Report: Pentagon to pay for transgender soldier’s surgery — despite Trump’s ban

The Pentagon will pay for a transgender soldier’s gender-affirming surgery, according to a new report by NBC News.

It will be the first such procedure “approved under a waiver allowing the Pentagon to pay for the operation,” Courtney Kube reported for NBC News. Vice Admiral Raquel Bono, head of the Defense Health Agency, approved the request on Monday.

The soldier is reportedly a trans woman who previously fought in Afghanistan, earning her Combat Infantry Badge in Operation Anaconda in 2003.

The waiver comes despite President Donald Trump’s attempts to ban transgender soldiers from the military. In July, Trump tweeted that he would ban trans military service. He argued, “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.”

But the research, based on the experiences of other countries, shows that the costs associated with trans service members are actually very small. A 2016 review of the research by the RAND Corporation found that by allowing trans-inclusive medical care, “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” — a very small amount.

This small cost may not mean much in budget terms, but it could mean a lot to trans soldiers: As the American Medical Association and American Psychiatric Association point out, transitioning helps reduce gender dysphoria — a state of emotional distress caused by how someone’s body or the gender they were assigned at birth conflicts with their gender identity. Untreated gender dysphoria, which not all trans people suffer from in the same way, can lead to anxiety, depression, and even suicide, so treating it could mean fewer mental health issues for trans people serving in the military.

Trump’s ban, which the White House officially instated in August, would ban the US military from paying for gender-affirming surgery, with some exceptions to “protect the health” of someone who had already begun transitioning. But an interim policy by Secretary of Defense James Mattis still requires the military to pay for these medical expenses for the time being. (A federal court has held up other parts of the ban too.)

For more on Trump’s ban on transgender military service, read Vox’s explainer.