Transgender veterans’ health services in question as VA rescinds guidance on care

The Veterans Affairs Department on Friday reversed a policy that had protected gender-affirming healthcare provided to transgender veterans, causing confusion and fear in the community.

In an internal VA memo seen by NPR Friday, the VA says it’s rescinding Directive 1341, which contains detailed guidance on the kinds of care transgender veterans can receive at VA facilities. The policy had also directed healthcare providers to use pronouns veterans preferred, directed facilities to allow veterans to use bathrooms and be assigned rooms in accordance with their self-identified gender.

The internal memo said that the rescission of the directive “does not affect existing clinical guidance” and that the VA “affirms its commitment to provide care to all Veterans.”

“It’s disingenuous.” said Lindsay Church, executive director of advocacy group Minority Veterans of America. “Transgender veterans now have to ask themselves: ‘Is it worth it for me to get my care at VA? Am I safe to do so? What are the discriminatory factors that I will have to face in order for me to even go to the bathroom?'”

Advocates had been bracing for the rescinding of the directive.

While transgender people make up a small percentage of the population, research suggest that they are more likely to serve in the military.

VA’s research shows that veterans who are sexual minorities — including LGBTQIA, non-binary, intersex and other veterans — are more likely than average veterans to take their own lives; that figure is higher for transgender veterans. Veterans have a higher average suicide rate than the general population.

In the internal memo, the VA also said it will “conduct a comprehensive review of care with respect to trans-identifying Veterans and will undergo the rulemaking process to revise the medical benefits package as deemed necessary”.

Church said advocates for these veterans are concerned the upcoming rule review could mean wholesale rollback on transgender health at the VA.

The VA currently offers gender-affirming healthcare that includes hormone treatment, prosthetic devices, as well as tools to help transgender veterans present as the gender identity of their choice.

While the VA does not offer gender-affirming surgeries, the rescinded directive also stipulated that veterans could receive surgeries for other medical conditions that also happen to be gender-affirming, such as procedures mitigating cancer risks.

Even before the VA rescinded Directive 1341 on Friday, VA staff members told NPR that they have been receiving more calls from trans veterans worried about trusting their healthcare providers.

In the wake of the White House executive order that says it’s now U.S. policy to “recognize two sexes, male and females,” the VA has removed references to the group on some of its websites as well as in internal documents in its healthcare system.

The VA has yet to respond to requests for comment on the new directive.

NPR’s Quil Lawrence contributed to this report