I am trying to find out what I need to do to prove that the surgery's i need to get done will be classified medically necessary by the VA hospital so i can get them done. Unfortunately even with the advancements from the regular health insurance companies the VA is sadly extremely behind. I will update this thread as I find any information out and let others know what has worked for me. I ask that if anyone has some information if they would please share it.

The surgery's i need to get done are BA, FFS, and GRS.

Look forward to sharing what i find and hearing back from others.

As far as I am aware, the VA doesn't do those surgeries or condone them and is kind of a gray area. It's basically up to the particular hospital or clinic to decide how far to go. However, good news is that as of 2012, the VA can no longer discriminate based on Gender identity. For example, I've talked to my local clinic and I can get hormones should I be without employer health care. There is a pdf out there that describes the VA non discrimination policy. I can't remember where I found it. What I would do is talk to your VA doctors and mental health services and see what they say.

Yeah, the surgery's are a REAL gray area for the VA. But i can say i am getting all of my hormones through them and i am also getting speech therapy. The speech therapist flat out said she's never done anything like what i needed, but she was willing to learn how to help from other therapists and resources. So far i think shes done good but it is slow progress.

Here's the pdf of VA Directive 2013: http://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2863

Not really a gray area:

6. Will VA provide sex reassignment surgery and plastic reconstructive surgery if needed?

VA does not provide sex reassignment surgery in VA facilities or through non VA care. In
addition, VA does not provide plastic reconstructive surgery for strictly cosmetic purposes in VA
facilities or through non VA care. However, patients with GID or other gender dysphoria conditions
may elect to have one or more medical or surgical procedures over their lifetime to bring their bodies in
to a closer alignment with their perceived gender.

NOTE:
Only a minority of transgender Veterans will undergo sex reassignment surgery, as their symptoms may often be
adequately treated with other therapeutic interventions. Some Veterans receiving care at the VA
may have had sex reassignment surgery somewhere else. The VA does provide health care to
pre- and post-operative transsexual Veterans, including treatment of surgical complications.

And to my understanding it all is done after receiving a DD214 correct?

Yes, are you active duty now?

Active drilling National Guard. Tricare covers the therapist but I don't know how much more as it goes more into the transitioning aspect.

Yeah the gray area commes in the they will not provide any cosmetic surgey, but if you can prove to everyone involved that it will not be cosmetic but medically nessary than surgerys like BA or FFS become an option, but then they also could say its all part of " surgeies to change genders". I know ill be starting the fight with them to try and get those 2 covered. I will keep everyone posted with how it goes.

   In reality, do you really want someone at the VA preforming these delicate operations on you? I would not. Go to a professional who specializes in them. I tried to get an orchi done by them and after a year they told me they would not do it basically because I am a transsexual and it was not approved under the VA directive. I have a pro picked for GCS and that is all I will have done,to put it mildly if I were a car they would send me to the crusher besides its the bottom that bothers me anyway.  Good luck girl !   Patty

I'm a nurse for the VA and as far as I know the idea of covering any gender-related surgery for vets has not come up. Aetna was just offered as an option for employees and GRS is covered but they say everything else is not so I'm going to fight to prove medical necessity when it's time.

The VA is very supportive of trans vets and employees so things may change in the future.

My FTM boyfriend is a veteran, no longer in the service, and all of his healthcare has been covered thus far by the VA (mental health, hormones, bloodwork, etc.) with the exception of surgery. I'm not sure if that was because he wanted to go to a particular surgeon who doesn't accept any kind of insurance or if they told him they wouldn't cover it. I think it would be worth some research though!