I received a call today from my local LGBTQ+ Veterans Care Coordinator.

She informed me that there have been some changes regarding transgender hair removal. Previously, hair removal for transgender veterans was determined on a case by case basis, so coverage varied from facility to facility.

THAT HAS NOW CHANGED.

VA Directive 1341 was amended on 18 AUG 2024. There were some changes made to make the VA's language more inclusive for the Gender Diverse (everyone in the Q+ part of LGBTQ+) so that providers understand what that means for veterans who identify as such.

The policy regarding hair removal is now that it is medically necessary. Period. Not on a case by case basis, and not determined by the local facility.

A copy of the amended Directive can be downloaded in PDF format HERE.

Scroll down to FAQ #25, which states:

25.  Is hair removal (electrolysis/laser hair removal) covered by the VA for
transgender Veterans?

In accordance with medical benefits package provided by 38 Code of Federal
Regulations (C.F.R) § 17.38, VHA provides Veterans with care that is determined by
appropriate health care professionals to be needed to promote, preserve, or restore the
health of the individual and is in accord with generally accepted standards of medical
practice. Medical necessity is established when hair removal or reduction will treat a
diagnosis, including but not limited to: polycystic ovary syndrome (PCOS), congenital
adrenal hyperplasia, Cushing's disease/syndrome, hidradenitis suppurativa, pilonidal
disease, prosthesis-related folliculitis, gender dysphoria or gender incongruence,
pseudofolliculitis barbae (PFB), acne keloidalis nuchae and other follicular disorders, or
other causes of hirsutism. This includes permanent/semi-permanent hair removal
procedures for transgender and gender diverse Veterans to include presurgical hair
removal, as well as removal of facial and body hair to establish patterns that are
congruent with the Veteran's gender identity.

(Bold font added by me for clarity).

This is a big win, but we still have a way to go to push for gender affirming surgeries.
Progress at the speed of government. 

Yes that's awesome. My Endo said the same thing, but when I asked which areas of the body it's covered for it was left pretty vague. And during my appointment call with the outside VA salon for the hair removal they said typically surgical areas or face only, but I doubt they received the latest guidelines for it

Quote from: Robbyv213 on October 30, 2024, 01:25:32 PMYes that's awesome. My Endo said the same thing, but when I asked which areas of the body it's covered for it was left pretty vague. And during my appointment call with the outside VA salon for the hair removal they said typically surgical areas or face only, but I doubt they received the latest guidelines for it

Use that link to download the Directive and print out FAQ #25 which specifies "face and body hair". My knees are part of my body, so I want it all done. Get rid of everything below my eyelashes. 

That's how I feel. I want all hair gone below my nose

If I go to my appointment this weekend and they only say they only do face and pre surgical areas. Even after showing them a copy of the newest policy for VA regarding hair removal, is my next course of action getting a hold of the LGBT rep for the Phoenix area and getting them involved? I'm just expecting push back so I can be prepared to go in with all the ammo I might need depending on how the appointment goes

Quote from: Robbyv213 on October 30, 2024, 03:25:01 PMIf I go to my appointment this weekend and they only say they only do face and pre surgical areas. Even after showing them a copy of the newest policy for VA regarding hair removal, is my next course of action getting a hold of the LGBT rep for the Phoenix area and getting them involved? I'm just expecting push back so I can be prepared to go in with all the ammo I might need depending on how the appointment goes

That would be what I would do. Have them start on face. Then have the LGBTQ Rep get clarification to them. They shouldn't care as long as the VA is paying them for it. The VA consult should specify what is being done, i.e. what Tri-Care is going to pay for. The LGBTQ Rep can help make sure that part is covered per the Directive. They might need to add something to your chart that clarifies that ALL body hair is a trigger for your dysphoria.

It may not be a problem, but you are right to be armed and ready just in case.

Ok sounds good. So at worst I might need to have another session with mental health so they can say yes all body hair vs just the norm they used to deal with.

Quote from: Robbyv213 on October 30, 2024, 03:45:02 PMOk sounds good. So at worst I might need to have another session with mental health so they can say yes all body hair vs just the norm they used to deal with.

Your Primary may just go ahead and make sure the consult says what it needs to. I did have a follow-up with mental health to verify that hair removal was medically necessary. It never hurts to ask. 

Hi Robby and Lori

Just a couple of points that you may consider in hair removal.  As you know, I started HRT immediately when I changed my life around and I started electrolysis on my face about three months in, I was working by then, although I had savings.

If I remember correctly, after those initial three months, I had electrolysis sessions on my face every weekend. Then, on Sunday evenings, I would wax my face, and during the week, I just used makeup. I suspect the combination of HRT and waxing contributed to my facial hairs turning white, so I was able to look "smooth" for most of the week, if you know what I mean.

Regarding my body hair, I was fortunate not to have any on my chest or back.  I had hairs on my legs and arms, I never shaved them, maybe once or twice and for me it was a real chore or pain to do so.  My legs were periodically waxed professionally and when they were not, I wore stockings.  For my arms I realised that other girls had hairier arms than I did.  So I stopped worrying about them altogether.

One time while having my legs waxed I noticed that they had become very fine and I thought they would break off at the surface and from then on, I do not think I have ever had my legs waxed again.  Recently I noticed that my arms and legs appeared to be hairless.  Upon close inspection I could see very fine barely there vellum hairs.

So what is my point?  I guess it's a combination of 3 things. Take your HRT, wax as needed and remember that plenty of women have to deal with a hairy body.

Best Wishes Always
Sarah B
Global Moderator