LGBT VA Care

The Department of Veterans Affairs provides health care and veteran outreach services for LGBT veterans, and has specific policies for helping LGBT troops in their journey from military life to the civilian world.

Healthcare for LGBT “and related identities” as described on the VA official site include hormone treatment, substance counseling, relationship counseling, plus transition care.

The Department of Veterans Affairs does not fund or perform gender confirmation surgery, but does provide pre-op and post-op care, and even long-term care for those recovering from gender confirmation surgery.

Veterans who need LGBT services, whether from the VA or any other facility, have been needlessly stigmatized in the past. The Department of Veterans Affairs has a stated policy of inclusion, and LGBT veterans do not need to worry that they will lose or compromise their VA benefits by discussing LGBT health care issues openly with VA staff, contractors, or care providers.

What Is LGBT And LGBTQ?

These two acronyms stand for Lesbian, Gay, Bisexual, and Transgender (LGBT), and Lesbian, Gay, Bisexual, Transexual, and Queer (LGBTQ). In the past these two acronyms have been used more or less interchangeably in the vernacular but at the time of this writing the acronym LGBT seems to be the more common term, at least in VA literature and policy toward the LGBT community.

Why Does VA Policy Toward LGBT Troops Matter?

For the majority of the history of the United States Military from the first days of the American Revolution and the Continental Army to the creation of U.S. Space Command, LGBT service members have served in uniform, but were not permitted to serve openly.

Most LGBT troops prior to the end of restrictive enlistment policies aimed at LGBT recruits had to pretend to be heterosexual, asexual, or otherwise conforming to the restrictive policies enforced against the LGBT community interested in serving in the Armed Forces.

LGBT service members were, until the end of what many term as the military’s “gay ban,” subject to non-judicial punishment, reduction in rank, forfeiture of pay, court-marital, and involuntary punitive military discharges for what the Defense Department once-upon-a-time labeled “homosexual conduct”, punishable under the Uniform Code of Military Justice.

The End Of The “Gay Ban”

The end of the Department of Defense prohibition on LGBT troops serving openly did not come quickly nor easily, and there are still pressing matters at the time of this writing that require addressing as transgender Americans are still discriminated against when it comes to enlisting and joining the Army, Navy, Air Force, Coast Guard, or Marine Corps.

Why The End Of The Military Gay Ban Matters To All Americans

Ask any DoD leader, unit commander, or even troops in the field – the U.S. military is made up of a cross-section of America. The troops serving today are intended to be a representation of the entire country. This concept has been discussed at high levels across the Department of Defense even at times when the LGBT ban was in full effect.

The obvious hypocrisy of operating a fighting force meant to represent all aspects of American society while excluding a significant group IN that society is unsustainable in pursuit of an all-volunteer military. Fortunately, some at the highest levels of decision-making in the Defense Department have recognized this and have made it possible to make strides so that all may serve who are physically and mentally capable of doing so.

Should The Military Exclude LGBT Troops?

In the interest of a fair discussion about whether LGBT troops should be permitted to serve and serve openly, it’s important to know what Defense Department officials think about the current state of military readiness and the future of American readiness.

In 2019, A Defense Department report includes the following quote about the military’s ability to recruit, retain, and effectively deploy troops to answer the call of today’s military missions:

“Today, a widening military-civilian divide increasingly impacts our ability to effectively recruit and sustain the force,” the report states.

This DoD report, issued in May 2019, adds,  “This disconnect is characterized by misperceptions, a lack of knowledge and an inability to identify with those who serve. It threatens our ability to recruit the number of quality youth with the needed skill sets to maintain our advantage over any near-peer competitor.”

In light of those statements alone, it seems clear that the United States military can’t afford to exclude anyone who physically and mentally qualifies for military service regardless of their orientation or identity.

Baby Steps Toward Open Service For All 

In 1993, President Bill Clinton signed a law known as “Don’t Ask, Don’t Tell” which was intended as a compromise between permitting LGBT troops to enlist openly and addressing the socially conservative concerns of certain aspects of DoD leadership at the time.

Don’t Ask, Don’t Tell allowed LGBT troops to serve as long as they did not reveal their sexual orientation, gender identity, or other identifying aspects of their sexuality or identity. This policy relieved some pressure on certain troops. It also created pressure in other areas.

Don’t Ask Don’t Tell was blamed by some for enabling certain discriminatory practices specifically related to gender and sexuality but also for creating situations where frivolous complaints of Don’t Ask Don’t Tell (often associated with accusing someone of violating the policy who is not actually a member of the LGBT community) were taken seriously.

Federal courts declared the military’s ban on LGBT troops serving openly to be unconstitutional. Don’t Ask, Don’t Tell was formally suspended in 2011. President Barack Obama signed legislation called the Don’t Ask, Don’t Tell Repeal Act of 2010. The provisions of this act ended restrictions on service by gay, lesbian, and bisexual personnel.

VA Policy Toward Members of The LGBTQ Community

Make no mistake, VA policy for all services (including health care related to LGBTQ-specific medical issues) is (and we paraphrase here) that any veteran who qualifies for care through their military service is entitled to use VA benefits regardless of their orientation or identification with what the VA describes as a “sexual minority.”

“As a health care institution,” the VA official site states, “we need to work to make sure that Veterans with LGBT and related identities know that they are welcome at VA.”

VA Health Care Services For LGBT Veterans

The VA official sites says there is assistance available at every VA facility to help LGBT veterans get the information, services, and care they need. You can get started by searching a collection of VA websites with LGBT resources broken down by state.

Some states have multiple VA LGBT resources, while others may have fewer resources, but since 2016 “each VA facility” has a local LGBT Veteran Care Coordinator, or VCC, who is in charge of “promoting best practices for serving LGBT Veterans and connecting LGBT Veterans to services.”

LGBT VA Health Care Services And Policy

As mentioned above, VA care for the LGBT veteran community includes pre-op and post-op care.

But VA services cannot be used for gender confirmation surgery or any variant it may be known by include “gender reassignment”(an older term that may not be in common use at the time of this writing), “sex reassignment”, “sex change surgery,” or any other surgical procedures that meet the definition.

LGBT veterans can apply for VA care including services that are unique to these communities as well as more generalized care and services. VA LGBT care includes:

• Hormone treatment
• Substance use/alcohol treatment
• Tobacco use treatment
• Prevention and care for sexually transmitted infections/PrEP
• Intimate partner violence reduction
• Counseling and treatment of after effects of partner violence
• Cardio health
• Cancer screening
• Cancer prevention
• Cancer treatment

VA Care For Transgender Veterans

Transgender veterans are entitled to all of the services mentioned above, but there are VA fact sheets specific for both trans men and trans women that remind these veterans that they are not required to hide their identity, pretend it does not exist, or pretend to be any gender other than what the veteran identifies as.

VA fact sheets include a reminder that VA care providers have “been trained to keep your conversations confidential” which means that those who seek transition help or related care do NOT have to publicly identify as transgender in order to get counseling, care, advice, treatment, etc.

The VA allows transgender veterans to request that their status as a transgender veteran remain undocumented in the medical record, “although medically necessary information must be included in your medical record (such as a medical diagnosis).”

All of the care listed above is available to trans veterans: heart health, relationship wellness, cancer prevention, and hormone therapy are all listed as options for LGBT patients, but it cannot be emphasized enough that an important part of getting VA care as a trans veteran includes locating a primary care provider and specialists you are comfortable discussing these medical care issues with.

Joe Wallace is a 13-year veteran of the United States Air Force and a former reporter for Air Force Television News