss of bone density.
Should the U.S. government endorse transgender surgery? Should it force taxpayers to foot the bill? Americans should weigh in when the public comment period begins.