<p>Dear Robert A. McDonald, Secretary of Veterans Affairs:</p><p>The Department of Veterans Affairs exists to provide care for all veterans, and it the responsibility of the Veterans Health Administration to provide adequate medical care for all veterans. That includes the estimated thousands of transgender individuals currently serving in the U.S. military and the thousands more who have already served. The coverage of gender reassignment surgery needs to be implemented and the ban on such medical care needs to end.</p><p>While a 2011 directive from the Department of Veterans Affairs began coverage for hormone therapy, that was just the first step towards providing the necessary care for transgender military personnel. The directive stated that the VA would assist with “mental health, pre-operative evaluation, post-operative long-term care, and any routine health screenings,” but that still leaves out coverage of gender reassignment surgery.</p><p>Transgender military personnel seeking gender reassignment surgery face depression – which can lead to suicide – if not given the ability to undergo the procedure. A study by the RAND Corporation in 2016 estimated that adding gender reassignment to the list of expenses covered by the VA would result in less than a 0.13 percent increase in current health spending. This is because only a small portion of the estimated 1,320 to 6,630 current transgender service members would elect to undergo the surgery each year.</p><p>However, in spite of recent talks in 2016 to lift the decades old ban on reassignment surgery, the procedure is still not being covered with the Department of Veterans Affairs citing budget issues as the reason. The slight increase in annual medial spending if this care were provided is far outweighed by both the potential detrimental mental health factors and the need to provide proper medical treatments for all service personnel without discrimination.</p><p>The VA should be accepting of all veterans and provide them with the best possible care. Yet, despite the fact that 18 different countries sport militaries that FULLY accept transgender service members, despite petitions from U.S. veterans themselves, and despite a perceived willingness to work with the transgender community, the VA still does not allow for the proper and full medical coverage for transgender individuals.</p><p>Secretary Robert A. McDonald, you can end discrimination and provide the best possible care for all of our veterans by allowing transgender individuals coverage of gender reassignment surgery in addition to the other medical services offered at the VA. Please reverse the recent decision to again disallow gender reassignment surgery at the VA and follow through with the plans to help all veterans as they seek the medical care that they need.</p><p>Sincerely,</p>