VA Halts Gender-Affirming Care for Transgender Veterans, Sparking Outcry
The Department of Veterans Affairs (VA) has ceased providing gender-affirming care to transgender veterans who are not currently receiving such care, marking a significant reversal of policy and igniting widespread condemnation from veterans and advocacy groups. The move, framed as a redirection of resources, is seen by many as the latest attempt to dismantle trans-inclusive policies within the federal government.
VA Secretary Doug Collins defended the decision in a statement, asserting that the VA should prioritize other areas of veteran healthcare. “I mean no disrespect to anyone, but VA should not be focused on helping veterans attempt to change their sex," Collins stated. "All eligible veterans – including trans-identified veterans – will always be welcome at VA and will always receive the benefits and services they’ve earned under the law. But if veterans want to attempt to change their sex, they can do so on their own dime.”
The announcement has triggered immediate and intense backlash from transgender veterans and their advocates, who accuse the VA of abandoning those who have served the nation with honor. Critics argue that the decision undermines the health and well-being of transgender veterans, potentially exacerbating existing mental health challenges.
"We feel defeated," said Rebekka Eshler, president of the Transgender American Veterans Association (TAVA). "We’ve served our country, and now they’re going back on promises." Eshler’s sentiment reflects the deep sense of betrayal felt by many in the transgender veteran community.
Alleria Stanley, a 20-year Army combat veteran who receives gender-affirming care through the VA, expressed profound disappointment. "Transgender veterans stepped up to serve their country with honor and dignity, but the country is now turning their back on them and denying the care that they’ve earned," Stanley stated. "There is incredible heartache."
The VA’s decision follows similar actions taken earlier, including the reinstatement of a ban on transgender individuals joining the military and the cessation of Pentagon healthcare coverage for gender-affirming care. These prior measures further contribute to the anxieties and concerns within the transgender veteran community.
A federal judge is currently reviewing the legality of the military ban on transgender service members, with a decision expected soon. The judge has previously raised concerns regarding the Pentagon’s justifications for the ban, citing issues with studies purportedly demonstrating the non-deployability of transgender personnel.
Adding to the controversy, the VA recently rescinded a directive that outlined guidelines for the respectful delivery of healthcare to transgender and intersex veterans. This directive included guidance for VA healthcare providers and facilities on using veterans’ preferred pronouns and allowing veterans to use the bathrooms that align with their gender identity.
The VA will now require transgender veterans to utilize patient rooms corresponding to their sex assigned at birth, reversing a prior policy that allowed transgender individuals to share rooms with those of their identified gender. According to VA spokesperson Peter Kasperowicz, "Previously, VA had allowed males who identify as females to share patient rooms with other females and vice versa. This administration has stopped that."
While the VA initially denied the policy change to media outlets, it later published the information and issued an official news release, adding to the confusion and distrust surrounding the announcement.
Veterans like Stanley, who already receive hormone therapy or were receiving it as part of their military service, are exempt from the new ban, creating a distinction that many feel is arbitrary and divisive.
The VA claims that the funds saved by eliminating gender-affirming care will be redirected to support paralyzed veterans and amputees. However, this reallocation has been criticized as an attempt to pit different veteran communities against each other, potentially creating friction and division.
Eshler argued that diverting funding towards another veteran group was an attempt to “cause problems and division in the veteran community."
The policy change has ignited fears that cutting off gender-affirming care could further endanger a population already at a significantly elevated risk of suicide. Studies have shown that transgender veterans die by suicide at twice the rate of veterans who are not transgender and 5.85 times the rate of the general population. Furthermore, research indicates that gender-affirming care can reduce this risk.
Stanley described the decision as "an arbitrary act that is very harmful," predicting that it will have "repercussions that will be seen, but also, unfortunately, repercussions that may not be seen as the harm takes place." Stanley came out as transgender during her military service after the Obama administration repealed "don’t ask, don’t tell" in 2011, allowing LGBTQ people to serve openly.
While the exact number of transgender veterans currently receiving gender-affirming care through the VA is unclear, estimates suggest that it is a relatively small percentage of the overall veteran population. According to the Veterans Health Administration, less than one-tenth of 1% of the 9.1 million veterans who receive VA healthcare identify as transgender. The VA acknowledges that it "has not kept consistent and reliable records" on this number or the associated costs.
Data from the Congressional Research Service indicates that the Pentagon spent a total of $15 million on gender-affirming care for nearly 1,900 service members over a five-year period. In comparison, the military’s total healthcare costs are approximately $25 billion annually.
A 2014 study from the Wilson Institute at the University of California, Los Angeles law school estimated that there are 134,300 transgender veterans and retired National Guard or Reserve service members, a number that is likely even higher today.
The VA has provided gender-affirming care to transgender service members since 2011, including hormone therapy and mental healthcare. However, the agency has never covered gender-affirming surgeries, despite a push during the Biden administration to mandate the procedure as essential for veterans suffering from gender dysphoria.
In 2021, then-VA Secretary Denis McDonough pledged to work towards overturning a 2013 ban on agency funds being used for gender-affirming surgeries, stating that the agency would begin covering the procedures within two years.
However, this effort never materialized. In April of the previous year, TAVA filed a lawsuit against the Biden administration, accusing it of failing to deliver on its promise.
While surgeries remained off the table, the VA previously provided support letters for veterans seeking the procedure from outside providers. The new policy also eliminates this service. The curtailing of this support is seen as another blow to the transgender veteran community, restricting their access to vital healthcare resources.
