A proposed rule allowing veterans to access gender affirmation surgery through the U.S. Department of Veterans Affairs (VA) was withdrawn over questions about funding. In a statement to Military.com, the VA says they will “continue to explore a regulatory change that would allow VA to perform [gender affirmation surgery] and a change in the medical benefits package, when appropriated funding is available.”
The rule was first proposed in June of this year and listed in the department’s Fall 2016 Unified Agenda, but pulled after the Office of Management and Budget questioned how the VA would fund the change.
In September, VA took significant steps to ensure that transgender veterans are treated with respect at VA facilities and have equal access to some medically necessary health care, including treatment of gender dysphoria. Unfortunately, the regulation categorically excluded gender affirming surgery, which is essential to the health and wellbeing of transgender veterans.
HRC sent a letter to VA Secretary Robert McDonald in September asking the department to repeal its categorical exclusion on medically necessary gender affirming surgery from medical benefits. The letter highlights the VA exclusion is inconsistent with the past several years of federal court decisions and federal agencies, like the Department of Defense, recognition that discrimination on the basis of sex includes discrimination on the basis of gender identity. Moreover, such discrimination is in direct violation of Section 1557 of the Affordable Care Act (ACA), which prohibits discrimination in medical care on the basis of sex, including gender identity.
HRC urged the VA to swiftly repeal the exclusion and issue new regulations expressly extending medical benefits to gender affirming surgery. The denial of this most basic benefit violates the dignity of all transgender veterans.
On June 30, 2016, Secretary of Defense Ash Carter announced that the Department of Defense was finally lifting the decades-old ban on transgender people being able to openly serve in the U.S. military. Until then, the estimated 15,500 actively serving transgender members of the military were forced to serve in silence by medically out-of-date regulations.