Service Without Discrimination: Advocating for Continued Gender-Affirming Care at the VA

As a veteran who proudly served our country for nearly 25 years, including many as a closeted lesbian, I stand before you today deeply troubled by the U.S. Department of Veterans Affairs' recent decision to phase out treatment for gender dysphoria. This policy change not only undermines the health and well-being of transgender veterans but contradicts the very principles of equality, dignity, and comprehensive care that the VA should uphold for every veteran.

This move, rationalized under the current administration’s commitment to reallocate resources to help paralyzed and amputee veterans—a group undoubtedly deserving of every possible support—ignores the essential, life-saving nature of gender-affirming care. The decision follows directives to combat so-called "Gender Ideology Extremism," yet it dismisses a vast body of medical research endorsing the efficacy and necessity of such treatment.

Medical Necessity and Efficacy of Gender-Affirming Care

Extensive research demonstrates that gender-affirming care significantly improves the mental health and overall well-being of transgender individuals. Studies published in the American Journal of Public Health and the Journal of the American Medical Association have repeatedly shown that access to gender-affirming care reduces the risks of depression, anxiety, and suicide among transgender people. A notable 2019 study from the American Academy of Pediatrics found that such care substantially decreases instances of mental health disorders, underscoring its necessity as part of standard healthcare.

Economic and Social Contributions

Denying transgender veterans access to necessary medical treatments not only harms their health but also impedes their ability to contribute to society fully. Veterans are among the most highly skilled, disciplined, and dedicated members of our workforce. When transgender veterans are supported in their healthcare needs, they, like their cisgender counterparts, are better able to integrate successfully into their communities and contribute economically and socially.

A Call to Honor All Veterans Equally

It is a profound disservice to suggest that the healthcare needs of paralyzed and amputee veterans are somehow more valid or urgent than those of transgender veterans. We must recognize that comprehensive veteran care encompasses a spectrum of services tailored to the diverse needs of all who have served. The VA's mission is to provide "world-class benefits and services" to all veterans, inclusive of all backgrounds and experiences.

The Path Forward

As a nation, we must demand that the VA rescind this exclusionary policy. I call on my fellow veterans, healthcare professionals, and advocates from all sectors to join me in urging the VA to maintain comprehensive, medically necessary services for all veterans. Let us champion the cause of equality and ensure that every veteran receives the respect and care they deserve.

We must not let bureaucratic decisions undermine the health of our veterans. Instead, let us stand together to affirm that in America, every veteran matters — regardless of gender identity.

As we face this challenge, let us remember the core values that we cherished during our service — honor, courage, commitment. It is time to embody these values by supporting all members of our veteran community equitably and passionately.

~ Elijah Nicholas, DBA, MBA, MAET, MSOL , Lt Col (Retired) USAF

Sources:

1. American Journal of Public Health: "Mental Health of Transgender Veterans in US States With and Without Discrimination and Hate Crime Legal Protection."
2. Journal of the American Medical Association (JAMA): "Using clinician text notes in electronic medical record data to validate transgender-related diagnosis codes."
3. Center for American Progress: "What You Need to Know About the Equality Act."
4. National Center for Transgender Equality.
5. U.S. Department of Veterans Affairs.