The Veterans Health Administration has informed its hospitals and clinics that transgender veterans are eligible for hormones, care before and after gender change surgery, and mental health counseling as part of their regular benefits.
In a directive issued Thursday, the VA reiterated that its facilities are not permitted to perform genital or breast surgeries on veterans in the process of changing genders.
But the agency confirmed that transgender patients are entitled to routine health care that takes their special needs into account and to transgender-specific treatments such as hormone therapy and "non-surgical, supportive care for complications of sex-reassignment surgery."
In accordance with what it termed "the respectful delivery of health care," the VA also instructed medical personnel at its 950 health care centers to refer to transgender veterans in conversation and on medical records by the gender pronoun they prefer, regardless of whether they have undergone surgery.
The policy also applies to veterans who appear to be one gender but whose sex chromosomes indicate they are another, a condition referred to as intersex.
Transgender activists have been pressuring the VA for years to make such a statement. They maintain care of transgender veterans varies too much from facility to facility, with some easily accessing the full range of care and others being denied all services.
"It doesn't create anything new. It just says to treat these veterans like you treat all veterans, but for trans vets that's really huge," National Center for Transgender Equality executive director Mara Keisling said.
The VA quietly posted the directive on a section of its website reserved for new directives, but has not commented on it. A telephone call and email to the Department of Veterans Affairs, which oversees the VA, were not returned Friday.
Autumn Sandeen, a Navy veteran who lives in San Diego, has been happy with the treatment she has received through her local VA facility, but said she knows of other transgender veterans who were refused not only hormones and the psychological counseling that is a precondition for sex reassignment surgery, but regular checkups.
"It's going to be a huge boon to veterans who are not getting any care at all or are not getting appropriate care," Sandeen said. "You have to be able to treat the whole person, and now the VA is telling them, you can't separate out the transgender component and you can't only give care that is not trans-specific."