Trans Veterans Deserve Full Access to Transition Surgeries
The Transgender American Veterans Association has filed an appeal against Veterans Affairs’ denial of their 2016 petition to include coverage for transgender surgeries.
Opinion, by Alyssa Steinsiek
The Transgender American Veterans Association has filed an appeal in court against a February 22nd decision by the United States Department of Veterans Affairs to refuse coverage of transitional surgeries for trans veterans.
TAVA’s suit started its life as a petition for the VA to begin work on rules for transitional surgery coverage in 2016, eight years ago. In 2021, VA Secretary Denis McDonough announced that the VA was “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.”
Three years passed without action from the VA. As a result, on January 25th, TAVA filed suit against the VA in the U.S. Court of Appeals for the Federal Circuit in Washington, D.C., asking that they be compelled to respond to TAVA’s petition.
“Enough is enough,” TAVA President Rebekka Eshler told NBC News the day before TAVA filed suit. “How can I stand here and keep saying, ‘Just be patient,’ and not do anything when these veterans are reaching out because they’re at death’s door? They can’t handle it anymore. This is about building this trust back with the VA. They keep using us for political gain, but not keeping their word and keeping their promise.”
On February 22nd, the VA finally responded by denying TAVA’s petition.
“Because VA is not ready at this time to initiate a rulemaking addressing the specific regulatory changes proposed in the petition, VA hereby denies the petition for rulemaking,” McDonough said of the decision.
On Monday, TAVA filed their second lawsuit against the VA appealing this denial, accusing them of “unconstitutional discrimination on the basis of sex and transgender status.”
The National Center for Transgender Equality estimates that there are 134,000 transgender veterans in America, and that more than 15,000 active duty military personnel in the US are trans. We know that gender-affirming care, including surgical procedures, are medically necessary for the trans people who pursue them. It’s also undeniable that the rate of regret for recipients of these surgeries is uniquely, remarkably low.
Why, then, would the VA refuse to provide coverage for these surgeries?
Many outlets have reported that active duty military personnel are able to access transitional surgeries free of charge. This isn’t exactly true, but may have become widely believed thanks to a 2021 Washington Examiner article published after President Biden’s rollback of former President Trump’s ban on transgender participation in the military. In truth, while both active duty personnel and veterans can expect to have cross-sex hormones, voice training and hair removal covered, TRICARE—the health insurer for active duty personnel—does not typically provide coverage for transitional surgeries. Since those surgeries cost thousands, or even tens of thousands of dollars, it’s often impossible for transgender people to pay for them out of pocket.
from the Washington Examiner
It’s unclear whether or not the VA will yield to TAVA’s appeal. There’s reason to be hopeful, however. The VA has expressed a willingness to work out coverage on transitional surgery for veterans. Further, TAVA is represented in court by the Yale Law School Veterans Legal Services Clinic, who earlier this year helped pressure the VA into making important changes to in vitro fertilization policies that now allow unmarried and same-sex married veterans to pursue IVF.
Right-wing pundits and anti-transgender activists suggest that the United States military’s combat readiness might be impacted by the inclusion of transgender service members. We know this isn’t true.
They fearmonger about trans women in particular, suggesting that we’re a danger to cisgender women. This, too, is a lie.
Transgender people are experiencing unprecedented hatred and targeted harassment. The Supreme Court, stacked with conservative justices, has ruled that Idaho may deny gender-affirming care to the trans youth who so desperately need it. Tennessee and Kentucky may be given the same privilege soon, while nearly five hundred pieces of anti-LGBTQ+ legislation work their way through courts throughout the United States.
These senseless, hateful bans on transgender healthcare seem particularly egregious when every major medical association and leading world health authority supports our right to gender-affirming care. When we know how important treatment is, and how inaccessible it is for many people.
It may be just one corner of the transgender community, but we can hold out hope that trans veterans will be able to pursue the healthcare they need once they’ve had their day in court.
Alyssa Steinsiek is a professional writer and video games nerd who cohosts a podcast about trans news!