VA to Cover Gender-Confirmation Surgery for Transgender Veterans for the First Time

By Daniel Politi, Slate

22 June 21

he Department of Veterans Affairs will be launching a process to start providing gender-confirmation surgery to veterans through its health care coverage. Veterans Affairs Secretary Denis McDonough announced the plan on Saturday during a Pride Month event in Orlando. “We are taking the first necessary steps to expand VA’s care to include gender confirmation surgery—thereby allowing transgender vets to go through the full gender confirmation process with VA at their side,” said McDonough, who vowed to overcome a “dark history” of discrimination.

The change won’t be immediate. The VA will start a process this summer that is expected to take two years. “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,” McDonough explained. The change is another stark illustration of how things have changed since former President Donald Trump, who banned most transgender people from serving in the military. That prohibition was reversed by President Joe Biden shortly after taking office. The National Center for Transgender Equality estimates that there are more than 134,000 transgender veterans and more than 15,000 transgender individuals serving in the military. But the VA estimates fewer than 4,000 veterans would be interested in undergoing surgery.

McDonough said it was Biden who ultimately made the decision to include gender-confirmation surgery in the health care system for veterans. “It’s the president’s decision, and we’ve just announced today that we’re executing that decision. That decision will carry out now over many, many months, but at the end of the day this is in the president’s authority to do,” McDonough said. “He’s made clear it’s time to do it and that’s precisely what we’ll do.” In 2013, when Biden was vice president, the VA had explicitly said it didn’t cover gender-confirmation surgery. Now that is changing amid a recognition of how the VA needs to be more inclusive. “At VA, we’re doing everything in our power to show veterans of all sexual orientations and gender identities that they can talk openly, honestly and comfortably with their health care providers about any issues they may be experiencing,” McDonough said.

The move received praise from both House Veterans’ Affairs Committee Chairman Mark Takano and Senate Veterans’ Affairs Committee Chairman Jon Tester. “Veterans in need of gender confirmation surgery should not have to seek healthcare outside of the VA health system or navigate complicated processes to get the care they need,” Takano said. “VA must be inclusive of all veterans who have served, regardless of their identity.” But the top Republican in the House Veterans’ Affairs Committee, Rep. Mike Bost, criticized the move as having “more to do with advancing a radical liberal agenda than serving veterans.”