Topic: Question for US Veterans - what has VA actually covered for you, medically?

[TSL_NB]

For those of us in the US (or in my case, a Canadian who served in the US Navy) who are covered by VA, I've heard of the transgender health policies described as being 'written in pencil.'  (Just because they get revised so many times)

I have a pretty good idea of what VA supports, but I'm reading some accounts from other veterans who are transitioning who have shared some pretty mixed stories.

I'm curious to know from other veterans here, regardless of what the instruction says (even though what's in writing is what should apply),  what has VA actually covered for you, medically?
 

[MxRileyQuinn]

I served seven years in the USAF and have come out to the VA as transgender.  They confirmed my evaluation and diagnosis from a civilian therapist of being transgender with their own evaluation and diagnosis, which, while annoying and a bit of a delay was actually pretty simple since I'd already been through all of that with the civilian therapist. 

Once that was done I was referred to the VA's Transgender Medical Services section where they assigned me to a case management doctor (who I've never met, but have conversed with over the phone...turns out she's a regional director) who then referred me to a local VA endocrinologist.  The VA endo sees me every three months to go over my bloodwork and adjust my HRT as/if needed. 

The VA has covered my HRT completely, they are covering my voice lessons completely, and they have offered (through my endo) to cover tucking gaffs and "prosthesis" (breastforms and genital forms)...the tucking gaffs were meh compared to the ones I bought through the Breastform Store in Canada (wonderful company) but they do work.  I have not gotten them to provide me with any prosthesis yet.  They are offering depilatory creams or similar at no-cost to me, but I have to work through my PCP to get the referral to dermatology first (that appointment is coming this month).  They have provided mental health care throughout all of this at no cost to me, and everyone on the LGBT+ care side of the VA has actually been absolutely wonderful.  Even the folks in only semi-associated offices (like the endocrinology front office staff) have been great. 

The VA will not cover any surgeries, to include hair removal.  That part kinda sucks, especially since I really, really, REALLY am desperate for hair removal services.

[Devlyn]

I served seven years in the USAF and have come out to the VA as transgender.  They confirmed my evaluation and diagnosis from a civilian therapist of being transgender with their own evaluation and diagnosis, which, while annoying and a bit of a delay was actually pretty simple since I'd already been through all of that with the civilian therapist. 

Once that was done I was referred to the VA's Transgender Medical Services section where they assigned me to a case management doctor (who I've never met, but have conversed with over the phone...turns out she's a regional director) who then referred me to a local VA endocrinologist.  The VA endo sees me every three months to go over my bloodwork and adjust my HRT as/if needed. 

The VA has covered my HRT completely, they are covering my voice lessons completely, and they have offered (through my endo) to cover tucking gaffs and "prosthesis" (breastforms and genital forms)...the tucking gaffs were meh compared to the ones I bought through the Breastform Store in Canada (wonderful company) but they do work.  I have not gotten them to provide me with any prosthesis yet.  They are offering depilatory creams or similar at no-cost to me, but I have to work through my PCP to get the referral to dermatology first (that appointment is coming this month).  They have provided mental health care throughout all of this at no cost to me, and everyone on the LGBT+ care side of the VA has actually been absolutely wonderful.  Even the folks in only semi-associated offices (like the endocrinology front office staff) have been great. 

The VA will not cover any surgeries, to include hair removal.  That part kinda sucks, especially since I really, really, REALLY am desperate for hair removal services.

Get ye to Roll Call right away, troop!

[TSL_NB]

I served seven years in the USAF and have come out to the VA as transgender.  They confirmed my evaluation and diagnosis from a civilian therapist of being transgender with their own evaluation and diagnosis, which, while annoying and a bit of a delay was actually pretty simple since I'd already been through all of that with the civilian therapist. 

Once that was done I was referred to the VA's Transgender Medical Services section where they assigned me to a case management doctor (who I've never met, but have conversed with over the phone...turns out she's a regional director) who then referred me to a local VA endocrinologist.  The VA endo sees me every three months to go over my bloodwork and adjust my HRT as/if needed. 

The VA has covered my HRT completely, they are covering my voice lessons completely, and they have offered (through my endo) to cover tucking gaffs and "prosthesis" (breastforms and genital forms)...the tucking gaffs were meh compared to the ones I bought through the Breastform Store in Canada (wonderful company) but they do work.  I have not gotten them to provide me with any prosthesis yet.  They are offering depilatory creams or similar at no-cost to me, but I have to work through my PCP to get the referral to dermatology first (that appointment is coming this month).  They have provided mental health care throughout all of this at no cost to me, and everyone on the LGBT+ care side of the VA has actually been absolutely wonderful.  Even the folks in only semi-associated offices (like the endocrinology front office staff) have been great. 

The VA will not cover any surgeries, to include hair removal.  That part kinda sucks, especially since I really, really, REALLY am desperate for hair removal services.

Thanks for that info, MxRileyQuinn, and thank you for your service.   (Like Devlyn said, if you go to the Roll Call thread, a whole bunch of other folks are there, too).

They never mentioned the depilatory creams as being covered...I'll be asking them about that.

Agreed, the hair removal part is frustrating.  And, also, I wouldn't have expected them to cover anything hair-restoration related either, as that surgery is even more expensive....but, who knows, maybe after November, the rules will be revised in our favour again?  (it never hurts to dream)   

But, apparently, for certain hair systems (wigs, toppers, etc.), one salon in NJ is still saying that VA covers their cost for hair replacement, so I'm looking a lot more into that, too (I thought they stopped doing that back in 2018, but this business is insisting VA is still opting to cover them). 

But, for me a lot of this is on hold until the Canadian/US border is relaxed a bit more.  I just don't feel like dealing with that hassle (and, Medicare here in my province covers some of it, too....I just want to get it all documented with VA, too).

[Rakel]

In my experience, the VA provides the following services:

1. Mental health counseling
2. Medications
3. Lab tests
4. Voice training
5. Surgery to treat service connected injuries to the genitals, but not elective GCS

Other services may be allowed on a case by case basis and if not available at any VA facility, these services may be contracted to outside providers.

[TSL_NB]

So, I thought I would just post an update here.

I had a phone appointment with my primary provider (I still can't go directly to the clinic with all of the border-crossing complications), and they apparently do cover the hair replacement part, but it's now something they directly provide.

I'm really not as worried about that part as I used to be, but it's good to know it's covered....I'm more excited about getting the HRT ball rolling.

[Jane.Shannon]

The VA also has a great program for prosthetics which I think was easy for them to expand to include transgender people.  They will provide breast forms with 2 bras and gaffs or packers and binders.  I got a set of breast form through them, and they were really nice set that would have cost me $500+ on my own. 

I have also used the speech training.  It was very professional and helpful.

[TSL_NB]

The VA also has a great program for prosthetics which I think was easy for them to expand to include transgender people.  They will provide breast forms with 2 bras and gaffs or packers and binders.  I got a set of breast form through them, and they were really nice set that would have cost me $500+ on my own. 

I have also used the speech training.  It was very professional and helpful.

Overall, my clinic in Togus has been great.

The one big complaint I do have, though (not with Togus, but VA overall), is the whole 'Foreign Medical' program.  I qualify for a hair system, but their regulations apparently forbid them to actually mail it out to my address here in Canada, since my dysphoria isn't service-connected (which is ridiculous....it's a hairpiece, not narcotics!).
 
I really think that needs to be reworked to serve us better.  There should be no issue with mailing out a prosthetic to someone who lives outside of the US.

[Jane.Shannon]

For hair removal, I understand VA will do hair removal for surgery prep.  Meaning they will clear the genitals as prescribed by a surgeon. 

For facial hair removal, I wondering if their hand could be forced somehow.  Does anyone know, do they cover electrolysis for women diagnosed with hirsutism, which is excess facial hair growth?  I believe if they cover that, they have to cover facial hair removal for trans women too.  The same would apply to Tricare.

[Rakel]

For hair removal, I understand VA will do hair removal for surgery prep.  Meaning they will clear the genitals as prescribed by a surgeon. 

For facial hair removal, I wondering if their hand could be forced somehow.  Does anyone know, do they cover electrolysis for women diagnosed with hirsutism, which is excess facial hair growth?  I believe if they cover that, they have to cover facial hair removal for trans women too.  The same would apply to Tricare.

I have spent more money on facial hair removal than I did for my GCS. For us late transitioners, facial hair removal is a big expense, even if it is spread out over several years.

Fortunately, under the Biden administration, the VA system is doing a complete review of what should be covered  for medical transition services for veterans. The covered services by the VA may change in the near future.

[NCmuse]

 The VA will cover laser hair removal but I can only get 1 appointment every 3 months and have not had one for a year because of covid.  (I have spend over 5k out of pocket on electrolysis since my hair was turning grey before I started)
   I had a 3 year fight with the VA to get anything and I have a 100% rating.  I get hormones now from them, I see 2 Endo one locally every 6 months and once a year with a trans specialist.   I helped start a support group and right now the VA is very supportive of the group. I could get a wig and breast forms, however I opted to go out and get hair transplants (12k out of pocket) so I should not need a wig. While the transplants are growing back in I have a topper that is only about 4x4 but covers the bald spot on my head.  The LGBT coord keeps asking me if I want the breast forms but I don't think I would use them, though I may test them out.
   At the end of the month I will be giving a talk to the employees as part of their staff development making them aware of some of my personal issues with the VA and cheering on the VA workers who have helped me out.   
     I have had a good relationship with the mental health workers at the VA and I was on a special board examining and fixing issues in the Mental Health depart of my VA.   However it took 3 years to get a diagnosis everyone just turned it over to someone else. Hopefully after I give this staff development they will know where to direct their trans clients and I will even let them call me so I can put them in touch with the right people.
    They also set me up with voice lessons, however I was only half way through the program when Covid struck and doing on video just didn't seem to work for me.

[BritneyX]

For hair removal, I understand VA will do hair removal for surgery prep.  Meaning they will clear the genitals as prescribed by a surgeon. 

For facial hair removal, I wondering if their hand could be forced somehow.  Does anyone know, do they cover electrolysis for women diagnosed with hirsutism, which is excess facial hair growth?  I believe if they cover that, they have to cover facial hair removal for trans women too.  The same would apply to Tricare.

One thing for us older gals and the younger lasses with light facial hair folicles is that laser removal is rather ineffective for us.  The laser has to also have a skin contrast to focus the energy wavelenght on the base of the folicle.  If you have dark skin, this is also problematic.