Good News for Trans Veterans: New VA Health Care Guidelines

Good News for Trans Veterans: New VA Health Care Guidelines

By Autumn Sandeen

July 28, 2011

The Veterans Administration released a new directive on transgender veterans in June 2011, “Providing Health Care For Transgender And Intersex Veterans.” This directive recognizes the reality of many service members’ lives: the intersection of trans women’s and women veterans’ experience, and the specific needs that they encounter.

It’s no surprise that women’s experiences intersect with multiple personal identities and that they are not confined to the traditional sex and gender binary of western society. Earlier in 2011, the National Center for Transgender Equality, a national social justice organization in Washington, D.C., released a 221-page report that created a demographic portrait of transgender people in the U.S., based on an extensive study sample of 7,000 and a rigorous survey review. Released in conjunction with the D.C.-based National Gay and Lesbian Task Force, one of the findings of the report, Injustice At Every Turn was that 20 percent of the adult, transgender people in the United States are military veterans, as compared to 10 percent of the adult population of the United States who are military veterans.

The “Injustice” report had other significant findings, as well. For example, 30 percent of the transgender adult respondents reported having a physical disability or mental health condition that substantially affected a major life activity. By contrast, the overall U.S. population reports a disability at a rate of 20 percent.

This report builds on other research about transgender people and the military. In 2008, the Los-Angeles based Palm Center, which disseminates research on gender, sexuality and the military, and the Transgender American Veterans Association (TAVA), based in Ohio, released Transgender People in the U.S. Military, which surveyed 700 transgender veterans about VA health care. Analysis of the survey responses found that 10 percent of the sample reported being turned away from the VA due to being transgender. Respondents also described organizational discrimination at the VA, such as a lack of clear and consistent practice, interpersonal discrimination and a lack of respect from VA doctors, nurses and non-medical staff.

The report, within its text, also stated:

[The] cases of interpersonal discrimination ranged from what many veterans describe as “typical” – refusing to change to gender-appropriate pronouns, failure to use a new name consistently – to the extreme – refusing to look at transgender patients, referring to them in dismissive ways, refusing to treat them for general medical care…Other transgender veterans reported having their medical privacy violated by VA doctors and nurses. In many of these cases, doctors and nurses violated the Hippocratic Oath – do no harm – by singling out and stigmatizing their transgender patients. Illustrating this, one [male-to-female trans woman] respondent recounted the following experience: “A nurse pulled my partner out in the hall of the VA Hospital where I was an in-patient [and said], ‘You know that is really a man, don’t you'”

These experiences and reports inform the background for the new VA directive on health care for transgender and intersex victims.

The National Center for Transgender Equality analyzed and described the new policy directive. The center reports that the directive states that VA staff must provide care to transgender patients “without discrimination in a manner consistent with care and management of all Veteran patients” and that all personal information about transgender status and medical care is to be kept confidential. The policy also reiterates two existing regulations — that sex reassignment surgery cannot be performed or paid for by the VA, and that all other medically necessary healthcare for transgender veterans is covered, including sex specific care like mammograms and pap smears, and transition-related care, such as hormones and mental health services.

The new directive specifically states that disabled transgender veterans deserve respect from the VA, as well as sex and gender appropriate care. And as a transgender veteran myself, that is extremely welcome news.

At the intersection of veteran, disability and transgender concerns is women’s experience. As feminists, just as servicemembers on battlefields, we shouldn’t leave any of our own behind. If we do, we forget the value of diversity that suffragist Alice Paul valued. “I always feel the movement is a sort of mosaic. Each of us puts in one little stone, and then you get a great mosaic at the end,” she said. Disabled, transgender women veterans are among those who bring stones to the wonderful and beautiful mosaic of the women’s movement.