The Department of Veterans Affairs announced Monday that it will immediately phase out gender-affirming care medical treatments fortransgender veterans, citing President Donald Trump’s January 20 executive order defining gender as strictly male or female and fixed at birth assignment. The decision, effective immediately, halts access to cross-sex hormone therapy for transgenderveterans unless they were already receiving it through the VA or the military at the time of their discharge. All other medical care for gender dysphoria, including speech therapy and prosthetics such as chest binders and wigs, has been discontinued, according to a VA press release.
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“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,” said VA Secretary Doug Collins. “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.”
All major medical associations in the U.S. support gender-affirming health care for transgender people.
Related: Trump's VA rescinds policy treating transgender vets with dignity (exclusive)
The VA claimed that savings from eliminating gender-affirming care would be redirected to support veterans with severe injuries, including amputees and paralyzed veterans. "VA will not provide any other medical or surgical therapy for gender dysphoria to any patients in any circumstance," the press release states.
The announcement comes just days after The Advocate reported on the VA’s rescission of VHA Directive 1341, which had provided protections and health care guidance for transgender veterans. At the time, VA press secretary Peter Kasperowicz denied that any policy change had taken place and demanded The Advocate retract its reporting. However, the VA’s website confirms the directive’s removal, with a new document published Friday formalizing the policy shift.
The rollback of support for trans vets has triggered a fierce backlash from veterans’ advocacy organizations, including Iraq and Afghanistan Veterans of America, which called the policy “the ultimate betrayal.”
“The recent action by the current Administration to eliminate life-saving care for veterans who need it is the ultimate betrayal of those who’ve served and sacrificed so much for our country,” said IAVA CEO and Iraq War veteran Allison Jaslow. “If as a country we tell ourselves that we want the very best for America’s veterans, this recent action by the VA flies in the face of that and makes one wonder if it’s one that VA physicians would agree with.”
IAVA, which represents over 425,000 post-9/11 veterans, vowed to fight the policy reversal: “Regardless, our nation has just said a big f-u to veterans who’ve served and sacrificed when so many are unwilling to, and that should bother all of us.”
Related: VA psychologist resigns over worry about Trump’s ‘unethical’ orders restricting care for trans vets
Dr. Mary Brinkmeyer, a psychologist who resigned from the Hampton VA Medical Center in February in protest of the administration’s approach to LGBTQ+ veterans, said she was deeply disturbed by the announcement.
“I’m shaken not only by the announcement but by the dismissive cruelty in the way Sec. Collins refers to transgender veterans and their medical care,” Brinkmeyer said. “I’ve worked with trans service members and veterans since 2016, and I’ve seen their patriotism and desire to serve. They deserve better than this. I’m extremely worried about the mental health effects of removing medically necessary care for gender dysphoria in this vulnerable population.”
Lindsay Church, a Navy veteran and executive director of Minority Veterans of America, was emotional when speaking with The Advocate about the decision.
“This is probably one of the cruelest things I’ve read in a long time,” Church said, their voice breaking. “I had two VA appointments today, and I canceled both. I don’t feel safe going to the VA right now.”
Church also condemned the administration for pitting transgender veterans against those with spinal cord injuries and amputations, a tactic, they said, Collins used to justify the decision by saying that cost savings would be redirected to other veterans.
While the department claims it is cutting services to save money for veterans with severe injuries, in the same press release, the VA admits that it has never consistently tracked how much it has spent on gender-affirming care or how many veterans received it.
The VA also acknowledges that transgender veterans make up less than one-tenth of one percent of the 9.1 million veterans enrolled in VA health care—raising questions about how much money, if any, is actually being “saved” by the cuts.
“One, VA doesn’t know how much money they spend on gender dysphoria care,” Church said. “And two, that’s not how VA’s budget works. You can’t just shift money like that. This is a bald-faced lie.”
Congressional leaders rebuked the policy shift, with Democratic California U.S. Rep. Mark Takano, chair of the Congressional Equality Caucus and ranking member of the House Committee on Veterans’ Affairs, calling it an act of cruelty.
“This isn’t cost-cutting, it’s cruelty,” Takano said in a statement to The Advocate. “Secretary Doug Collins is unilaterally restricting medical care for transgender veterans, ignoring the clinical judgment of the VA providers that have prescribed this care and the expertise of all the major medical associations in the United States that support this care. Veterans deserve access to the medical care their providers deem appropriate—without Secretary Collins’s interference. Secretary Collins’s willingness to pit veterans against each other in today’s announcement is shameful. It shows that he is unwilling to take his responsibility to support all of our veterans, regardless of their identity or medical needs, seriously.”
The Human Rights Campaign also condemned the VA’s move, with President Kelley Robinson calling it an attack on those who have served.
“Transgender veterans share the same commitment and the same love of country as all other veterans. They made the same sacrifices and are owed the same respect and care after their service,” Robinson said. “Despite this, the VA has decided to turn its back on transgender veterans who committed their lives to serving in our armed forces—complying with an administration hellbent on harming and scapegoating the transgender community. We must continue to stand up for our transgender servicemembers and veterans. We must push back against these attacks until our nation’s policies reflect the values of honor, respect, and duty that our transgender veterans embody.”
Church accused the administration of weaponizing fear and misinformation to justify stripping transgender veterans of essential medical care.
“Most people who receive hormone therapy, prosthetics, or surgeries at VA are not transgender,” they said. “VA is still going to provide all of these services, just not for gender dysphoria. This isn’t about medical necessity—it’s about bigotry. They are sentencing us to death.”
Church also took issue with Collins’ claim that he made the decision “with respect.”
“For the secretary to issue this release and say, ‘I mean no disrespect’ while issuing the most disrespectful press release I’ve ever read—it’s just cruel,” Church said. “The secretary is doing harm to the community and pretending that he is doing something good for the veteran community. He doesn’t have data. He doesn’t have statistics. He just has abject hate for our community.”
Church said the psychological toll of the decision cannot be understated.
“I’m terrified to even step foot in a VA facility now,” they said. “They have made us public enemy number one. For what? Just for trying to live our lives?”
Advocacy groups and medical providers warn that it would have devastating consequences for transgender veterans, who already experience disproportionately high rates of mental health struggles and suicide. Research shows transgender people serve in the military at nearly twice the rate of their cisgender peers.
The Advocate has contacted Kasperowicz for comment on Monday’s announcement and the agency’s previous denial.
Editor's note: This developing story has been updated with additional reporting.
