According to a national survey by NCTE and the National Gay and Lesbian Task Force, fully one in five transgender adults in the United States – or an estimated 140,000 transgender people today – have served in the armed forces. While still not able to do so openly (nearly one in ten transgender veterans reports having been discharged due to their gender identity), transgender people have served in every conflict in our nation’s history, and many continue to today.
In recent years, enormous steps have been taken toward achieving equal access to support and earned benefits for transgender veterans. Undoubtedly the most visible achievement has been the 2011 Veterans Health Administration directive, updated in 2013, calling for respectful and nondiscriminatory services for transgender veterans, and equal access to health care to the greatest extent possible under current regulations. The Veterans Administration has continued in recent years its efforts to increase providers’ cultural competence and clinical knowledge for serving transgender veterans, and NCTE serves as an advisor for an ongoing VHA working group on these efforts, which have included developing training, clinical guidelines, and consultation for providers. This is an area where a very modest effort can lead to significant gains in health care quality by giving targeted attention to previously-neglected barriers.
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However, there is still much to be done. The inability to obtain records of one’s military service that don’t list a former name creates barriers to employment and other benefits and infringes trans veterans’ privacy. For some, the inability to update gender designations in Department of Defense benefits systems has also created problems. Following our tremendous success in updating documentation policies with other federal agencies, NCTE is actively advocating with the Department of Defense to modernize its own policies in these areas. In addition, for those who receive health care through the VA, eliminating the medically unfounded exclusion of transition-related surgeries from VA care remains a critical goal.
In addition to the unique barriers that trans veterans still face, many broader challenges remain for veterans in general, some of which may disproportionately affect trans vets. Too many veterans still face long wait times to see a mental health provider through the VA. Post-9/11 veterans face significantly higher levels of unemployment than those who served previously or the country as a whole. And though chronic homelessness among veterans appears to be declining, much more needs to be done to ensure every veteran has a home. (For transgender veterans, this includes ensuring their gender identity is respected in shelters and housing programs.) While fewer Americans serve in the armed forces than ever before, it is critical today to honor those have, not just in word but in deed.
As we continue our advocacy on behalf of trans veterans, we need to hear and share the stories of trans people’s experiences with the VA health system. Have you had a good or bad experience as a trans person using a VA medical center? Has the VA directive changed your experience as a patient or not? How have barriers to equal care through the VA impacted your health and life? How has the refusal to cover surgery impacted you? Share your story by emailing us at ncte@transequality,org.