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VA Weighs Lifting Exclusion on Gender Reassignment Surgery

Administration already fighting multiple lawsuits against its transgender policies

People demonstrate outside the Capitol in July 2017 to protest President Donald Trump’s rst ban on transgender Americans serving in the military. (Bill Clark/CQ Roll Call file photo)
People demonstrate outside the Capitol in July 2017 to protest President Donald Trump’s rst ban on transgender Americans serving in the military. (Bill Clark/CQ Roll Call file photo)

The Department of Veterans Affairs is considering removing an exclusion on medical coverage for transgender services as the Trump administration battles multiple lawsuits against its transgender policies.

The VA released a request for comment Friday in response to a 2016 petition it received under former President Barack Obama to allow coverage of sex reassignment surgery. The petitioners, Dee Fulcher, Giuliano Silva and Transgender Veterans of America, eventually sued the Trump administration in 2017 in the U.S. Court of Appeals for the Federal Circuit. The case is ongoing.

Sasha Buchert, an attorney with Lambda Legal who is representing the plaintiffs, said the move is likely in response to the court’s questions on whether the administration adequately considered the petition.

“Based on this administration’s relentless hostility towards transgender service members and veterans, I can only believe that they are going through the motions to achieve a preordained result,” Buchert said.

In May, the court ordered the VA to supply additional documents by July 9 that show deliberations concerning the petition, saying it had so far received “scant evidence” on why a response has been delayed. The VA did not respond to a request for comment Friday.

The administration’s attitude toward transgender individuals makes a rule change unlikely. President Donald Trump announced via Twitter last July that transgender individuals would not be allowed to serve in the military “in any capacity.” Multiple judges blocked the sudden ban, and the administration is appealing.

The VA is seeking public comment on the impact that gender reassignment has on mental health, suicide, and access to care for veterans in areas where relevant specialty doctors are in short supply. But the department highlighted its doubts about the benefits by citing a recent report from the Department of Defense.

“That report noted considerable scientific uncertainty and overall lack of high quality scientific evidence demonstrating the extent to which transition-related treatments such as sex reassignment surgery remedy the multifaceted mental health problems associated with gender dysphoria,” the VA wrote.

But the nation’s most prominent medical groups, including the American Medical Association, endorse gender reassignment surgery as a treatment option for individuals with gender dysphoria, a condition in which a person’s psychological gender identity differs from his or her physical gender. The AMA has filed a brief in support of the plaintiffs.

The Department of Health and Human Services has also worked to make policy changes that advocates worry could negatively affect transgender individuals. In January, HHS proposed enforcing a number of “conscience protection” laws that allow doctors to opt out of procedures they find morally objectionable.

Trump cited “tremendous medical costs” as part of the reason for his decision to ban transgender troops from the military. But Buchert sought to counter that argument, pointing to a 2016 report from the RAND Corporation commissioned by the Pentagon that estimated the cost of transgender surgeries was at most $8.4 million annually or a 0.13 percent increase in spending.

“It’s just a ridiculous argument that this is going to be some costly issue they’re going to have to cover,” she said.

Comments are due by Sept. 9.

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