Department of Veterans Affairs Ends Gender Dysphoria Treatments

The Department of Veterans Affairs (VA) announced Monday it will phase out medical treatments for gender dysphoria, aligning with President Donald Trump’s recent executive order defining sex as strictly male or female. Any savings from the policy change will be redirected to support severely injured VA beneficiaries, such as paralyzed veterans and amputees, to help regain their independence, the agency said.

Gender dysphoria is distress caused by a mismatch between a person’s gender identity and their sex assigned at birth. It can emerge at any age and may lead some transgender individuals to seek social, legal, medical, or surgical affirmation, according to the American Psychiatric Association.

The policy change means the VA will no longer provide cross-sex hormone therapy to veterans who have a diagnosis or history of gender dysphoria unless they are already receiving such care from VA or were receiving it through the military at the time of their separation.

Additionally, the VA will not offer any other medical or surgical interventions for gender dysphoria under any circumstances.

The decision, which affects transgender veterans and veterans experiencing gender dysphoria who are seeking medical care through VA facilities, drew criticism from U.S. Sen. Tim Kaine, D-Va., who argued that veterans’ healthcare should be determined by medical professionals, not politics.

“All of our veterans deserve the best care, as determined by medical professionals — not politicians. Culture wars should have no place in those decisions,” Kaine said in an email.

“If the administration really wanted to stand up for veterans,” Kaine added, “President Trump would reinstate all the thousands of veterans he has illegally fired from the federal workforce, halt plans to fire 15 percent of the VA workforce, and reverse course on the cancelation of over 500 VA contracts, including those that were helping to implement the PACT Act and other benefits.”

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VA Secretary Doug Collins defended the decision, saying the department should focus on supporting veterans with severe medical needs, such as those who are paralyzed or have amputations.

“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 in a statement.

“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.”

Although the VA has never provided sex reassignment surgeries, the department has offered treatments for gender dysphoria for over a decade, including hormone therapy, voice training, and support letters for veterans seeking surgical procedures from private providers.

The policy change rescinds Veterans Health Administration Directive 1341(4), which had authorized these services. As of Tuesday morning, references to the directive had been scrubbed from the VA’s website.

According to VA estimates, less than one-tenth of 1% of the 9.1 million veterans enrolled in VA health care identify as transgender, which equates to about 9,100 individuals. However, in 2014, the Williams Institute at UCLA School of Law estimated that approximately 134,300 transgender individuals are veterans or retired from the Guard or Reserve, though their eligibility for VA health care remains uncertain.

Marquis Mapp, executive director of Side By Side, a Richmond-based LGBTQ+ rights advocacy group, expressed deep concern over the VA’s decision, emphasizing the importance of gender-affirming care for those affected.

“At Side By Side, we are actively assessing the impact of this recent change on the families we serve,” Mapp said, adding that such care is widely recognized by medical and mental health professionals as an evidence-based, life-saving practice.

Mapp emphasized that access to essential healthcare plays a critical role in reducing hardships faced by veterans and reaffirmed the organization’s commitment to supporting those impacted by the policy shift.

The VA’s move comes amid broader efforts by the Trump administration to roll back protections for transgender individuals in the military and federal government.

Last week, the U.S. Navy announced that transgender sailors and Marines who want to voluntarily separate before the military enforces its forthcoming ban have until March 28 to come forward. Those who choose to leave will be eligible for separation pay that is twice as much as they would receive if they were later discharged involuntarily.

Virginia, home to one of the largest veteran populations in the nation, has long been regarded as a veteran-friendly state, with a strong network of VA medical centers and support programs. The state has previously supported initiatives to expand healthcare access for all veterans, including those identifying as LGBTQ+.

Despite the administration’s latest policy shift, VA officials insist that transgender veterans will continue to receive general healthcare services, including preventive care and mental health support. LGBTQ+ Veteran Care Coordinator roles will also remain in place to ensure that veterans have access to knowledgeable providers.

by Markus Schmidt, Virginia Mercury

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