VA to phase out care for new gender dysphoria cases

(The Center Square) – The U.S. Department of Veterans Affairs plans to phase out care for gender dysphoria, but veterans already receiving care will be allowed to continue treatment.

VA Secretary Doug Collins said the veterans health agency would fully comply with President Donald Trump’s executive order on sexes. Shortly after taking office, Trump signed an executive order called “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.”

Trump’s executive order states: “It is the policy of the United States to recognize two sexes, male and female. These sexes are not changeable and are grounded in fundamental and incontrovertible reality.”

Collins said VA is adjusting its policies to fully comply with the order.

“I mean no disrespect to anyone, but VA should not be focused on helping Veterans attempt to change their sex. The vast majority of Veterans and Americans agree, and that is why this is the right decision,” Collins said. “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.”

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The agency said any potential savings VA achieves by stopping specific medical treatments for gender dysphoria will be redirected to help severely injured VA beneficiaries – such as paralyzed Veterans and amputees – regain their independence.

VA will not offer cross-sex hormone therapy to Veterans who have a current diagnosis of gender dysphoria, unless they are already receiving such care from VA or they were receiving such care from the military as part of their separation from military service and they are eligible for VA health care. Veterans who do not meet the criteria are not eligible for cross-sex hormone therapy through VA health care.

“VA will not provide any other medical or surgical therapy for gender dysphoria to any patients in any circumstance,” according to the memo.

Eligible veterans diagnosed with gender dysphoria or identifying as transgender will continue to get comprehensive VA health care, which includes preventive and mental health care.

Collins said the announcement does not affect VA medical care for eligible veterans who identify as lesbian, gay, bisexual and queer. He also said VA’s LGBTQ+ Veteran Care Coordinator and VISN Lead roles are not affected by the policy change.

Collins noted that “VA has not kept consistent and reliable records regarding the total number of Veterans who endured these procedures, the total amount of money spent on them or the total number of employees involved.”

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Veterans Health Administration estimates indicate that less than one tenth of one percent of the 9.1 million Veterans enrolled in VA health care are trans-identified.

The change at the VA comes after U.S. Department of Defense Secretary Pete Hegseth said service members diagnosed with gender dysphoria will be processed for separation by their respective military branches, according to a memo on the matter.

During former President Joe Biden’s tenure, the VA provided medically necessary gender-affirming care to transgender veterans, but not gender-affirming surgical interventions due to an exclusion in the department’s medical benefits package. Biden’s VA Secretary Denis McDonough was working to change that when Trump won a second term in the White House.

Costs of such care vary widely. A 2022 article in “The Journal of Law, Medicine & Ethics” noted gender-affirming health care services can include mental health support, hormone therapy and reconstructive surgeries. It also noted that “scant information is available about the utilization or costs of these services.” The peer-reviewed article found vaginoplasty and phalloplasty are often multi-episode procedures. The total average cost of vaginoplasty per person was $53,645. For phalloplasty, it was $133,911.

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