Phoenix va

[Robbyv213]

I have been enrolled in the VA since 2015, I've lived in 4 different states since then. The last state I physically went in to my primary care doctor was in Maryland.

Since moving to Phoenix Az area I have never done anything with the VA besides update my contact info using the online portal. I never went into eligibility or enrollment for a new local primary care physician.

I figured I had to go into the main branch here in Phoenix and enroll and find a new doctor in person. Turns out while attempting to apply online it said I was already enrolled in the local VA, which again I had never done anything besides update my contact information. Again I was under the impression I had to enroll and choose another primary care doctor to get the ball rolling on using the VA for transitional care through the VA.

I have reached out to the local LGBTQ rep for the Phoenix area VA, they are currently working with me to get set up with a good primary care doctor and to get other things moving in the right direction.

I will update as I have more. My goal was to try to get 1 thing done a month with the VA. My goal for June is to get a new primary care doctor. July hopefully have my 1st appointment, Aug 2nd appointment and so on. May actually be a lot quicker than 1 appointment a month or so but we will see.

[Robbyv213]

I had a phone call with the Phoenix LGBTQ sponsor/coordinator, Dr Ash helped explain alot of things to me about the VA in general and specific questions I had about gendering affirming care that they offer here in Phoenix and the surrounding area. As of right now the game plan is to get my first initial appointment scheduled and completed with a new primary care physician, and then meet back with Dr Ash and discuss a game plan for me based on what I feel transitioning looks like for me at this time. Since I'm in no rush and have to talk to my wife about me being on hormones and getting her used to the idea or on board with it, Dr Ash feels certain things can wait and to get basic things completed first. However that being said Dr Ash did say I don't need a primary care Dr to refer me to their gender affirming care team to get those services. So if I wanted to start hormones asap then Dr Ash would get that process rolling and get me aet up with one of their teams the get that going, and then I could get with a primary care physician at a later time that is convenient.

I found out that the Phoenix area VA covers a lot of things from therapy, prosthetics, hormones, hair removal, voice training, however Dr Ash did mention that some surgeries are covered as long as there is a medical condition, not just based on a gender dysphoria diagnosis. So for example if a female to male wants to have top surgery their also has to be a medical condition that goes with it like having breast cancer or something that would suggest medically his breast should be removed other than just a diagnosis of gender dysphoria. Dr Ash was not super specific about as to what surgeries are covered (and or how to get them covered) if any.

So anyways I finally feel like I'm making progress, even if it's baby steps. 1 thing at a time. I def can't wait to discuss with Dr Ash about a transition 'game plan" for myself and get placed with one of their gender affirming care teams.

[Lori Dee]

Robby,

That is great news! I am so happy you have a good coordinator to help you navigate the system. You are correct about things needing to be "medically necessary" to be covered. If someone has testicular cancer or injury, an orchiectomy could be "medically necessary". However, a transgender person with gender dysphoria cannot have that exact same surgery. But we are working on changing that.

Ask Dr. Ash if they have a Transgender Support Group you can join. I have found it very helpful. I got to meet some of the other transgender veterans there and it helps so you don't feel alone in this. For a long time, I wondered if I was the only trans vet in South Dakota. Now that we have all met, I see them in the grocery store or out and about.

I look forward to your progress and anything you care to share.

[Robbyv213]

@LoriDee I did ask, and Dr Ash said that they're working on having more VA support group meetings, but she said most of the trans vets she works with and their families go to the trans spectrum of az meetings which I have looked into, just been difficult trying to find the time and schedule to make it happen. But Dr Ash said that they all have said very positive things about it. So hopefully I can attend one soon and hopefully make it a regular thing.

Yes I am excited to feel like I'm finally make steps in the right direction even if it's just very basic beginner things that need to get done first before the bigger steps can be taken. I definitely want to find out more about the hair removal and what they cover or don't and if it's for specific parts of the body or anything and everything, or if it's a you get one free body part like for example your face and then once that's finished with how ever many sessions it takes then next body part is not 100% covered ( just an example) I am not sure how it works since they partner with a non gov  health spa that does their hair removal services for them.

But yes very excited to be making some progress even if it's just administratively. Lol

[Lori Dee]

On hair removal, the VA does cover it as medically necessary for transgender veterans. When a consult is submitted, it doesn't specify any number of sessions. So ongoing return visits are covered because the hair is still being removed. That is for facial hair.

For genital hair removal, it is covered under the Pre-op necessity. The VA covers everything needed to prepare for surgery: hair removal, mental health evaluation, surgical recommendation letters, EKG and lab tests, etc. They do not cover the surgery itself. But all post-op care is also covered: bandages, catheters, pain medication, etc.

When I got my consult, they sent me to a local dermatology clinic that does laser for facial hair removal. The PA that did the treatment told me that laser would not be effective because most of my facial hair is white or gray. She reported back to my Primary, recommending electrolysis. So the consult was re-worded to specify electrolysis for facial hair removal. The Medical Chief of Staff here approved the request as medically necessary. But there is no one locally who does electrolysis. So I have been fighting to get them to send me someplace that does it.

I was told that there are no VA facilities anywhere in the US that can do electrolysis in-house. Those that offer it, are sending vets to community providers, as you mentioned. However, since those providers are not local to me, they are not able to refer me to them. I have been fighting this battle since 2019. There is a lot of talk that indicates someone is trying to fix this, but for now, it is just talk and not helpful to me.

I hope you have a good result. If they do electrolysis there, please let me know. I have been unable to locate any electrolysis provider that works with the VA anywhere in the country.

[Robbyv213]

@LoriDee I will be sure to update you more as when I find out more of the specifics for what they offer and cover here for the hair removal and if the community spa that works with them here does electrolysis or not.