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VA asks court to dismiss lawsuit seeking gender-affirming surgery for veterans


Attorneys for the U.S. Department of Veterans Affairs have asked a federal appeals court to toss a lawsuit filed by a group that wants the VA to offer gender-confirmation surgery to 163,000 transgender veterans.

The agency said it is working to make such offerings available, but wasn’t prepared to finalize rules on the issue.

“VA remains committed to providing care to transgender Veterans and will continue to take steps to consider any potential changes to the provision of medical care to that important population,” U.S. Secretary of Veterans Affairs Denis McDonough said in denying the group’s request.

The Secretary said that any “potential change in coverage … must be implemented in a manner that has been thoroughly considered and ensures that the services made available to Veterans meet VA’s rigorous standards for consistent and quality health care nationwide,” according to the lawsuit.

The Transgender American Veterans Association lawsuit, filed in January, sought an order that the Department of Veterans Affairs act on the group’s 2016 rule-making petition for gender-confirmation surgery. The department denied the petition and said that made the TAVA suit moot because it had granted the relief the group sought.

In its lawsuit, the Transgender American Veterans Association said the department hasn’t lived up to the promises it made.

The Department of Veterans Affairs provides medically necessary gender-affirming care to transgender veterans, but not gender-affirming surgical interventions due to an exclusion in the department’s medical benefits package. It also has LGBTQ+ Veteran Care Coordinators in every VA health care system.

McDonough announced more than two years ago that VA would provide gender confirmation surgery. At the time of the announcement, McDonough said it would take time.

In its response to the TAVA lawsuit, the Department of Veterans Affairs said it needed more time.

“The Secretary formally denied TAVA’s request to appeal or amend … at this time in light of the Secretary’s conclusion that further consideration was in order regarding any proposed changes to the provision of medical care to transgender veterans,” according to court records.

Costs of such care vary significantly. A 2022 article in “The Journal of Law, Medicine & Ethics” noted that gender-affirming health care services can include mental health support, hormone therapy and reconstructive surgeries. It also found that “scant information is available about the utilization or costs of these services.” The peer-reviewed article found vaginoplasty and phalloplasty are often multi-episode procedures. The total average cost of vaginoplasty per person was $53,645. For phalloplasty, it was $133,911.

TAVA did not immediately respond to a request for comment on Friday from The Center Square.