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I currently work at a military hospital and it is possible to transition while on active duty. The process, of course, is not easy and the servicemember has to attend many medical appts prior to being "accepted" into the program. Initial treatment can take place at your work station (e.g. testosterone injections) but the member must be transferred to a shore command near a military hospital for surgery. Overall cost is around $200k per person and military healthcare will cover the entire cost.
While this is rather expensive treatment and does inhibit the member from working at full capacity, I personally don't believe it is as detrimental as Pres Trump is making this out to be. As Chemda said, this treatment is not an option, it's necessary for the mental and physical health of the person.
I do hope that this provided a bit more insight into the military process. Happy to discuss further with anyone who is interested.
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