VA announces plans to cover gender-confirmation surgery for trans veterans


VA Secretary Denis McDonough called the surgery coverage something 'transgender veterans have called for and deserved for a long time.'

Secretary of Veterans Affairs Denis McDonough announced on June 19 that his department will move forward with plans to offer veterans gender transition-related surgeries.

According to a transcript published by Lambda Legal, McDonough said, "I am announcing today that we are taking the first necessary steps to expand VA's care to include gender confirmation surgery — thus allowing transgender vets to go through the full gender confirmation process with VA by their side."

Military and LGBTQ groups celebrated the announcement of one of a number of big shifts by the Biden administration from the actions of previous administrations on LGBTQ rights.

In 2013, under President Barack Obama, the VA issued a directive that included the determination, "VA does not provide sex reassignment surgery or plastic reconstructive surgery for strictly cosmetic purposes."

In June 2016, the department updated its understanding of the medical importance of such surgery, stating in a memo, "Increased understanding of gender dysphoria and surgical techniques in this area have improved significantly, and surgical procedures are now widely accepted in the medical community as medically necessary treatment for gender dysphoria." But in November 2016, after the election of Donald Trump to the White House, the Office of Management and Budget dropped the proposal out of what it said were financial concerns, reported Mother Jones.

The Obama administration's move in 2016 to end the ban on military service by transgender people was followed by an announcement by then-Defense Secretary Ash Carter that the cost of service members' transition procedures would be covered by the Pentagon.

in 2017, Rep. Vicky Hartzler (R-MO) introduced an amendment to the 2018 National Defense Authorization Act to cut military funding for transition-related care. After it was defeated, Trump announced on Twitter that he would institute a ban on transgender people serving in the military, which went into effect in April of 2019. President Joe Biden reversed the ban in March.

Before it can offer gender-confirmation surgery, the Department of Veterans Affairs has to move through the long process of federal rule-making, which will begin sometime this summer, according to the Washington Post. The process allows for a period of notice and public comment, after which the agency will review whether the rule needs to be changed at all.

Assuming it decides it does, the rule will then be submitted to Office of Information and Regulatory Affairs within the White House Office of Management and Budget for a regulatory review before a final version is published.

The rule-making process can take a year or more to complete; the New York Times reported that the process of implementing the changes could take years.

McDonough emphasized in his announcement, which was made at a Pride event in Orlando, Florida, that the process of putting this new policy in place would take time:

Now, this process will require changing VA's regulations and establishing policy that will ensure the equitable treatment and safety of transgender veterans.


There are several steps to take, which will take time.


But we are moving ahead, methodically, because we want this important change in policy to be implemented in a manner that has been thoroughly considered to ensure that the services made available to veterans meet VA's rigorous standards for quality health care.


This time will allow VA to develop capacity to meet the surgical needs that transgender veterans have called for and deserved for a long time, and I am proud to begin the process of delivering it.

LGBTQ and military groups said the policy has been a long time coming.

Ann Murdoch, president of the Transgender American Veterans Association, said the organization was "delighted" and applauds the secretary for his advocacy for "equality for all of America's veterans," adding, "Transgender veterans have earned the right to the accepted, medically necessary procedures and protocols prescribed by their health care providers without being subject to discrimination based on gender identity."

Jennifer Dane, executive director of the Modern Military Association of America, which represents LGBTQ service members, vets, and their families, said in response to the policy, "It takes more than words to make true progress, and we are thrilled to hear Secretary McDonough’s announcement that the VA is expanding care to include gender-confirmation surgery and updating health services to be more inclusive. These are clear examples of turning words into actions, the only way we can keep marching forward."

The National Center for Transgender Equality tweeted, "Big win! Veterans Affairs will begin the process to cover gender confirmation surgeries! This is huge for the 134k trans veterans in the US! We're proud to have long advocated for @DeptVetAffairsto lift the prior ban." 

Sasha Buchert, a staff attorney at Lambda Legal, stated, "This important update to the VA's health plan will provide continuity of care for transgender service members and will ensure we don't turn our backs on transgender veterans who served our country when they need lifesaving medically necessary health care."

Buchert added that although it is moving methodically on this policy, the department should "recognize in this process the needs of transgender veterans who have already waited too long for the health care they deserve."

Published with permission of The American Independent Foundation.