Veterans' Affairs Department will pay for gender reassignment surgery

Biden’s Veterans Affairs secretary tells Pride event the government will pay for free gender reassignment surgery for up to 4,000 transgender vets

  • Denis McDonough made the announcement at an Orlando event marking Pride
  • He spoke a week after the fifth anniversary of the Pulse nightclub shooting
  • McDonough said that the new policy was ‘the right thing to do’
  • A VA spokesman said they expect fewer than 4,000 people to take up the offer
  • Biden in January signed an executive order overturning a 2017 Trump administration ban on transgender individuals serving in the military 

Transgender veterans will be offered gender confirmation surgery paid for by the US Department of Veterans’ Affairs, its secretary announced Saturday. 

Denis McDonough told an event in Orlando to celebrate Pride Month that the move was ‘the right thing to do’.

He spoke a week after the fifth anniversary of the Pulse nightclub shooting in the Florida city, which saw 49 people killed at the gay bar.

McDonough said the new policy was part of an effort to overcome a ‘dark history’ of discrimination against LGBTQ service members.

Denis McDonough, the Veterans’ Affairs Secretary, on Saturday announced that his department would begin to pay for gender confirmation surgery for all veterans

Gender confirmation surgery used to be known as gender reassignment surgery, and involves changing a trans person’s body to align with the gender they identify as. 

The cost was of the program unclear, but Terrence Hayes, VA spokesman, told The Washington Post that they expect fewer than 4,000 people to take up the offer.

VA statistics estimate that there are a total of 134,000 transgender veterans, although it is unclear whether they have already gone gender confirmation surgery, or have decided not to do so.  

The cost of medical treatments can add up to more than $100,000, Insider reported in 2019. Fees for the surgery are often not covered by insurance companies, which consider the procedures cosmetic. Many trans people say having a body that matches the gender they identify as is crucial to their mental health and wellbeing. 

The move is just the first step in what’s likely to be a years-long federal rulemaking process to expand VA health benefits to cover the surgery, but McDonough said the VA will use the time to ‘develop capacity to meet the surgical needs’ of transgender veterans.

The decision, he said, will allow ‘transgender vets to go through the full gender confirmation process with VA by their side.’ McDonough also referenced what he said were higher rates of mental illness and suicidal thoughts among LGBTQ veterans, and a fear of discrimination that prevents those veterans from seeking care.

‘We’re making these changes not only because they are the right thing to do, but because they can save lives,’ he said.

McDonough spoke during Pride Month, with celebrations taking place across the country. Pictured is a June 12 rally in Washington DC

McDonough was previously Barack Obama’s chief of staff. He’s pictured sitting next to Hillary Clinton on May 2, 2011, when Osama bin Laden was killed. At the time McDonough was Deputy National Security Advisor

McDonough said the decision was based on the ‘recommendation of our clinicians, so this is a health care decision that has very real physical health care impacts as well as significant mental health impacts.’

The National Center for Transgender Equality estimates that there are more than 134,000 transgender veterans and over 15,000 transgender individuals serving in the military today.

McDonough’s announcement is the latest in a series of moves by the Biden administration to expand protections and benefits to transgender individuals in the military.

In 1994, the U.S. adopted ‘Don’t Ask, Don’t Tell’ as the official federal policy on military service by lesbian, gay and bisexual individuals, meaning that LGBTQ service members had to keep their sexuality a secret.

The policy was repealed by Barack Obama on September 20, 2011, allowing openly gay people to serve in the country’s armed forces. 

In May 2016, a study commissioned by Ash Carter, the defense secretary, and carried out by the RAND Corporation found that allowing transgender people to serve openly would ‘cost little and have no significant impact on unit readiness.’ 

The study estimated that 2,450 active-duty members were transgender and predicted that around 65 would seek to transition each year. It estimated that the cost to the Pentagon of those procedures would be $2.9 million to $4.2 million a year.

In July 2016 the U.S. formally opened up the military to transgender individuals.

In 2017, Trump reversed Obama’s policy. He claimed it was a waste of resources and would affect combat readiness, despite multiple retired top officials blasting the ban as cruel political point-scoring. 

Just days into his term, President Joe Biden signed an executive order overturning a Trump administration ban on transgender individuals serving in the military.

And in February, McDonough ordered a review of the department’s policies to ‘ensure that transgender Veterans and employees do not face discrimination on the basis of their gender identity and expression.’

Gina Duncan, director of transgender equality for the statewide LGBTQ civil rights organization Equality Florida, told the Orlando Sentinel that her agency was ‘thrilled to have allies at the highest level of government.’

She pointed out that the Republican governor of Florida, Ron DeSantis, has recently banned transgender girls from taking part in women’s sport.

‘In a moment of fierce state and local backlash against the transgender community, this move by the Biden administration is a reminder that elections matter,’ Duncan said.

‘Support for transgender veterans and the lifesaving health care they need to live authentically is a critical component to fulfilling our nation’s promise of caring for those who’ve served.’

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