Department of Veterans Affairs Will No Longer Offer Gender-Affirming Care

The Department of Veterans Affairs is “phasing out” gender-affirming healthcare. On Monday, the VA, which provides lifelong healthcare to over 9 million veterans across the country, announced it would no longer provide “medical treatments for gender dysphoria” to patients not already receiving such care. The move is aligned with President Trump’s January executive order defining gender as one’s biological sex assigned “at conception,” part of the administration’s larger ongoing attacks against the trans community.  

In a Monday press release, VA Secretary Doug Collins said any money the agency saves by ceasing gender-affirming care will be redirected to serve paralyzed veterans and amputees. Of its roughly 9 million patients, the VA estimates fewer than 0.1% identify as transgender. Collins claims the VA has “not kept consistent and reliable records” surrounding the total cost of gender-affirming care. However, the Congressional Research Service estimates that of the Pentagon’s $25 billion annual healthcare budget, gender-affirming care for veterans took up a total of $15 billion (or roughly 0.00012%) over the five-year period from 2016 to 2021. 

Despite the VA’s small number of trans patients, Monday’s announcement was not the agency’s first attack against the community. In February, a separate executive order gave the Pentagon one month to implement a procedure for identifying active military troops who identify as transgender, in order to remove them from service by June. At the time, a Pentagon policy memo stated, “Service by these individuals is not in the best interests of the Military Services and is not clearly consistent with the interests of national security.” However, neither the executive order nor the Pentagon’s response outlined changes in policy for transgender veterans. 

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Then last week, Collins rescinded Directive 1341, a comprehensive guide for medical providers outlining the VA’s offerings for veterans seeking gender-affirming care. While the VA itself has never offered gender-affirming surgeries, under Directive 1341, the agency provided letters of support for veterans seeking such surgeries from outside providers. This service is no longer in place. In his press release, Collins also identified hormone therapy, “voice and communication training,” and gender-affirming prosthetics as services no longer offered to new VA patients.

Directive 1341 also included specific protocols for interacting with trans veterans, instructing medical providers to respect their chosen pronouns and assign them to bathrooms matching their gender identities. Upon rescinding the directive, Collins stated in an internal memo that doing so would “not affect existing clinical guidance.” However, the VA’s latest announcement directly reverses this guidance, requiring that all veterans be required to use the “intimate spaces”—including bathrooms—aligned with their assigned sex at birth.

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Per Monday’s announcement, while trans veterans already receiving care may continue to do so through the VA, new patients will not be accepted. In his press release, Collins said of the change, “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.”