Transgender veterans' health services in question as VA rescinds guidance on care
Link to Full Article
NPR - Huo Jingnan
March 14, 20258:35 PM ET

The Veterans Affairs Department on Friday reversed a policy that had protected gender-affirming healthcare provided to transgender veterans, causing confusion and fear in the community.

In an internal VA memo seen by NPR Friday, the VA says it's rescinding Directive 1341, which contains detailed guidance on the kinds of care transgender veterans can receive at VA facilities. The policy had also directed healthcare providers to use pronouns veterans preferred, directed facilities to allow veterans to use bathrooms and be assigned rooms in accordance with their self-identified gender.

The internal memo said that the rescission of the directive "does not affect existing clinical guidance" and that the VA "affirms its commitment to provide care to all Veterans."

In the internal memo, the VA also said it will "conduct a comprehensive review of care with respect to trans-identifying Veterans and will undergo the rulemaking process to revise the medical benefits package as deemed necessary".

Even before the VA rescinded Directive 1341 on Friday, VA staff members told NPR that they have been receiving more calls from trans veterans worried about trusting their healthcare providers.

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The rescinded VA Directive 1341 only addresses healthcare benefits for transgender veterans. Healthcare for LGBQ veterans is covered under VA Directive 1340 and is apparently unaffected at this time. The LGBTQ+ Patient Care website is still operational, although it has been edited to remove videos and the link to download a copy of Directive 1341 is now broken.

Thank you for your service.

That VA webpage is located at: https://www.patientcare.va.gov/lgbt/

Special thanks to @ChrissyRyan for finding this news article for us.

UPDATE: I have downloaded a copy of the VA Memo that rescinds VA Directive 1341(4) concerning patient care for transgender and intersex veterans.

You can download a copy at:
https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=12188

The important paragraph in the Memo is paragraph 3:

3. To comply with Executive Order 14168 of January 20, 2025, VA is rescinding
VHA Directive 1341(4). In addition, VA will conduct a comprehensive review of care with
respect to trans-identifying Veterans and will undergo the rulemaking process to revise
the medical benefits package as deemed necessary; however, this rescission does not
affect existing clinical guidance.

As we saw back in 2016, when the then-Secretary of Veterans Affairs promised to begin the rulemaking process to authorize coverage of gender-affirming surgeries, nothing happened. Eight years later, the Transgender American Veterans Association asked the court to force the VA to make a decision. It never made it in front of a judge. The VA made a decision and decided to refuse coverage.

This "rulemaking process" to amend the medical benefits package may follow a similar track, i.e., get delayed for years and end up with no changes at all. However, with the current Directive rescinded, that means that VA care providers are without official guidance, so the effects of that are unknown.

The end of that paragraph goes on to state, " ... however, this rescission does not affect existing clinical guidance." That means that providers can continue doing what they are currently doing. The problem is that without an official Directive, Medical Chiefs of Staff at each VA healthcare system can make their own local policies.

I have a wonderful medical team here in Rapid City, SD. They will all do what they can to continue treating me as they always have. BUT, they have a boss that they answer to. And that boss has a boss, and so on up the line, ending at the White House.

I will be talking to my healthcare providers at the VA on Monday morning. I suggest that all veterans who receive ANY care from the VA talk to your providers to see how this will affect your care.

IMPORTANT UPDATE

I have met with VA personnel today for clarification on the VA's policy and the rescinding of VA Directive 1341(4).

The following is a direct quote from the memo dated today, March 17, 2025:

March 17, 2025
RESCISSION OF VHA DIRECTIVE 1341(4), PROVIDING HEALTH CARE FOR
TRANSGENDER AND INTERSEX VETERANS

1. To comply with Executive Order 14168, dated January 20, 2025, the Department of
Veterans Affairs (VA) hereby rescinds Veterans Health Administration (VHA) Directive
1341(4), Providing Health Care for Transgender and Intersex Veterans, dated May 23,
2018. A prior draft rescission was erroneously promulgated on March 14, 2025, and is
void.

2. VA affirms its commitment to providing respectful and dignified care to all Veterans.

3. Veterans who have a current diagnosis or history of, or exhibit symptoms consistent with gender dysphoria, shall receive cross-sex hormone therapy only if:

a. Such Veterans are already receiving such care by VA as of the date of this notice;
or
b. Such care was provided as part of and upon separation from military service, if otherwise qualified for VA Health Care.

4. Veterans who do not meet the criteria in paragraph 3 above are not eligible for cross-sex hormone therapy through VA Health Care.

5. Veterans who have a diagnosis or history of, or exhibit symptoms consistent with gender dysphoria, shall continue to receive comprehensive health care, which includes preventive and mental health care.

6. VA does not provide any other medical or any surgical therapy for gender dysphoria.

_________________

If you have been diagnosed with gender dysphoria, and are currently receiving medications (hormone therapy), that treatment will continue. If you do not yet have a diagnosis or are not already receiving treatment, you will not be started on hormone therapy through the VA.

This also indicates that things like Voice Training and hair removal will no longer be covered, if you are not currently receiving this treatment. Check with your provider for questions about non-hormonal treatment for gender dysphoria.

A "public-facing version" of this memo was posted on the VA website at:

VA to phase out treatment for gender dysphoria
https://news.va.gov/press-room/va-to-phase-out-treatment-for-gender-dysphoria/

If you are a veteran in crisis, please call the Veterans Crisis Line:
Call: 988 (Press 1)

<<Stunned SILENCE>>

As we are already in the system, we should be okay.  We'll have to see where this goes.  I have appointment tomorrow.  Back in the closet or pay out of pocket for any other vets.

I am so sorry for this loss of VA paid services for those impacted.

Not good for our veterans.


Chrissy