So I have my last mental health appointment today through the VA.

Since the government reversed some of the policies for gender affirming care specifically for or through the VA the information that my therapist told me specifically for the Phoenix area va's that as of right now they're no longer sending people out for laser hair removal. That basically the government completely canceled the Nationwide contract with whatever salons they were using for it so now basically if you wanted laser hair removal you have to pay out of pocket for it. I'm not sure if individuals who still have days weeks or months left on their approval for laser hair if that will be able to be used until it runs out and they just can't put in a request to add more time or if it's completely gone even if you were just approved for 6 months.

They are no longer referring people over for voice therapy. Again she said that if you were already approved for it and already had a session or two or in the middle of your sessions she doesn't know if they're going to be canceled or if you can continue seeing them or not they she just knows that they are not sending people over new people over for voice.

With the endocrinologist and hormones she said people that are already on hormones will continue to receive care but no one knew will be referred for hormone therapy until policies change. And those individuals who are currently receiving treatment there's no guarantee that that may change in the future.

Prosthetics and wigs and things of that nature she said that if you're already approved for a specific amount that you should be able to use it but double check with whatever community Care business that they're having you go through first before you go out and get a wig or whatever other type of prosthetic and then you wind up getting a bill from the VA through the mail.

And as of right now she said mental health is still seeing their clients and they're still at this point accepting clients but again they're not able to make any referrals for any other care if they weren't already approved and enrolled in that care before these policies came out.

And from what she said that there was no real communication from their supervisors about any of this and how to actually implement it so what the Phoenix VA is doing may not necessarily be what your local VA is doing.

So it seems as of right now the only things that existing patience can receive is hormones and mental health therapy sessions and whatever else mental health does like writing up letters for surgeries or whatever the case may be. But if you're not already on hormones the VA will not refer you to get on hormones at this point. They may write a letter for you so that you can go out in town to get hormones and pay out of pocket for them but they won't send you to a VA facility for hormones at this point if you don't already have them.

So I guess just keep an eye out for future policy changes. I'm sure at some point they're going to revoke All Care.

Quote from: Robbyv213 on April 24, 2025, 03:42:33 PMAnd from what she said that there was no real communication from their supervisors about any of this and how to actually implement it so what the Phoenix VA is doing may not necessarily be what your local VA is doing.

Thanks, Robby. My VA 'talk' therapist is out of Butte, MT, and didn't mention any of that to me during today's session. She kicked our next session a month down the road, primarily to accommodate visit limits currently in place. However, I did ask her about additional transitioning services during a previous visit, and she said, for me, there aren't any. I'll take what I can get and, no doubt, other VA clients know far more than I do. But it is not looking good for any of us.

Yeah she basically said that at least here for the Phoenix VA they're going to just continue doing whatever they can until they're told they can't. That because of the policy change there wasn't really any guidance on how to implement any of it so all the va's are kind of doing their own thing as to how they interpret how the policy should be enforced.

She said that if you're already receiving care for certain things as of right now you'll continue to receive it but like I said they basically aren't covering everything else that they used to. 

So basically at least here in Phoenix if you're in existing patient you'll still be able to get hormones you'll still be able to use mental health to an extent and mental health will still be able to write any kind of letters you may need for the time being.

Speech therapy laser hair removal and prosthetics are basically all off the table and I'm not sure if you're already approved for it or already receiving it and still have a chunk of time left if they're going to be able to continue to see you or not.

for example I know I have till about mid-may for laser hair removal I don't know if I try to get one in say this weekend if they're going to cover it or not.

I was already approved for 500 bucks for a wig but again I don't know if it's still covered or not since I haven't used it yet

And I've only had one session with a speech therapist so far and I haven't scheduled any more again I don't know if they'll continue seeing me or not I know they're not accepting any new referrals for anything related to gender affirming care.

I met with my psychologist on Monday, and what you have stated does seem to be the policy nationwide. The mental health and LGBTQ Care Coordinators are still doing their jobs because they are in the best position to recommend various types of care.

I have one session left in my Voice Training online with the Iowa City VA. Iowa has recently changed their State law, so I doubt they will be seeing any trans patients for voice. All of my healthcare team had agreed to provide me with letters when I see them in June, before I move to Colorado. They will also issue me a "vacation supplement" of all of my meds to hold me over until I can get care established after the move. They also have connections with the VA in Colorado and have offered to contact them to let them know I am coming and what my needs are.

But new patients are SOL. I think that is a crappy way to treat any veteran, but "Orange Man Bad" as they say.

The angle that I am working on is to get the VA to recognize that I am a woman. They do, but my records show that I am trans. As a woman, laser hair removal and/or electrolysis is a recognized treatment for hirsutism. I am trying to get that diagnosis in my charts so that the VA can cover treatment.    Likewise, wigs are covered for women with alopecia. So if you can get them to enter a diagnosis in your charts, we may have a loophole. My other meds are already covered as "hormone replacement," which is appropriate for any woman my age.

I have a friend who owns an accounting business, and he would often tell me (while doing tax returns) that it is not what you say but how you say it.

I am hoping that all veterans will be treated well.

Chrissy

As you were I just found this gem.

https://www.politico.com/news/2025/04/24/transgender-troops-military-care-00306827

Granted the article is more geared to active duty service members not specifically veterans. But if they're opposing it for active service members until a court decides then I can't see they would not do the same for veterans shortly afterwards

Quote from: Robbyv213 on April 24, 2025, 06:47:57 PMGranted the article is more geared to active duty service members not specifically veterans.

I often wonder where we would be without the courts. There seems to be scant adherence to the rule of law from any other branch of government. If I was still a young, wide-eyed idealist, I would become a Constitutional attorney (lawyer, advocate? I don't know, whatever it was that Barack Obama decided to study in law school).

Quote from: Robbyv213 on April 24, 2025, 06:27:35 PMAs you were I just found this gem.

https://www.politico.com/news/2025/04/24/transgender-troops-military-care-00306827

That is good for active duty military, but doesn't help veterans. The Department of Defense and Department of Veterans Affairs are two separate agencies under Trump. While the Pentagon is in court battle for the DoD personnel, the VA's policy still shows Directive 1341(c) as rescinded. Even if the DoD is ordered to remove all bans, the Department of Veterans Affairs can continue on until they get dragged into court for the same reasons.

I hope that the DoD policy gets a final ruling as unconstitutional. That would pave the way for lawsuits against the VA to get its policy ruled the same.

Yea hopefully it's a step in the right direction depending on the official ruling, when ever that happens.

Since my VA therapist scheduled our next session for late in May, I asked her if she would be willing to read a little story I wrote about a trans-woman and a cis-woman who fall deeply in love. My therapist has considerable experience with many LGBTQ+ veterans but confessed I'm the first one that fell in 'T' category, so, I thought the story might help her understand me and she enthusiastically agreed to look at it. I was a bit surprised when she directed me to send it to her VA e-mail, but, what the heck, I sent it to her. I find it pleasingly ironic that somewhere in the VA internet system, a tale with a trans protagonist is floating about in the ether connecting me to a million VA computers.   

I just received a phone call from my Voice Therapist in Iowa City, Iowa. Her supervisors have been instructed to cancel all long-term follow-up appointments.

Those who are in the middle, where appointments are close together, may continue. Since my appointment was a 6-month follow-up scheduled for July, it has been cancelled.

She also confirmed what @Robbyv213 stated, that voice, prosthetics (wigs, breastforms, binders, packers), and hair removal have been discontinued for Gender Affirming Care.

To receive these services, you will need a diagnosis other than GAF, such as alopecia, hirsutism, or speech pathology. HRT and mental health services are not affected at this time.

I bet my voice therapy is cancelled as well then. I only had one and never set the second one up yet.

I need to call them Monday. I'm sure I already know the answer but I mind as well.

For laser, I call the salon that the Phoenix VA uses and they confirmed that they're only aloud to finish out what ever contracts they already have. They are not getting any new ones.

I called the wig shop as well, and I'm waiting for a response if my original approval is still good or if it was void.

I just heard from the wig shop the lady said that she actually just had a veteran come in today and use their voucher which was approved around the same time as mine and her VA voucher for a wig did go through no issues.

So I'm hoping that since it was already approved that mine will go through as well when I'm actually ready to use it here in a week or two once the wigs that I ordered it come in for me to try

Quote from: Robbyv213 on April 25, 2025, 07:25:22 PMI just heard from the wig shop the lady said that she actually just had a veteran come in today and use their voucher which was approved around the same time as mine and her VA voucher for a wig did go through no issues.

So I'm hoping that since it was already approved that mine will go through as well when I'm actually ready to use it here in a week or two once the wigs that I ordered it come in for me to try

I hope it does go through.  I also hope the wigs are nice.  I did not get an expensive one until after I tried a number of the less expensive ones and learned how to wear them, style them to the extent I could, clean them, and store them.

Now I only have the wigs that have hair longer than my own.  I usually do not wear a wig.

I hope this all works out well for you.

Chrissy

By the way, if you like downward bangs, it is possible to add a clip-in front bang to your appearance with a wig, if your wig has not already been styled and cut to have front bangs.  Not every color is available, the main colors have these available.  You would get these at a wig salon or at a beauty supply store.  The bang hair just blends in and lets you have a slightly different look.

@ChrissyRyan that's good information. I didn't know any of that was even an option.

Most of the wigs at this shop offer wigs from 50- well over 500. The ones I'm looking at are in the ball park of 400-500. I had them order as many different styles they could from the one specific brand I like in the correct size for my large head. With those options there were only about 6-7 total wigs that they make for a large front lace synthetic wig.

All the other brands didn't fit well or correctly.

Also this wig shop does clean cut and style wigs as well.

So when the rest of the wigs come in there will be about 3-4 more I have never tried on yet.. Hopefully out of all those wigs I'll find one that I feel suits me best.

But unfortunately I feel I could try any wig on and I won't like it. I feel my face is too masculine right now for me to really like what ever I see in the mirror, be it a wig I'm trying, clothes, or make up.

Quote from: Robbyv213 on April 28, 2025, 12:59:48 PM@ChrissyRyan that's good information. I didn't know any of that was even an option.

Most of the wigs at this shop offer wigs from 50- well over 500. The ones I'm looking at are in the ball park of 400-500. I had them order as many different styles they could from the one specific brand I like in the correct size for my large head. With those options there were only about 6-7 total wigs that they make for a large front lace synthetic wig.

All the other brands didn't fit well or correctly.

Also this wig shop does clean cut and style wigs as well.

So when the rest of the wigs come in there will be about 3-4 more I have never tried on yet.. Hopefully out of all those wigs I'll find one that I feel suits me best.

But unfortunately I feel I could try any wig on and I won't like it. I feel my face is too masculine right now for me to really like what ever I see in the mirror, be it a wig I'm trying, clothes, or make up.

Robby,

I hear you.  I get the masculine face thing concern. 

You will look more feminine with a stylish, nice fitting wig of the right color for your face.

Wear a typical top you think you may be wearing with the wigs as you try them on, if possible.  Remember that no matter how much you like wig with hair of a particular color, it may not work well for you.  Also consider wearing a little makeup.

I have some foam wig heads for storing and light styling (non-professional!) at home. 
They are not necessary for at home storage but they are not expensive.  These will take up more space compared to a wig in a dresser drawer.

Hope it all works out well. 

Chrissy

I notice the same thing, Robby. What makes a BIG difference is to do your makeup first. Even if it is just a little eyeliner and lipstick. Then put the wig on. You will see the difference. Without makeup, we tend to see the same old masculine face. But a clean shave, eyeliner to make those eyes pop, and a touch of lipstick changes what you see to a more feminine image. Your brain will register this immediately. Then the wig will either add to the look, or not so much.

@Robbyv213