Opponents of inclusive policy often emphasized financial considerations, and estimated that the cost of providing transition-related medical care for transgender service members would be $135 million per year. In this study in the New England Journal of Medicine, the Palm Center responded to concerns by showing that the cost of transition-related care would be an estimated $5.6 million per year, or one one-hundredth of one percent of the military’s health care budget. In 2021, the Defense Department reported that it had spent $15 million over five years of inclusive policy ($3 million per year) on health care for transgender troops.