VA Nixes Plan To Cover Gender Reassignment Surgery

The Obama administration has scrapped a proposed rule to cover gender reassignment surgery for veterans.


The Department of Veterans Affairs has scrapped a proposed plan to cover gender reassignment surgery for transgender veterans, citing concerns about appropriate funding.
A VA spokesperson confirmed to the Washington Blade the proposed rule to cover the procedure — which is widely considered medically appropriate by major health organizations — has been withdrawn from the department’s agenda. The news was first reported by

“VA has been and will continue to explore a regulatory change that would allow VA to perform gender alteration surgery and a change in the medical benefits package, when appropriated funding is available,” the spokesperson said. “Therefore, this regulation will be withdrawn from the Fall 2016 Unified Agenda.”

Although plans to cover gender reassignment surgery are scrapped, the VA currently provides other services for trans veterans, including hormone therapy, mental health care, preoperative evaluation and long-term care following gender reassignment surgery, the spokesperson said.

The decision to nix coverage of gender reassignment surgery comes amid fears a Trump administration would roll back advances on LGBT rights seen under the Obama administration. However, the decision to drop the proposed rule was made prior to Election Day, the VA spokesperson said.

The proposed rule first came to light in June as a result of media reports in its publication in the Federal Register, the publication in which the U.S. government announces changes in regulations. According to the Department of Veterans Affairs, the change was under consideration beginning in 2014, but became public after only the media report.

The abstract for the proposed rule indicated it would have lifted the ban on coverage of gender reassignment surgery and allow the department to make on a case-by-case basis a decision on whether gender reassignment surgery is warranted.

Ashley Broadway-Mack, president of the pro-LGBT American Military Partners Association, said in a statement the decision to withdraw the proposed rule is “deeply disappointing.”

“All of our nation’s veterans, regardless of their gender identity, deserve access to the medical care they earned serving our nation,” Broadway-Mack said. “This is a deeply disappointing setback in making sure an often medically necessary procedure for transgender veterans is part of that care. Moreover, as we face a new incoming administration, we implore fair-minded Americans to stand united in holding our new administration officials accountable by insisting this be fixed. The medical care of all our nation’s heroes, including transgender veterans, must be a priority.”

Members of Congress received notification on Monday the VA would nix its plan to cover gender reassignment surgery. A spokesperson for Rep. Mike Honda (D-Calif.) said he was among the lawmakers to receive notification.

Gender reassignment surgery is considered an expensive procedure. The cost for male-to-female surgery is estimated at between $7,000 and $24,000. The cost for female-to-male surgery can exceed $50,000. A 2011 executive order from President Obama requires agencies to take into account costs when considering rule changes.

But other government-funded health care systems cover the procedure. In 2014, Medicare lifted its ban on covering gender reassignment surgery, allowing contractors to cover the procedure on a case-by-case basis. Transgender people in the armed forces were eligible to obtain the procedure through the military’s health care system starting Oct. 1 following the Pentagon’s decision to lift the ban on transgender service.

Earlier this year, the Department of Health & Human Services made final a proposed rule requiring health providers to cover transition-related care, including gender reassignment surgery, if they offer comparable care for non-trans people. That proposed rule applies to both Medicare and Medicaid.

The Trump administration has not stated a view on whether the government should fund transition-related care for transgender people. On the campaign trail, Trump referred to transgender military service as “political correctness” and said he’d rescind a directive prohibiting schools from discriminating against transgender students or barring them from the restroom consistent with their gender identity.

Autumn Sandeen, a San Diego-based transgender activist and Navy veteran, said the decision to nix the proposed rule change will have a negative effect on her personally.

“I have a request for a vaginoplasty into the VA that I now expect to be rejected,” Sandeen said. “It’s unconscionable that the VA has a blanket exclusion policy for all gender affirmation surgeries when these surgeries are known to be medically necessary for a large number of transgender people. Transgender people who served their country with honor deserve better from their country’s bureaucrats than this.”