Transgender veterans file second lawsuit against VA over gender-affirming surgery coverage

An advocacy group for transgender veterans filed a second lawsuit against the U.S. government Monday for excluding gender-affirming surgery from former service members’ health benefits. 

In a federal complaint filed Monday, the Transgender American Veterans Association (TAVA) challenged the Department of Veterans Affairs’s (VA) denial of a 2016 petition asking the VA to begin the process of expanding its health benefits to cover gender-affirming surgery for transgender veterans. 

While other gender-affirming treatments — including hormone therapy, fertility preservation and hair removal — are covered by the VA, the department has effectively banned transgender veterans from accessing surgery since 2013, when a department directive stated that the VA “does not provide sex reassignment surgery.” 

VA Secretary Denis McDonough at a 2021 Pride Month event in Orlando said the department planned to expand care for transgender veterans to include surgery but cautioned that implementing the change would take time. 

TAVA’s lawsuit, filed Monday in the U.S. Court of Appeals for the Federal Circuit in Washington, D.C., claims the VA’s refusal to provide gender-affirming surgery “defies clear medical consensus” and discriminates based on sex and transgender status. It asks the court to review the VA’s denial of the group’s 2016 rulemaking petition and to direct the VA to provide gender-affirming surgery. 

“TAVA will not stand idly by as VA continues to discriminate against and breaks its promises to transgender veterans,” said Josie Caballero, the group’s vice president. “VA’s refusal to provide gender-affirming surgery is an affront to the dignity and well-being of transgender veterans.” 

“Gender-affirming surgery is not a choice for many transgender individuals — it’s often a critical part of our care that healthcare professionals consider medically necessary. Denying us access to these puts our lives at risk,” Caballero said. 

A VA spokesperson said the department is unable to comment on potential or pending litigation. 

TAVA in a January lawsuit asked the court to compel the VA to respond to its 2016 petition, which McDonough denied the following month. 

“Because VA is not ready at this time to initiate a rulemaking addressing the specific regulatory changes proposed in the petition, VA hereby denies the petition for rulemaking,” McDonough wrote in his letter rejecting the petition. 

In a statement, TAVA President Bekky Eshler called the VA’s continued denial of care an “insult to transgender veterans.” 

“It is well past time for the VA to ensure that all veterans have access to the complete slate of healthcare services they need and deserve,” Eshler said. “TAVA is not giving up this fight, and VA is not off the hook.”