My spouse is a post op m2f and I'm asking for her.

She has liver problems, specifically cirrhosis of the liver, and the FNP that she went to at our local VAMC she felt not only dropped the ball, but in the charts continuously reported my spouse as a 'post op transexual' and then proceeded to use 'he' throughout the notes as well as 'male appropriately dressed'. 

Her liver enzymes had gone from slightly elevated to cirrhotic with little to no followup... though they did chart they were following 'appropriate measures'.

After filing a complaint with the local vets rep, apparently a chief doctor there went through the chart & stated it was appropriate to note the gender distinction as there are slight differences in disease process from those that are male vs female.

Essentially... any one can argue there are slight variations in response to ANYTHING in the human body from male vs female paving the way for blatant discrimination for any post op trans.  He's essentially saying its ok to mark male in the charts & continue this ...

This gets me seething mad because they're using lawyer logic to discriminate.  And its pretty obvious.  To add insult to injury, the EEOC manager, Cynthia McCass kept using 'he' when referring to my spouse on the phone call despite being corrected.   This is blatant and utter discrimination.  They know she went through the sex change operation (SRS).  They know she goes by she... yet feel justified in this blatant disregard for the patients rights.

Do you folks have any recommendations on an appropriate response to this?  They already took MONTHS to get back to her on her complaint.  Is there anything that can even be done?  Fighting a behemoth like the VAMC... is probably a losing battle if they're going to automatically assume any VA employees were in the right & the patient is wrong (which is how every interaction with them felt like).

Have you contacted the national center for transgender equality, The ACLU or lamda legal? One and 3 definitely look up.


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I've had issues as well. I'm early in my transition, but it doesn't hurt any less. Referencing her as male isn't entirely wrong as genetically she is. There are subtle differences anatomically. But metabolically she is female. But there is NO excuse to refer to her as "he" at any point. I've only been with the VA for about 9 months at this point. I'm constantly referred to as MR. (My new legal name). Even before I speak! (My voice isn't very feminine yet). I completely get your frustration.

As Gertrude suggested, you could contact one of those organisations to get some sort of legal action, or at least pressure them. I suggest downloading and reading VHA Directive 1341. That is the rules that the VA are to follow in regards to transgender (and intersex) patients.

Quote from: StacyRenee on August 07, 2018, 05:17:32 PM
I've had issues as well. I'm early in my transition, but it doesn't hurt any less. Referencing her as male isn't entirely wrong as genetically she is. There are subtle differences anatomically. But metabolically she is female. But there is NO excuse to refer to her as "he" at any point. I've only been with the VA for about 9 months at this point. I'm constantly referred to as MR. (My new legal name). Even before I speak! (My voice isn't very feminine yet). I completely get your frustration.

As Gertrude suggested, you could contact one of those organisations to get some sort of legal action, or at least pressure them. I suggest downloading and reading VHA Directive 1341. That is the rules that the VA are to follow in regards to transgender (and intersex) patients.

Thank you both for this info, I will do that.

The sad part was the EEO manager continuously violated their own ordinance in this.  They know my spouse refers to herself as a female, she, etc... yet continued to use 'him' at least 2 dozen times on the phone.

It just showed me all they did was 'close the ranks' and didn't give one bit of care to the veterens actual wishes or care.  REading up on directive 1341 they clearly violated their own rules.. multiple times, and most likely hoped we we just be swept under the rug.

Our plans are to first inform them of this violation, and take it from there.  This will not end how they want it.

Hi Doreen,

The VA can be a tough system to deal with...and work within.  What I found during my service with them was that was a lot of good policy & procedure, high standards and expectations, and good working guidelines.  But...so many working within the system just don't follow them.  There tended to be this "meh" kind of attitude in some areas or with some groups.  It drove me nuts.  So much so that I couldn't stay. 

You're going to have to keep pressing and pushing, and probably escalating.  Just don't take your foot off the gas if you want to get some kind of satisfactory resolution. 

I have zero love for the VA for many of the reasons already mentioned.  But if you can manage to hold someone accountable for this crap that they have grown so accustomed to getting away with, you'll be doing everyone a great service.

Are they doing this because her BC/License/IDs are not listing her as female?  I recently changed my name and gender with the VAMC in Missouri and wonder if they require the system to be updated with her sex as F to feel obliged to use her proper pronouns?  I would not put it past them to hang on some technicality like that.

Quote from: ainsley on August 08, 2018, 11:22:26 AM
Are they doing this because her BC/License/IDs are not listing her as female?  I recently changed my name and gender with the VAMC in Missouri and wonder if they require the system to be updated with her sex as F to feel obliged to use her proper pronouns?  I would not put it past them to hang on some technicality like that.

When I registered with the VA I had already changed both my photo ID and my BC. But my DD-214 still had my old name which was distinctively male. Not to mention 90% of patients at the VA are male, and with an ambiguous name like Stacy, they often just assume (at least in my case).

Quote from: Doreen on August 07, 2018, 11:10:46 AM
My spouse is a post op m2f and I'm asking for her.

She has liver problems, specifically cirrhosis of the liver, and the FNP that she went to at our local VAMC she felt not only dropped the ball, but in the charts continuously reported my spouse as a 'post op transexual' and then proceeded to use 'he' throughout the notes as well as 'male appropriately dressed'. 

Her liver enzymes had gone from slightly elevated to cirrhotic with little to no followup... though they did chart they were following 'appropriate measures'.

After filing a complaint with the local vets rep, apparently a chief doctor there went through the chart & stated it was appropriate to note the gender distinction as there are slight differences in disease process from those that are male vs female.

Essentially... any one can argue there are slight variations in response to ANYTHING in the human body from male vs female paving the way for blatant discrimination for any post op trans.  He's essentially saying its ok to mark male in the charts & continue this ...

This gets me seething mad because they're using lawyer logic to discriminate.  And its pretty obvious.  To add insult to injury, the EEOC manager, Cynthia McCass kept using 'he' when referring to my spouse on the phone call despite being corrected.   This is blatant and utter discrimination.  They know she went through the sex change operation (SRS).  They know she goes by she... yet feel justified in this blatant disregard for the patients rights.

Do you folks have any recommendations on an appropriate response to this?  They already took MONTHS to get back to her on her complaint.  Is there anything that can even be done?  Fighting a behemoth like the VAMC... is probably a losing battle if they're going to automatically assume any VA employees were in the right & the patient is wrong (which is how every interaction with them felt like).

Have you tried the Patient Advocate? https://www.va.gov/health/patientadvocate/

Quote from: ainsley on August 08, 2018, 11:22:26 AM
Are they doing this because her BC/License/IDs are not listing her as female?  I recently changed my name and gender with the VAMC in Missouri and wonder if they require the system to be updated with her sex as F to feel obliged to use her proper pronouns?  I would not put it past them to hang on some technicality like that.

I don't use the VA, I get my care from Fenway Health, a top rated LGBTIQ clinic. My medical records state male. Which is fine by me, I want my remaining male bits healthy and monitored. Denying that I have them gets me nowhere but an oncology ward.

Hugs, Devlyn

Quote from: StacyRenee on August 08, 2018, 04:43:49 PM
When I registered with the VA I had already changed both my photo ID and my BC. But my DD-214 still had my old name which was distinctively male. Not to mention 90% of patients at the VA are male, and with an ambiguous name like Stacy, they often just assume (at least in my case).

I think everything of my spouses is changed except the DD-214 like yours, still has the old name.  I think she's still having issues with some of the gender markings in the charts not being changed, and some are.  Its a mess and it seems noones willing to be her advocate.

On that note, she did see the patient advocate who then sent her on to the EEO manager who... was the one that basically helped 'close ranks' against her.  And herself discriminated as was abundantly evident in her interactions with me about my spouse.

Thanks for all the thoughts & advice, I'm giving all of them serious thoughts.