VA closer on paying for surgeries of transgender veterans

ORLANDO, FLA. • The U.S. Department of Veterans Affairs is taking the first step toward providing gender-confirmation surgeries through its health care network, Secretary Denis McDonough announced at a Pride Month event in Orlando Saturday — a historic move he said is simply “the right thing to do.”

Vowing to create a “safe and caring” environment for all veterans, McDonough cited the need to overcome a “dark history” of discrimination against LGBTQ military service members.

The rule-making process needed to fully approve and implement coverage of gender-confirmation surgery can take two years to complete and includes a period of public comment.

“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,” McDonough told a cheering crowd.

The move is partly in response to reports from VA clinicians that transgender veterans face considerable mental health harm — including a heightened risk of suicide — when denied surgery that would allow their bodies to match their sense of who they are, he added.

In 2013, the military began providing mental health services and prescription hormone therapy for transgender veterans, but the directive also specifically denied coverage of what was then called “sex reassignment surgery.”

Gina Duncan, director of transgender equality for the statewide LGBTQ civil rights organization Equality Florida, said her agency was “thrilled to have allies at the highest level of government” and noted the contrast with recent moves by the Florida Legislature and Gov. Ron DeSantis to limit transgender youth participation in school sports.

“In a moment of fierce state and local backlash against the transgender community, this move by the Biden administration is a reminder that elections matter,” Duncan said. “Support for transgender veterans and the lifesaving health care they need to live authentically is a critical component to fulfilling our nation’s promise of caring for those who’ve served.”

McDonough said he did not know how much opposition to expect but noted that the decision is ultimately up to President Joe Biden, who repealed the former ban on transgender military service on his fifth day in office.

According to VA Press Secretary Terrence Hayes, the department estimates that fewer than 4,000 veterans would be interested in the surgery. The cost to the VA has yet to be calculated, he said.