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VA again delays decision on transgender surgery options

Veterans Affairs leaders will delay plans to offer expanded surgery options to transgender veterans for at least several more months as they conduct new studies into the issue, a decision a senior House Democrat called “unacceptable.”

The move comes in response to a lawsuit filed last month by the Transgender American Veterans Association, which argues department officials are endangering the health of transgender veterans by refusing to provide gender confirmation surgery.

VA Secretary Denis McDonough in June 2021 announced plans to offer the procedures, also known as gender reassignment surgeries, at some department medical centers as part of larger efforts to make VA “more welcoming” to all veterans.

But in the nearly three years since that announcement, no surgeries have been performed, and the issue remains stalled in the rulemaking process.

Transgender vets sue VA to force move on gender confirmation surgeries

In response to the TAVA lawsuit, McDonough on Feb. 22 issued a memo saying the department has not yet decided “how and when it might ultimately provide gender affirming surgery” and that officials need to better understand how other recent rules changes — including an expansion of health care options under the PACT Act — might impact the number of veterans eligible for those procedures.

During a press conference on Monday, McDonough said he expects that review to take several months.

“I’ve said before that transgender veterans deserve world-class health care and benefits, and that gender-affirming care should be available to all vets who need it,” he said. “But we’re not ready to begin rulemaking at this point to address [gender confirmation surgeries.]”

Advocates have decried those delays. In their lawsuit, TAVA officials called the surgeries “medically necessary care” and said the failure to move ahead with the procedures “puts transgender veterans at increased risk of physical harm, psychological distress, and suicide.”

In a statement Monday, officials from the Yale Law School’s Veterans Legal Services Clinic (which filed the lawsuit along with TAVA) said that McDonough “has broken his promise to transgender veterans to provide life-saving, doctor-prescribed, transition-related surgical care” with the latest move.

On Monday, House Veterans’ Affairs Committee ranking member Mark Takano, D-Calif., echoed those concerns.

“VA has been studying the impact of gender-affirming care on the veteran community for years,” he said in a statement. “All of the studies I have read point to this type of care being important and necessary for transgender veterans. I am extremely frustrated that it has taken three years for VA to make this disappointing decision.”

Takano noted that the department’s inaction on the issue comes as transgender health care has become a target of conservative lawmakers across the country. He criticized the department for failing to lead on the issue.

“I will continue to push the secretary to make the right decision,” he said. “This unacceptable outcome cannot be the final word from this administration.”

McDonough did not give a specific end date for the latest review, but said he would “be prepared to dig into that as soon as it’s finished.”

In the past, VA officials have estimated that as many as 4,000 veterans nationwide would be interested in the procedures, also known as gender reassignment surgeries. The department does offer other support for transgender veterans, but those services have come under criticism from conservative lawmakers in recent months.

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