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Veterans Affairs to provide gender-confirmation surgery reversing 2013 ban

McDonough said that he pledged to overcome a “dark history” of discrimination and expand access to care for transgender veterans

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The new Orlando VA Medical Center at Lake Nona (Photo Credit: U.S. Department of Veterans Affairs )

ORLANDO – U.S. Department of Veterans Affairs Secretary Denis McDonough announced his Department is moving to provide gender-confirmation surgery through its health care coverage reversing a 2013 ban on those surgical procedures.

Speaking at a Pride Month event at the Orlando VA Healthcare System Saturday, McDonough said that he pledged to overcome a “dark history” of discrimination and take steps to expand access to care for transgender veterans.

With this commitment McDonough said he seeks to allow “transgender vets to go through the full gender confirmation process with VA by their side,” McDonough said. “We’re making these changes not only because they are the right thing to do, but because they can save lives,” he added.

The process to roll-back the restrictions may take upwards of two years. The federal rulemaking process, expected to begin this summer, will include a period for public comment, spokesman Terrence Hayes told The Washington Post on Saturday.

“This time will allow VA to develop capacity to meet the surgical needs that transgender veterans have called for and deserved for a long time,” McDonough said in his remarks. “and I am proud to begin the process of delivering it,” he added.

On February 8, 2013, the VA issued a directive that stated that the VA Healthcare System does not provide sex reassignment surgery. This directive sought to clarify a previous VA directive issued June 9, 2011, “Providing Healthcare for Transgender and Intersex Veterans,” which established the provision of hormone therapy, gender-related mental health counseling, and other transition-related services through the VA, as well as a mandate that the VA health system provides care “without discrimination and in a manner … consistent with the Veteran’s self-identified gender.”

“This directive, however, does not include coverage of surgical procedures although the VA does provide transgender veterans with pre- and postoperative care.”

The outcome was that the directive(s) effectively prevented transgender veterans from a surgery considered medically necessary by the World Professional Association for Transgender Health.

38 CFR § 17.38 Medical benefits package, is the specific federal code that makes provisions for veterans healthcare, which Section (b) clearly defines as; “Care referred to in the “medical benefits package” will be provided to individuals only if it is determined by appropriate health care professionals that the care is needed to promote, preserve, or restore the health of the individual and is in accord with generally accepted standards of medical practice.”

However, 38 CFR § 17.38 does limit care for transgender veteran’s stating: “(c) In addition to the care specifically excluded from the “medical benefits package” under paragraphs (a) and (b) of this section, the “medical benefits package” does not include the following: […] ‘(4) Gender alterations.'”

McDonough noted that changes “will require changing VA’s regulations and establishing policy that will ensure the equitable treatment and safety” of all transgender veterans.

“There are several steps to take, which 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 services made available to veterans meet VA’s rigorous standards for quality health care.”

In a study related to the 2011 and 2013 directives, the VA noted that research showed that the transgender population in general experiences severe physical and mental health disparities, compared to the cisgender population, including high rates of HIV, suicidality, depression, anxiety, and mental health-related hospitalization.

Studies have found that these disparities are even more glaring among transgender veterans. In a survey of transgender veterans and transgender active-duty service members, transgender veterans reported several mental health diagnoses, including depression (65%), anxiety (41%), PTSD (31%), and substance abuse (16%).  In a study examining VHA patient records from 2000 to 2011 (before the 2011 VHA directive), the rate of suicide-related events among veterans with a gender identity disorder (GID) diagnoses was found to be 20 times higher than that of the general VHA patient population.

McDonough acknowledged the VA research pointing out that in addition to psychological distress, trans veterans also may experience prejudice and stigma. About 80 percent of trans veterans have encountered a hurtful or rejecting experience in the military because of their gender identity.

“LGBTQ+ veterans experience mental illness and suicidal thoughts at far higher rates than those outside their community,” McDonough said. “But they are significantly less likely to seek routine care, largely because they fear discrimination.

“At VA, we’re doing everything in our power to show veterans of all sexual orientations and gender identities that they can talk openly, honestly and comfortably with their health care providers about any issues they may be experiencing,” he added.

All VA facilities have had a local LGBTQ Veteran Care Coordinator responsible for helping those veterans connect to available services since 2016.

“We’re making these changes not only because they are the right thing to do but because they can save lives,” McDonough said. He added that the VA would also change the name of the Veterans Health Administration’s LGBT health program to the LGBTQ+ Health Program to reflect greater inclusiveness.

Much of the push for better access to healthcare and for recognition of the trans community is a result of the polices of President Joe Biden, who reversed the ban on Trans military enacted under former President Trump, expanding protections for transgender students and revived anti-bias safeguards in health care for transgender Americans.

U. S. House Veterans’ Affairs Committee Chairman Mark Takano, D-CA, who is openly gay, issued a statement applauding McDonough’s actions.

“Veterans in need of gender confirmation surgery should not have to seek healthcare outside of the VA health system or navigate complicated processes to get the care they need,” Takano said. “VA must be inclusive of all veterans who have served, regardless of their identity.”

The Chairman of the Senate Veterans’ Affairs Committee, Jon Tester, D-MT also approved of the expansion of health care offerings for trans veterans.

“Every service member and veteran deserves equal access to quality care from VA, and this includes our LGBTQ+ veterans,” Tester said in a statement. “We must reaffirm our commitment to making VA a more welcoming place for everyone who fought to protect our freedoms.”

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” and noted the contrast with recent moves by the Florida Legislature and Gov. Ron DeSantis to limit transgender youth participation in school sports.

“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 healthcare they need to live authentically is a critical component to fulfilling our nation’s promise of caring for those who’ve served.”

U.S. Department of Veterans Affairs, Washington D.C. (Photo Credit: GSA U.S. Government)
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Louisiana lawmakers fail to overturn Edwards veto of Trans sports bill

Edwards further said that the bill was “mean” because it targets “the most emotionally fragile children in the state of Louisiana.”

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Louisiana Democratic Governor John Bel Edwards (Photo Credit: Official state portrait)

BATON ROUGE – Louisiana lawmakers failed to override Gov. John Bel Edwards’ (D) veto last month of a bill that would have barred trans girls and women from participating on athletic teams or in sporting events designated for girls or women at elementary, secondary and postsecondary schools.

The measure, Senate Bill 156 authored by Sen. Beth Mizell titled the ‘the Fairness in Women’s Sports Act,’ in the Governor’s eyes, “was a solution in search of a problem that simply does not exist in Louisiana,” Edwards said in his veto statement;

“As I have said repeatedly when asked about this bill, discrimination is not a Louisiana value, and this bill was a solution in search of a problem that simply does not exist in Louisiana. Even the author of the bill acknowledged throughout the legislative session that there wasn’t a single case where this was an issue. 

The Republican majority state House chamber failed to override the Governor’s veto after voting 68-30 to override it, according to the state legislature’s website.

The vote narrowly missed the 70-vote threshold needed in the lower chamber to override the veto.

Two-thirds of both the House and Senate must vote to override a governor’s veto, according to the local Baton Rouge newspaper The Advocate.

The Governor reacted to the news that his veto withstood Republican efforts to overturn it in a press conference Wednesday.

Edwards noted that in his view he had “rejected a play” that had no place in Louisiana. 

“I would rather the headlines going out from today be that Louisiana did what was right and best. We rejected a play out of a national playbook that just had no place in Louisiana. That bill wasn’t crafted for our state, I mean go read it and look at the arguments that were made. None of that applies here,” Edwards said.

He further said that the bill was “mean” because it targets “the most emotionally fragile children in the state of Louisiana.” 

“We have to be better than that,” Edwards said. “We have to be better than that.” 

 

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Federal court blocks West Virginia Law banning Trans youth sports

“It hurt that the State of West Virginia would try to block me from pursuing my dreams. I just want to play.”

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Becky Pepper-Jackson (Photo credit: ACLU/Raymond Thompson)


CHARLESTON, W.Va. — A judge of the United States District Court, Southern District of West Virginia ruled Wednesday that 11-year-old Becky Pepper-Jackson must be allowed to try out for the girls’ cross-country and track teams at her school, blocking West Virginia from enforcing a law that bans transgender girls and women from participating in school sports. 

The ruling came in the lawsuit challenging the ban filed by Lambda Legal, the American Civil Liberties Union, the ACLU of West Virginia, and Cooley LLP.

“I am excited to know that I will be able to try out for the girls’ cross-country team and follow in the running shoes of my family,” said Becky Pepper-Jackson, the plaintiff in the lawsuit. “It hurt that the State of West Virginia would try to block me from pursuing my dreams. I just want to play.”

West Virginia Gov. Jim Justice signed H.B. 3293 into law at the end of April. It was one of hundreds of anti-LGBTQ bills pushed in state legislatures across the country in 2021. During legislative debate, it was not endorsed by any mainstream sporting or health organizations. A similar law in Idaho was blocked by a federal court in 2020, and a federal court in Connecticut recently dismissed a challenge to policies that allow all girls, including girls who are transgender, to participate on girls’ sports teams. Legal challenges are underway against similar laws passed in other states.

The Supreme Court recently refused to disturb Gavin Grimm’s victory at the U.S. Court of Appeals for the Fourth Circuit, where he prevailed in challenging his school’s anti-transgender discrimination against him. This decision — which is binding precedent in West Virginia federal court — said that federal law protects transgender students from discrimination in schools.

“This is great news for Becky, and while our work is not done yet, today’s ruling jibes with similar rulings in other courts across the country,” said Avatara Smith-Carrington, Tyron Garner Memorial Law Fellow, Lambda Legal. “It is our hope that courts recognize and address discrimination when they see it, and nowhere is it more visible than in these stark attacks against trans youth.”

“Becky — like all students — should have the opportunity to try out for a sports team and play with her peers,” said Josh Block, senior staff attorney with the ACLU LGBTQ & HIV Project. “We hope this also sends a message to other states to stop demonizing trans kids to score political points and to let these kids live their lives in peace.” 

“We’ve said all along this cruel legislation would not survive a legal challenge, and we’re encouraged by the court’s decision today,” said ACLU-WV Legal Director Loree Stark. “We hope trans kids throughout West Virginia who felt attacked and wronged by the passage of this legislation are feeling empowered by today’s news.”

“We are extremely gratified — for Becky, and for all trans youth — at the court’s recognition that the law and the facts clearly support treating people who are transgender fairly and equally. Discrimination has no place in schools or anywhere else,” said Kathleen Hartnett of Cooley LLP.

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Conservative groups attack proposed Alabama capital city’s LGBTQ law

The groups allege that the law would require Christians to violate their religious beliefs or face fines under certain circumstances

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Approach to the Alabama State Capitol (Blade file photo)

MONTGOMERY – The Alabama capital’s City Council is being urged to reject a proposed ordinance that would make sexual orientation and gender identity protected classes under the law.  Matthew Clark, the Executive Director of the conservative Alabama Center for Law and Liberty sent a letter on behalf of his group and six allied organizations asking the Council to abandon a vote implementing the ordnance.

According to the letter, the groups allege that the law would require Christians to violate their religious beliefs or face fines under certain circumstances. Prominent among the other signatures is Mathew D. Staver, Chairman of Liberty Counsel which the Southern Poverty Law Center lists as an extremist anti-LGBTQ hate group.

The SPLC, which has its headquarters in Montgomery, writes; “The Liberty Counsel has also been active in the battle against same-sex marriage and hate crimes legislation, which it claimed in a 2007 news release to be “’thought crimes’ laws that violate the right to freedom of speech and of conscience” and will “have a chilling effect on people who have moral or religious objections to homosexual behavior.” In that same release, the Liberty Counsel falsely claimed that the brutal murder of Matthew Shepard in Laramie, Wyo., had nothing to do with homosexuality, but instead was “a bungled robbery.”

In the letter Clark noted; ““As we read the ordinance, churches could be fined if they refuse to allow transgender people to use the bathroom of their choice, and they might be fined if they refused to let same-sex couples use their facilities for weddings,” Clark said. “They could also be fined if they declined to hire non-ministerial personnel, such as facility managers or secretaries, whose sexual orientation or gender identity contradicts the tenants of the church’s faith.”

“Christian schools, small business owners, and homeowners are also in the crosshairs. Schools could face liability if they decline to let transgender students use the locker rooms of their choice,” Clark said. “Small business owners like Jack Phillips [referring to Masterpiece Cakeshop v. Colorado Civil Rights Commission] could face liability. And homeowners who list their homes on Airbnb could be fined if they declined to let a same-sex couple engage in sexual activities in their home that violate the tenants of their faith.”

Clark then warned the City Council that if it passes the ordinance, litigation could result and the City would likely lose.

The Montgomery Advertiser reported last month that City Mayor Steven Reed said a council vote in favor of the LGTBQ nondiscrimination ordinance that’s now being drafted in Montgomery would send a message. 

“There are signals that communities can send, and this is an important signal not only to those residents that live here right now but people all over the country that have maybe one idea of Alabama and Montgomery, and we want to show them that there’s a different reality here,” he said. 

Reed and his team have been working with the Human Rights Campaign and other advocacy groups to draft an ordinance that would expand protections for LGBTQ residents in the state’s capital city. The proposed measure, which would specifically target discrimination in government, employment and housing based on sexual orientation or gender identity the Advertiser reported.

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