Transgender Vets Want Their Surgeries Covered

If we're going to publicly fund medical treatments, why should there be an exception here?


Credit: DVIDSHUB / photo on flickr

As the Obama administration and the Department of Defense try to hash out a plan to accommodate transgender members in the military, some ex-troops are demanding changes to the way the Department of Veterans Affairs (VA) handles their affairs.

The VA offers a host of medical treatment services to the military. Or at least it's supposed to, given the current scandals about its utter failure to properly care for its customers. While it covers the costs of treatment for counseling and hormone treatments that transgender veterans may seek, it currently does not cover the cost of the actual surgical treatment to alter the body.

The Transgender Law Center and Lambda Legal have filed a petition to argue that the VA should cover the surgery. They're making the argument on behalf of the Transgender American Veterans Association, which counts more than 2,000 members. Katy Steinmetz got the details over at Time:

In the petition, the legal team essentially makes four arguments. The first is that the V.A. already provides transition-related healthcare for transgender people, such as hormone replacement therapy and mental health services, so the ban is "arbitrary," says Lambda Legal's Dru Levasseur. (The V.A. issued a directive in 2011 indicating that staff must provide such care "without discrimination.") The second is that the V.A. covers the same procedures that transgender people are seeking, such as mastectomies, for non-transgender and intersex veterans. The third, says Levasseur, is "the V.A. created this exclusion without examining any relevant data," ignoring the "medical consensus" on the topic.

On that point, the legal team has gathered materials to point to, such as a statement from the American Medical Association that "an established body of medical research demonstrates the effectiveness and medical necessity of mental health care, hormone therapy and sex reassignment surgery" in treating people with gender dysphoria. That's not to say that every transgender person needs or wants surgery, and having had more surgery does not make someone more transgender, cautions the Transgender Law Center's [Sasha] Buchert, but those procedures can be "life-saving" for those who do want them.

They are also following the lead of the Department of Justice and arguing that refusing surgical treatment for transgender vets counts as sex discrimination under a particular interpretation of the Civil Rights Act. That interpretation is based on an expansion of a Supreme Court decision that ruled that discrimination on the basis of whether or not a person behaves according to certain gender stereotypes counts as sex discrimination. There are several federal court rulings that uphold an interpretation that it could also apply to discrimination against transgender people, but it currently lacks a final clarification from the Supreme Court. The fight in North Carolina between the governor and the Department of Justice over its transgender bathroom law could eventually get us there.

It is very easy to reach for an outcome where—if for no reason beyond simple acceptance of human, individual liberty—transgender citizens are perfectly welcome to pursue a surgical solution while at the same time not obligating taxpayers to cover everything. Making it "free" (or really, deflecting the costs onto other people) reduces the incentives for all parties involved to really, truly work through the issues and make sure surgery is the right solution. That sounds paternalistic, but we have ample evidence in the medical field already that professionals, in an environment where the patient is not the actual customer, are quick to order unneeded tests, drugs and treatments. It's unlikely that a transgender person is going to treat such surgery in the same vein as a patient getting an unnecessary EKG, but we should not ignore the changes in financial incentives that would be involved in subsidies. Furthermore, subsidies for gender reassignment surgery will inevitably drive up the cost of treatment. As a result, anybody who actually falls through the cracks might find it even harder to save up to pay for it on his or her own.

But there is another issue here, which is that Americans, regardless of political affiliation, have generally accepted and embraced publicly funded medical services to veterans as a benefit for those who have been willing to put their lives on the line for the sake of the country. And that promise has not typically been connected to illnesses or issues that are just the result of military service. That gender dysphoria is obviously not an issue caused by military service isn't relevant to the decision to not cover it. Rather, it has been lumped in with a disparate collection of uncovered medical procedures like abortion, plastic surgery (except when ruled "medically necessary"), and in-vitro fertilization.

The surface argument is that these are not "necessary" procedures, but clearly not everybody agrees, and by "everybody," that includes medical professionals. These are politically unpalatable medical procedures that some Americans don't want their tax dollars spent on. So, medical treatment for veterans has become a politicized process that either bends to the will of experts, who have their own agendas and biases, or to democracy, where people are often selfish jerks. Neither solution seems all that responsive to the patient's decisions about what he or she needs, which sounds about right for the VA's reputation.

This fight is a good reminder that when healthcare is in government's hands, citizens have less and less control over their own well-being and are left having to prove to bureaucrats that their medical needs are actually "real." Bureaucracy moves slowly. Ask British men trying in vain to get access to an HIV-prevention treatment that has become more and more widely available in the United States.

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  1. Nothing makes us more “ready to fight” than a soldier recovering from taxpayer paid gender reassignment surgery.

    1. The VA provides medical services to military veterans. That is, people who are no longer on active duty.

      1. We’re all veterans of the gender wars.

        1. Not me, I’m a conscientious objector.

          1. It’s true – this man has no dick. Or vagina.

        2. Better to be a veteran of the psychic wars.

        3. What’s the War of the Ring, chopped lembas?

      2. They are fighting to make the military pay for it while in service, as well. The Department of Defense is already working on that:…..e-1.391637

        So, yea – the Obama admin has turned the military into a place to throw a bone to all their favored identity groups. At the expense of combat effectiveness.

        1. Sorry dude – you can’t blame this on Obama. There are all sorts of elective, even cosmetic, procedures that are covered for AD, this is just expanding the list.

          1. The colonel’s wife needs bigger tits. They aren’t going to implant themselves.

            But the mastectomy comparison is nuts. That is to remove a cancerous growth that might otherwise kill you. Not the same.

            1. Which is why I said nothing about mastectomies.

            2. Look, it’s only fair that every military member receive the cosmetic surgery of their choice upon being discharged. Cock extentions and balloon tits for everyone!

              After all, returning servicepeople deserve whatever bodymods they want, for free, because the last thing the VA wants to do is treat them for actual problems. That’s why they delay care so long, and kill so many ex-soldiers. They wanted treatment for things like bullet holes and blown off limbs. Nuts to that. Tits and dicks for everyone, unless they already have them! Then they’re removed and replaced with the null value.


      3. Sure. If VA is going to provide breast enhancements and genitalia modification for trannies, cis-female veterans deserve free boob jobs and vaginal surgery as well. And face lifts and liposuction for all veterans who want it. Free tattoos and cosmetic dentistry, too.

        Veterans medical benefits ought to be confined to treating serious injuries sustained in war, not cosmetic surgery.

    2. Nothing makes us more “ready to fight” than a soldier recovering from taxpayer paid breast enlargement surgery.

      Or taxpayer funded artificial insemination (for single parents even).

      Just two of the elective procedures already covered by the military medical system.

      This isn’t a new can of worms and it certainly isn’t freshly opened.

      1. Are you seriously conflating “post mastectomy breast augmentation” with “elective breast enlargement”? And Tricare does not cover artificial insemination. It will cover treatment for physical issues related to infertility, but it will not pay to artificially conceive.

  2. Squad! Camp it UP!

  3. “I went to the VA for gender reassignment surgery, and they turned me into a newt!”

  4. If this goes through, it will prove the terrorists haven’t won.

  5. Peak Lunatic Accommodation is far ahead in the future.

  6. Birth control and gender reassignment surgery? Who has genitals that do not require Crusty’s funds?

    1. I was gonna ask to borrow $20 for a Thai massage, but now I feel bad.

      1. Only $20? I respect that.

        1. It’s LA man, healthy competition drives down prices.

          1. Note to self: move to LA.

            1. Nope, too many trashplants already. San Bernardino is as far west as you can go.

                1. I’d say you’re more along the lines of Manager’s Special.

                    1. Uh Crust, he means you’re airquotes special. So just be sure you’re wearing a bike helmet at all times.

                    2. Have you ever had the pleasure of a massage performed by a tranny? How about an Asian tranny?

  7. Lights ______ signal

  8. Making it “free” (or really, deflecting the costs onto other people) reduces the incentives for all parties involved to really, truly work through the issues and make sure surgery is the right solution. That sounds paternalistic…

    I think you’re allowed to show a little paternalism with your own tax dollars.

    1. Once the government takes your money away, it ceases to be yours.

      1. THE + IRS = THEIRS

      2. There are some that argue it ceases to be yours even before it’s taken away.

        1. It was never yours. It belongs to society. After all, you didn’t pave those roads…

  9. Are you single tonight? A lot of beautiful girls waiting for you to
    The best adult dating site!

    1. Pre or post-op? Asking for a friend.

  10. If we’re going to publicly fund medical treatments, why should there be an exception here?

    Do we publicly fund plastic surgery?

      1. So, maybe the solution is to stop doing that?

        Is it widely known that we buy implants for our soldiers?

      2. I don’t think they do. I heard of some breast implant and other cosmetics allowed on a limited basis to allow doctors to get experience for trauma but I have never heard of any soldier or family member ever getting an elective cosmetic procedure.

        1. Tricare doesn’t do elective cosmetic procedures. They do pay for Soldiers who were wounded to get treatment to repair/conceal those wounds. If you’re a small-chested female Soldier who wants a boob job because you want tig ol’ bitties, tough luck. If you’re a small-breasted female Soldier who took shrapnel from an IED and suffered some serious wounds to your chest you can have that repaired, including augmentation.

  11. I’m not an expert, but it was my understanding that the only free services the VA provides are for service-connected conditions? Is that wrong?

    1. Yes, I think it’s for “service connected” conditions. Everything scare quotes imply.

  12. If we’re going to publicly fund medical treatments, why should there be an exception here to subsidizing the fantasies of the bughouse crazy?

  13. Yeah lets take money that is supposed to be used for people who lost limbs or suffer severe brain injury or have whatever injuries suffered serving the country and spend that money instead on trannies getting sex change operations.

    Fuck these people. I am sorry they suffer from this illness. And I am even more sorry that the country has decided to enable them rather than try and help them. But this gone past the point of insanity. Fuck them.

    1. ..enable them rather than try and help them

      Why can’t it be both?

    2. Fuck these people. I am sorry they suffer from this illness. And I am even more sorry that the country has decided to enable them rather than try and help them. But this gone past the point of insanity. Fuck them.

      Given that we’re talking about a significantly different kind of transgender animal here I agree.

      Want to work a private job and cover your illness out of your own pocket? You’re insane, but a respectable insane.

      Want to work a public job nominally devoted to killing people and destroying things and have the public cover the treatment for your illness? Fuck off. Get your gender reassigned on your own dime and then fuck off again.

      1. But they sacrificed man. You just don’t get it because you weren’t there.

        – Almost every veteran I know.

        1. Fuck that. and Fuck them You got paid to go over there. Be thankful you came back in one piece. A lot of people didn’t.

          1. That’s pretty much how I look at it.

          2. Agreed. Amusingly, this is what they’re pointing at when the entire VA system is essentially killing people? Priorities, huh? I guess this could serve the ‘change the conversation’ away from that unfortunate fact. Lets point at the trannies instead of the massive failures of the system from doing basic care.

  14. The real questions is, given the VA’s record. who is going to be first one under the knife?

    1. You mean the first one not under the knife.

    2. “Ladies first!”

  15. “Daddy, what did you do in the war?”

    “You mean ‘Mommy’ you little cis-fuck!”

  16. There should be an “exception” because this is not medical treatment. It’s very extreme cosplay.

    1. I think arguing about it being “medical” or not is the wrong way to frame the issue. either way it’s still voluntary (whatever you think of the legitimacy of transgenderism your life isn’t going to get worse if you don’t get this medical care, it just maybe won’t get better in the way you want. voluntary.)

  17. The good news is, progressives have decided that Obesity no longer has a public cost, and will now officially leave me alone.

    1. Oh they’ll get back around to it

  18. Hey, is *race* reassignment surgery a thing?

    *** googles it ***

    The Facts And Fiction Of Racial Reassignment Surgery

    1. Where you not alive for most of Michael Jackson’s life?

      1. I thought he fell in a vat of acid or something, like the Joker.

      2. Don’t forget our dear friend Rachel Dolezhal.

        Then there’s always the cinematic treatment; see C. Thomas Howell. Speaking of the Soul Man, last fall, my wife and I saw Woodlawn and my jaw dropped seeing him in a fairly prominent role in the film. Later, I checked out his IMBd and discovered that he has been working all along.

        1. What, no love for ‘White Chicks”?

      3. I think Michael Jackson offers a very good way to look at this. Was Michael Jackson born a white person in a black man’s body? Or did he suffer from a mental illness that unscrupulous doctors took advantage of?

        1. Have you read the Antioch Review piece? Michael Jackson was brought up.

          1. I just tried. I can only read prose now, apparently.

            1. What?

  19. I was legally blind and yet had to pay for lazik out of pocket. And I have no problem with that because I’m not a bitch.

    1. What’s your need to see when someone is trapped in the prison of the wrong body?

      1. Apparently lazik didn’t remove the plank.

        1. You’re free to donate as much as you want to the cause.

    2. You *could* be one if you had reassignment.

      *** ducks ***

    3. How far gone were you? My optometrist straight up shelved any talk of LASIK with my -7 prescription and astigmatism. Said it would shave off too much of my cornea.

      1. He’d probably rather sell you glasses. Ophthalmologists do the surgery.

        1. I am well aware of both of those things. Which is why I was asking JB for his experience. I wanted to know what his prescription was before the surgery, and how he’s doing now. Now get off my thread.

          1. At this point it is you posting in my thread.

            1. /burns down everything

          2. I don’t remember the actual number but probably very close to where you are with a slight stigmatism. I saw nothing but a blur. Best thing I ever did. Yeah, cornea thickness is always a concern. I had it 4 years ago. I’m developing cataracts now as I’m sure you will. Depending on how old you are they may want to wait until cataract surgery to save some of that cornea in case they need to tweak it later. If your not starting to develop them, try and get it if you can. My eye doctor freaks out everytime he sees me because of how bad my vision was and how good it is now.

            1. I want to say -6.5 but I’m not 100%. It was at least that bad though.

            2. No cataracts or glaucoma yet. Just got examined last month, and I’m 24. But yeah…I was a bit deflated when he said he wouldn’t recommend it. But second/third opinion and all.

              1. I’m guessing it is because of how young you are. I was 47 when I got mine. I’m sure he is thinking that your eyes will continue to degrade and you only have so much cornea to work with. If I were you I would wait a few years and if your eyes remain stable during that time then revisit it. You really want to try and stabilize first because you will get cataracts probably fairly young. You don’t want to get it and 4 years later need glasses again if you can help it. It is nice to not be blind though.

                1. Right, that’s what I thought too. If they attempt LASIK at my age and my eyes haven’t stopped getting bad, then it’ll all be a giant and expensive failure. I guess only time will tell.

                  1. I’m hoping for cybernetics.

                    We already can fit HD camera equipment into a space smaller than the orbit (witness the iPhone), but we can’t get nearly that much data throughput (a) to the brain and (b) interpreted into the sort of picture and resolution you’d see on the screen.

                    That’s the problem with all prosthetics; tying them into the brain. We’re still working out digital-to-biological interface.

  20. True story: there was a military pharmacy worker on base who completely failed her testing requirements. In the military, the medical folks still have to take the civilian tests in order to be compliant (I’m not medical, this is just how they summarized it). She was also charged with stealing prescription medication. She was obviously placed under investigation.

    One day, she showed up to a ceremony wearing a male service dress uniform. She was promptly disciplined, though with everything going on and her apparent desire to be a male, it was treated with kid gloves.

    Not only did she go to the media, she threatened to sue the military for gender bias, arguing that she was the subject of undue scrutiny because she was transgender and that this is what caused her to do the things she did (stress or something).

    I don’t know how the story ends, really. She’s not in the military anymore, and I don’t even know whether or not she’s a she.

    Now, of course, various branches of the military are switching to gender neutral uniforms and politically correct titles. Make of it what you will, but I have serious doubts that it does anything to increase readiness.

    1. gender neutral uniforms

      Muu Muus?

    2. Various branches of the military are not changing to gender neutral uniforms (though they should as the male uniforms look better on women than the stuff intended for them) and politically correct titles.

      Female officers are still addressed as ‘ma’am’, male as ‘sir’, or by their rank, enlisted are still addressed by rank and last name – none of this has changed since before I joined in 1990.

      The closest you get to ‘gender neutral’ is that BDU’s and working uniforms are mostly the same across the sexes (though women typically have a larger selection of covers to choose from) – and have been for a couple decades at least – and the Navy allows women to wear the Dress White Jumper top with a skirt now.

      1. No one told senator boxer.

        1. Good. Most of the shit they’ve been making women sailors wears is god awful looking.

      2. And my other link doesn’t work, but the Marines are changing/changed some titles to gender neutral. Google it.

        1. If you’re talking about changing things like ‘Engineman’ to something more gender neutral – why shouldn’t they? Its a waste of time (IMO) but its a harmless one – unlike the sorts of things I assumed you were talking about.

      3. When I was in the Navy, we fought the change to dress white jumpers for women, because unless you are flat as a washboard and have no hips they look like shit. If you are endowed, the jumper emphasizes just how far yer tits stick out, and the jumper top falls straight down making one look perpetually pregnant and/or fat. If you have hips (which strangely enough most women do), the jumper top which is cut straight rides up around the waist and you always look wrinkled. I recently saw a SN in one of these monstrosities and even though she was average weight, she looked very frumpy. Add that to the 1000 or so reasons I am so happy I got out when I did.

      4. Navy allows women to wear the Dress White Jumper top with a skirt now.

        Usually you have to pay extra to put a woman in that kind of a getup.

    3. I guess the military was oppressing her by refusing to recognize her transcompetence and the fact that she identified as a pharmacist.


  21. I hate how everything incentivizes expanding the scope of protected classes for politicians. Probably to the detriment of the people actually affected by whatever it is you’re purporting to care so much about (getting a sex change surgery is in no way comparable to being hit by a truck). there’s layers of awfulness.

    1. (getting a sex change surgery is in no way comparable to being hit by a truck)

      Chop your dick off and then get back to me.

      1. Well, say hello to my little friend Mac, and you will not be getting back to anyone.

        1. Can’t tell if dick joke or truck joke.

  22. Since we’re rapidly moving towards a society where your “identity” is the only legal underpinning for any accommodations that differ based upon sex or race, what’s the end game for affirmative action? Its collapse may be the only good thing to come of this lunacy, if this identity construct reaches its logical conclusion.

    If I identify as Native American on a college admissions form, and I no longer have to actually *be* Native American in order for that claim to be valid, won’t the racial spoils system implode?

    Further, what’s stopping your gender and/or racial identity from being fluid? If we’re going to accept that it’s ok to switch teams at some point, at your own whim, then what prevents gender/racial free agency? What legal basis would there be to restrict my gender identity to just one change? If you’re going to allow Bruce Jenner to become a woman then how can you disallow Caitlyn Jenner from turning back into a man?

    I’m amazed that high school kids aren’t already playing these games with college admissions.

    1. If I identify as Native American on a college admissions form…

      You can be a Senator from Massachusetts!

    2. Maintaining inconsistent views and double standards is easy when you lack actual principles of any kind.

    3. then what prevents gender/racial free agency?

      We’re not The Culture?

  23. I’ve always felt like a healthy straight white man trapped in a healthy straight white man’s body. That is, I’m a healthy straight white man and I like being a healthy straight white man, but it bothers me that I was never actually given a choice in the matter, you know? So what I want is sex, race, and sexual orientation re-assignment surgery plus both my legs chopped off so that I can be a gay black handicapped woman – and then I want everything put back the way it was so I can be a healthy straight white man again, but this time because I want to be and not because I have to be. All I’m asking is that I be given a choice, a choice that was denied me at birth. Who’s with me? Say it loud and say it proud: My Body, My Choice!

    1. All I’m asking is that I be given a choice

      You want an abortion?

      1. We have the fed gov of the united states and the complicit cathedral media. Isn’t that enough of an abortion already?

    2. Who’s with me? Say it loud and say it proud: My Body, My Choice!

      Since reality is not a constraint do we have to limit ourselves strictly to victimized minorities and/or SJW classes? Personally, they’re all too self-defeatist for my taste.

      1. Dammit, if you’re going to radically alter your body, why not void any and all victim statuses.

        Maybe even get SF’ed link auto-correction thrown into the deal.

  24. The surface argument is that these are not “necessary” procedures, but clearly not everybody agrees, and by “everybody,” that includes medical professionals.

    And I’m sure those medical professionals are in the operating room insisting “Turn that man into a woman! Stat!”

    Or more plausibly we’re talking about more generic “wellness” care that isn’t about medicine, but about emotional well being. Well, I’m sorry, but handle your emotional well being on your own dime.

  25. reaction to this kind of crap is what has the religious nuts passing stupid bathroom bills.

    do what you want, where you want, and get whatever you want cut off…

    but don’t expect someone else to pay for it!!!!!

  26. XY wants cosmetic surgery to feel and to help look more like XX.

    XY insists that wearing social-consensus XX attire is not sufficient.

    Without the cosmetic surgery, XY feels bad.

    Feeling bad is a medical condition, obviously – you anti-science flat-earther.

    Are there other medical treatments than cosmetic surgery to make XY feel better? – Who effing cares? – you heartless bigot.

    Logic always wins – now pay up, tax slave.

  27. Can’t turn an X into a Y.

      1. In beer yeast?

        1. I got a couple packets downstairs. Don’t know the gender of the fungus, but I suppose it is among us.

          1. Don’t know the gender of the fungus

            Male, obviously. It’s always trying to get into pussy.

        2. Well, you start from simple to complex, no? The fundamentals of the technology would be the same once it’s refined enough to do so. The Y chromosome is basically a deformed X one to begin with. It happens by accident already.

          1. Well, you start from simple to complex, no?

            Umm… Unless you just fucking love science, No.

    1. “A is A.”

  28. is this covered?

  29. I realize we’re playing at Social Justice Commando, which requires neutron-star levels of denseness and virtually no command of the facts, but we are operating far afield from what is historically considered medicine when one demands cutting your dick off as a necessary part of the profession dedicated to health.

    It doesn’t terribly bother me to provide male-to-female op surgery as a benefit of enlistment. Haven’t much thought about it and don’t much care, to be frank. It isn’t, however, an expected or necessary part of the medical benefits already provided for and I’m not particularly keen on receiving the Trojan horse wherein pretending to have the characteristics of something that you’re not is a necessity of any kind, much less a medical necessity. We can split the difference on whether having access to M-to-F procedures is a perk of Western society or an example of its decadence, but it sure as hell isn’t a requirement to living a healthy life.

  30. I’m OK with the surgery being taxpayer funded as long as they amputate the relevant bits with the same level of anesthetic and sterilization as was enjoyed by civil war soldiers.

  31. Transgender Vets Want Their Surgeries Covered

    And I want a pony! A sparkly unicorn pony!

  32. this surgery is to enable their mental illness and delusions,not to actually help them get well. it’s a gross misuse of public funds.

    1. So par for the course and no major deviation from govt policy in all other realms

  33. OK,let the VA pay for the surgeries,but they all have to be done by Dr. Kevorkian.

  34. I remember when i was a nerdy d&d playing teenager that I desperately hoped for a day when LARPing wouldn’t be social suicide and would become widely accepted and mainstream.

    The moral of the story is be careful what you wish for.

    1. Cutting your dick off is now OK, but tossing imaginary lighting bolts still not cool.

      But nerds are the weird ones. Go figure.

  35. So, they want cosmetic surgery.

  36. How far down the Rabbit hole can we go?

    1. Wait until people come to believe they’re an animal.

      1. Hey! Are you othering Mr Lizard? Not cool, dude!

      2. Should we allow soldiers to wear fox tail butt plugs in the trenches?

      3. Too late, dude. I take it you’ve not run into Otherkin yet.

  37. 2?once I saw the draft of 3500 bucks, I admit that my sister was like really generating cash in his free time with his COM. My aunt has done this for only 6 months and by now repaid the loan on their home and bought a new BMW..K4..

    ———— http://www.E-cash10.COM

  38. Has America moved so far to the left that an ostensibly libertarian magazine is arguing, even if only gently, that the military needs either to cover the cost of sex changes for veterans or to drop all non-service related health care coverage entirely?

  39. If you wonder how the VA is failing combat veterans, look no further than this.

    The VA should be providing health services to veterans with service related injuries and disabilities, and assisting recently separated veterans with their transition to civilian life.

    The idea anyone who serves 24 months in the military should get lifetime general health care benefits is not reasonable, and should exceed the charter of the VA.

    1. The problem is that the government has historically evaded responsibility for injuries and diseases acquired through service by denying the conditions are service related.

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