Should Transgender People be in the Military? An overview of relevant studies

On July 27 (2017,) President Trump tweeted his intention to ban transgender people from serving in the military, a move which would reverse President Obama’s decision to allow them to serve. (Prior to Obama, trans people were not allowed to serve.) As of the writing of this post, Trump’s tweet has not become official law or policy, but it has set off a firestorm of internet debate, with everyone picking sides primarily based on whether they like trans people or not, rather than what’s actually best for the military.

So I decided to review whatever studies I could find on the subject:

CLAS (Community Alliance for Cultural and Linguistically Appropriate Services) finds:

On September 20, 2011, the repeal of “Don’t Ask, Don’t Tell” (DADT) went into effect in the U.S. military. The repeal marked the end of discriminatory practices in the military based on sexual orientation, but it did not end the prohibition on transgender military service. The National Transgender Discrimination Survey (NTDS) found that transgender Americans serve in the military at a high rate; 20 percent of NTDS respondents had served in the armed forces as compared to 10 percent of the U.S. general population.

According to 538, about 7.3% of the US population has served in the military (0.4% are active personnel; the rest are veterans.) The majority of those are male: 13.4% of men have served in the military, compared to 1.4% of women. Given the slight discrepancy in the data, I thought I’d check the NTDS numbers as well, but the PDF isn’t opening, but the Williams Institute has an article, Transgender Military Service in the US, which helpfully discusses the NTDS data in depth.

Overall, trans people are less than 1% of the population, and according to the Williams article, 60% MtF (male to female) and 40% FtM. According to 70 U.S. Veterans with Gender Identity Disturbances: A Descriptive Study, 91% of trans vets are MtF:

Retrospective descriptive data were obtained from chart reviews of 70 U.S. veterans who were evaluated by the second author for gender disturbances over a 20-year period (1987 to 2007). The modal veteran with gender identity disturbance was a natal male (91%) identifying as female, >40 years old, Caucasian, employed, with more than 12 years of education. Fifty-seven percent were parents with a history of sexual involvement with opposite sex individuals. Histories of autogynephilia were not elicited in vets interviewed since 1997. Classic “flight into hypermasculinity” was described by a majority of the natal male vets as a retrospective understanding of why they joined the military.

If we break the trans population down by gender, NTDS estimates that 30% of MtFs have served in the military and 5.5% of FtMs. (Williams cites a couple of other studies which found similarly high numbers.)

According to CNN, (which probably got its data from NTDS,) there are about 15,000 active trans troops; NTDS estimates a further 134,000 veterans. Given 1.4 million total people in the armed forces and 22 million vets, that gives us an estimate of a bit over 1% of the military and 0.6% of vets are trans. The discrepancy between current and historical numbers of trans people could be a side effect of younger people being more likely to identify as trans or of volunteer forces being more heavily trans than drafted ones. (Here is an interesting article about a trans WWII veteran; CNN has a couple about active troops.)

According to a RAND Corp study commissioned by the DoD, Assessing the Implications of Allowing Transgender Personnel to Serve Openly:

  1. There Are an Estimated 1,320–6,630 Transgender Service Members in the Active Component
  2. A further 1,510 in the Selected Reserve
  3. Not all will seek gender transition–related treatment (some have already had it and some don’t want it.)
  4. 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.
  5. 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.
  6. 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.

They further claim that:

  1. The limited research on the effects of foreign military policies indicates little or no impact on unit cohesion, operational effectiveness, or readiness.
  2. 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.

Note that RAND’s estimates of the number of trans military personnel is much lower than NTDS’s, which is kind of odd, given how easy the NTDS data is to find. Forgive me a bit of cynicism, but RAND seems to be trying to minimize projected costs by excluding the very large body of trans veterans who might also qualify for treatment and failing to include non-physical psychological expenses (see discussion below.)

Washington Free Beacon has a much higher estimate of physical costs, but I must warn that their website nearly crashed my computer. Quoting:

The 2014 Williams Institute study found there were 15,500 transgender individuals actively serving, or 0.7 percent of the military population. …

Thirty percent will likely seek surgeries, or 4,473 transgender troops. The average cost per surgery is $132,000, which is a combination of the average cost of male to female ($140,450) and female to male ($124,400) surgeries.

In other words, RAND estimates a small % of a small # will seek surgery–between 29 and 129 people. The Free Beacon study estimates a much higher % of a higher #, for an estimate of 4,473 people. RAND is also calculating about $80,000 per surgery, vs. Free Beacon’s $132,000.

The cost to taxpayers for these surgeries would be $590 million, and $770 million with a 3 percent inflation rate by 2027.

If the first set of numbers they cite are correct, then $590 million is an under-estimate, because it uses the average cost of male and female surgeries, but the majority of trans people in the military are MtF and so want the more expensive surgery.

There are 178,000 new military members per year, and assuming 0.7 percent are transgender, 1,246 new transgender service members each year. Assuming 30 percent get surgeries, there would be an additional 374 surgical transitions per year, or 3,740 over 10 years. Those surgeries would cost $493 million, and with 3 percent inflation a total of $579 million by 2027.

The costs of active duty transgender surgeries and those of new recruits over a 10-year period total $1.349 billion.

And this is still not considering veterans.

What about expenses besides surgical transition? According to Mental Health and Medical Health Disparities in 5135 Transgender Veterans Receiving Healthcare in the Veterans Health Administration: A Case–Control Study:

Statistically significant disparities were present in the TG cohort for all 10 mental health conditions examined, including depression, suicidality, serious mental illnesses, and post-traumatic stress disorder. TG Veterans were more likely to have been homeless, to have reported sexual trauma while on active duty, and to have been incarcerated. Significant disparities in the prevalence of medical diagnoses for TG veterans were also detected for 16/17 diagnoses examined, with HIV disease representing the largest disparity between groups.

Trans people have really high rates of depression (62% for MtFs and 55% for FtMs,) suicide attempts (32%,) and HIV infection (35% for MtFs but only 2% of FtMs.)

I found two other potentially relevant studies, one from the Journal of Homosexuality and one from HEIN Online, but both are paywalled so I can’t read them.

So. Tentative conclusions/discussion:

The military is not a charity, nor is it a means of dealing with pre-existing health issues. The military’s primary–some would say only–purpose is to defeat America’s enemies. The military does not take people with health problems like diabetes or Asperger’s, even though there are many diabetic or aspie people who would be GREAT soldiers. There are jobs in the military that you can’t get if you wear glasses.

Some of these rules may be wrong. Maybe we should let people with high-functioning autism/Asperger’s in the military if they can hack it. The Israeli military has a special division where autists put their skills to good use monitoring surveillance footage; it also allows transgender soldiers. But Israel is a small country surrounded by hostile enemies, so it may feel it cannot afford to turn down any willing soldiers.

I propose that the military may serve a secondary purpose: allowing citizens to feel like productive, contributing members of society. Service in the IDF, for example, may have a beneficial effect on Israeli society as a whole beyond merely insuring its safety. If military service is not appropriate for a group of people, perhaps some other form of service to society is.

Trans folk are a very small percent of the military, but a surprisingly large percent of trans folk are current or former military, especially if we only look at MtFs. It seems that the military is more important to trans folks than they are to it.

It makes sense that a larger percent of FtMs than cis-women would join the military, as they would naturally be drawn to more typically “male” occupations. The MtF preference for military work is harder to explain. One study attributes it to overcompensation–that is, covering up their desire to be female by trying to be as masculine as possible. I propose a second possibility: the military pays, and trans people are disproportionately poor.

I would like to draw here on an anecdotal case study of a single individual I knew in childhood:

This fiend has a rare genetic condition (Klinefelter) in which instead of having a normal set of sex chromosomes (XX for female, XY for male,) they’re XXY. Biologically, “male” and “female” are defined by gamete size–females produce large gametes (eggs) and males produce small gametes (sperm.) XXY people basically look male but don’t develop normal testicles and are often infertile, so I don’t think they really count as “male” in the biological sense.

The current vogue for asserting that “gender is a social construct” is pure nonsense, and IMO, will ultimately be harmful to trans people like my childhood friend, who has a true intersex condition. Even chimpanzees show gender roles similar to humans. There are many observed statistical differences between male and female brains, from better mental rotation (men) to lower rates of retardation (women.) These mental differences are caused by the different amounts of male and female hormones the fetal brain is exposed to at different points in its development, which trigger different aspects of brain development. There are whole books on the subject of fetal brain development if you want to know more.

Exposing a fetal brain to incorrect hormone levels–say, by taking a formerly popular anti-miscarriage medication that contains high levels of artificial estrogens–could trigger the development of a more “female” brain in a male body (or with the right hormones, the opposite.) In my friend’s case, an extra X chromosome rather than medication is to blame.

My friend identifies as “female” despite looking male. Why remains a mystery to me, as their life would be much easier if they identified as male and injected testosterone than identifying as female and injecting estrogen, but I certainly can’t naysay their sense that they “aren’t a proper male.”

But in a perhaps not odd twist, my friend is (or was) absolutely obsessed with everything military, from battleships to rifles to historical re-enactments. (Friend also has a very good memory, rendering them a walking military encyclopedia.)

Look, I acknowledge that “obsessed with the military” and “insists they are female and wants surgery in that direction” is a weird combination and I don’t understand it. Trans identity and stereotypically-male spheres overlap in a few other dimensions. People have lately been discussing an overlap between trans and autism, (which researchers often characterize as extreme male brain,) and of course Kaitlyn Jenner was, pre-transition, an Olympic Athlete. But all of that is getting a bit off topic.

“Transgender” is a vaguely defined term, and I don’t see why, even if trans people were allowed to serve in the military, the military would be required to cover the cost of transitioning. Why not declare that the military doesn’t cover it, that members aren’t allowed to put themselves out of commission by getting surgery, and that people using hormones/medications are ineligible for service (just as diabetics are ineligible,) but allow someone who transitioned decades ago and requires no medication or surgery?

However, the psychological co-morbidities, especially depression, are much more concerning. A group with high levels of depression, suicide, HIV, etc., sounds like a bad match for the military.

None of the studies I found really went into much detail (at least in the parts I could access) about trans soldiers’ ability to cope psychologically with the rigors of war nor their effects on group cohesion or effectiveness.

Allow me to express a bit of doubt: if people think the folks running the study want a particular outcome, they may be reluctant to complain about a fellow squad member. What I really want is a study of squad performance comparing squads with and without trans members, similar to the one highlighted in “The US Marines Tested Mixed-Gender Squads Against all Male ones, and the Results are Pretty Bleak” (which I wrote about here and followed up on here):

All-male squads, teams and crews and gender-integrated squads, teams, and crews had a noticeable difference in their performance of the basic combat tasks of negotiating obstacles and evacuating casualties. For example, when negotiating the wall obstacle, male Marines threw their packs to the top of the wall, whereas female Marines required regular assistance in getting their packs to the top. During casualty evacuation assessments, there were notable differences in execution times between all-male and gender-integrated groups, except in the case where teams conducted a casualty evacuation as a one-Marine fireman’s carry of another (in which case it was most often a male Marine who “evacuated” the casualty.)

The report also says that female Marines had higher rates of injury throughout the experiment.

People often argue that men and women ought to have an equal chance to try to be in the military, but what if even women who meet the military’s standards are more likely to get injured (putting their whole squad at risk) than men? Such vulnerability would call for a blanket exclusion of women from certain parts of the military (though there are many support roles, like military doctors, where they perform admirably.)

I have a gut dislike of sweeping “policies;” they tend to lack flexibility. I tend to think it would be better to let individual officers of appropriate rank decide if the particular trans people serving under them are doing a good job than have a sweeping rule that automatically kicks everyone out or demands that everyone be let in.

And before I say anything sweeping, I want a study of squad cohesion and effectiveness. I’ll let you know if I find one.

 

Final note: I am not a military expert and don’t normally write about the military, so forgive me if I’ve mixed up some of the terms.

Advertisements

20 thoughts on “Should Transgender People be in the Military? An overview of relevant studies

  1. How about saying no because the rural and Southern White kids that do the actual combat arms fighting are no longer volunteering becuase of shit like this?

    How smart is it to alienate the he demographic group that does the majority of the war fighting?

    Like

    • Military rejects people for all sorts of reasons. It ought to all boil down to effectiveness, but I’m sure there are a variety of people who think the military should be a jobs program or way to promote social justice or something.

      Like

      • Things are a tad more complexe given its an all volunteer military these days. Shitty eccnomy and the military is struggling to reach recruiting goals because the rural and Southern White kids aren’t signing up. LOL

        They aren’t signing up because of the cultural sjw type changes. It’s an open secret sort of thing but wont be addressed

        Liked by 1 person

  2. The problem isn’t the people. It is the false therapy. If they go down that road they are increasingly broken, and they change from potentially being a reasonably decent member of the military to being a narcissistic trainwreck.

    If you are in the military and you decide to take steroids, it had better be so that you can be bigger and stronger than whoever might try to kill you.

    Liked by 1 person

    • People’s private internal self-identity and certain medical/surgical treatments certainly are different things. I can certainly see how the surgical costs/complications simply are not something the military wants to be involved in.

      Like

  3. This is very interesting. I wonder how the startlingly high percentage of MtF in the military fit into Bailey’s taxonomy of early-onset versus late-onset transgenderism. (This is a good article about it http://www.weeklystandard.com/the-transgender-triumph/article/859614 ). If they are disproportionately late-onset, then it does same something about the etiology of that condition, which seems often to involve very stereotypically masculine mean.

    Liked by 1 person

  4. My experience suggests that the military ought have stayed segregated in as many ways as possible. Having women in the same shop as men destroyed productivity and morale. The presence of gays put a strain on group cohesion. In general, having narcissists dramatically hobbled OPSEC.

    Liked by 1 person

      • True, though in its (extremely weak) defense, the heavy filter effect of the ASVAB and Basic Training selects for the cream of the Subsaharan crop, plus culture and behavior in the military are heavily and authoritatively managed, so integration in the military hasn’t been as problematic as integration outside of the military.

        Like

  5. “I found two other potentially relevant studies, one from the Journal of Homosexuality and one from HEIN Online, but both are paywalled so I can’t read them.”

    Have you tried sci-hub.cc ? It can open pretty much anything with a DOI.

    Like

  6. I realized I should actually drop a book reference here, because you might enjoy reading it. Check out van Creveld’s Transformation of War. It’s somewhat dated, and the main thrust is something else (also interesting), and I don’t agree completely with the central premise or conclusions, but he has a very good section on the morale effects of inclusion of women (and by extension trans-people) in the military, and he’s in a position to know what he’s talking about.

    Like

  7. “…I propose that the military may serve a secondary purpose: allowing citizens to feel like productive, contributing members of society…”

    Uhhh…couldn’t they sweep the sidewalk or something that is less injurious to our National Defense? Lots of things need to be done and if we’re bound and determined to sweep everyone up in some grand scheme of togetherness then we could find plenty of things to do. How about building a wall?

    “…It makes sense that a larger percent of FtMs than cis-women would join the military…”

    I find this cisgender business highly offensive. It’s, I believe, a purposely pejorative attack on normalcy.

    All Female and Male troops should be mostly separated. They should have the same thing they had in WWII Waves and WACS. I was in the Air Force and found almost uniformly that the girls would get a boyfriend to help them do their jobs. (Not all some big country gals would put some of the Men to shame but they were the minority). The Women whined a lot also. Constant whining about this and that. During war time this whole charade would come crashing down with all the Women getting pregnant so they wouldn’t have to fight. We’ve already seen this. We should decide what Women can do as well or better than Men, and I do believe that there are things Women are much better at, and then get them to do those things. Roaming around with rifles and packs is not one of those things.

    Like

      • I don’t get it too specialized, maybe? I’m looking at the paper and they loaded it up with so much jargon it’s incomprehensible without having a biology dictionary handy. Actually by reading it again slowly I can tell what they’re saying. It’s ridiculous to use words like ligated instead of cut. The whole paper is like this. It could be reworded to mean exactly the same thing without all the odd wording. None of the words they use are foreign to me but the way they’re used is odd. Me thinks they were saying to everyone who read the paper, “look how we can use obscure meanings of words, strung together in ways not normally used to show how clever we are”.

        Maybe you can explain how splitting proteins and protein splicing translates into cisgender. I don’t get it????

        Like

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s