VA Sec: Transgender Vets Get Gender Confirmation Surgery After Rulemaking Process

Today, Department of Veterans Affairs Secretary Denis McDonough announced plans that the offer will start offering gender confirmation surgery to transgender Veterans. The announcement was made at a Pride event at the Orlando Vet Center in Florida.

In prepared remarks, Secretary McDonough said, “We are taking the first necessary steps to expand VA’s care to include gender confirmation surgery — thereby allowing transgender vets to go through the full gender confirmation process with VA at their side.”

The decision to make changes in the VA health care system was based on what McDonough said was the “recommendation of our clinicians, so this is a health care based decision that has very real physical health care impacts as well as significant mental health impacts.”

To date, the VA offers mental health services and hormone therapy for transgender Veterans but has not included gender confirmation surgery and today’s announcement indicates a substantial shift in VA policy.

That is to say that the changes in policy will take time implement as the VA has not yet begun the federal rulemaking process. The VA does plan, however, to begin the process this summer.

Read more about the VA’s rulemaking process here.

“There are several steps to take, and that will take time. But we are moving ahead, methodically, because we want this important change in policy to be implemented in a manner that has been thoroughly considered to ensure that the service made available to Veteran meet VA’s rigorous standards of quality health care,” said McDonough.

A graphical representation of the informal federal rulemaking process. The process is governed by laws including but not limited to the Administrative Procedure Act (APA) (5 U.S.C. Chapter 5), Congressional Review Act, Paperwork Reduction Act, Regulatory Flexibility Act and can lead to a new Rule, an amendment to an existing Rule, or the repeal of an existing Rule. Executive Orders such as 12866, 13563, and 13579 also establish principles and guidance for the rulemaking process.

McDonough also stated that members of Congress are aware of the move and that the process will be carried out transparently and with Congress’ full coordination. As with anything federally-related, this will take time as the process of creating a new federal regulation can take years.

That said, transgender Veterans seeking gender confirmation surgery today will need to standby while the VA begins the mechanizations of altering a years-old policy that excluded the surgery from the benefits package. If a transgender Veteran goes to the VA on Monday morning seeking the surgery, they will not be able to as the process for change has not yet started. McDonough’s announcement today was just that: an announcement.

Today’s announcement falls in line with the Biden Administration’s efforts to make diversity and inclusion a priority. Secretary McDonough said that the decision ultimately would be President Biden’s.

“It’s the President’s decision, and we’ve just announced today that we’re executing that decision. That decision will care out now over many, many months, but at the end of the day this is in the President’s authority to do. He’s made clear it’s time to do it and that’s precisely what we’ll do.”

The SITREP will be following the progression of this change in the days/months/years ahead.

Read more:

First on CNN: Biden administration moves to make gender confirmation surgery available through Veteran Affairs health care system, CNN Politics

VA to offer gender surgery to transgender vets for the first time, Military Times

VA to Cover Gender Confirmation Surgery for Transgender Veterans, Rolling Stone