The Veterans Affairs Bureau is phased out gender-affirming care for veterans, including hormonal treatment for newly diagnosed patients with gender discomfort, the VA announced Monday.
The VA will continue hormone treatment for veterans who are currently receiving it or who were receiving it when they separated from the military. The rationale is that sudden cessation can be detrimental to the patient's health.
The policy changes were made to comply with President Trump's executive order, titled “Protect women from gender ideological extremism and restore biological truth to the federal government,” the VA said in a news release.
The order states that the United States only recognizes two genders: male and female, but that “will not change.”
“I'm not rude to anyone, but the VA should not focus on helping veterans try to change sex,” said VA secretary Doug Collins.
Transgender veterans will continue to be welcomed in the VA, he added.
Since 2011, VA has been providing treatment for gender transitions to veterans. We have never provided surgery, but we offer support services. In addition to hormonal therapy, these include mental health care, preoperative assessment, and letters, postoperative and long-term care to support the need for procedures.
Infertility services, prosthetic devices such as wigs and voice coaching were also provided. These services are known as 1341(4) under the VA directive on health care guidance for transgender and intersex veterans.
Many VA mental health providers are concerned about the pamphlet, which describes the ability to continue to provide proper care to transgender patients after being ordered to remove the rainbow flag and strap, a pamphlet describing the services offered to LGBTQ+ veterans, “all welcome here” and “we serve everyone we are offering.”
Mary Blink Meyer, a psychologist who coordinated the care of LGBTQ+ veterans at Hampton VA Medical Center in Virginia, refused to remove the signs and flyers. She recently resigned for fear that mental health care for transgender veterans would compromise.
“Our code of ethics is to “do no harm in the first place.” And if you get caught up in between institutional requirements and your code of ethics, you have to settle it in favour of the code of ethics,” Dr. Brinkmeyer said.
The suspension of hormone therapy, along with the recent designation of VA bathrooms and biological sex for hospitalized patients, “has a real calm effect on veterans' willingness to seek gender discomfort,” she said.
Studies show that gender dysphoria is much higher in veterans than in the general population, and the risk of suicide-related events is 20 times higher for degraded veterans than the general Veterans Health Department population.
“If veterans don't have other health insurance, and if many trans veterans are homeless or shortaged, commit suicide rather than going to the VA, why don't they seek care?” asked Dr. Brinkmeyer.
