The costs of surgery can be significant, but not all choose to do the final surgeries. We in the US military all had required training on the new Obama administration policy, how the transition would be done, and when the transition would be declared complete, and that we were to treat all with dignity and respect. A complex process with medical, psychology, the member and the commands involved. The "costs" can also include not being able to deploy while in transition, numerous medical screenings, and an imprecise transition period (up to 2 years I recall). The member could stop the process at any time. And yes the military was going to pay for everything.