<p>The Department of Veterans Affairs for years defied a rule barring “gender alterations&#8221; to provide procedures designed to help people present as the opposite sex, internal documents obtained by The Daily Wire show.</p>
<p>The VA, known for providing prosthetic limbs to war heroes who suffered wounds on the battlefield, provided prosthetic penises called &#8220;3-in-1 (pee/pack/play),&#8221; as well as prosthetics designed to look like breasts, chest binders, wigs, and dilators for fake vaginas, the documents show.</p>
<p>Federal regulations exclude “gender alterations” from the medical services the VA is permitted to provide. But the VA interpreted that phrase narrowly, to mean only the surgeries themselves. “Since 2011, VA has provided all medically necessary transition-related care for transgender and gender diverse Veterans except surgeries,” one document said.</p>
<p>The Biden administration also stretched the definition of “medically necessary.” While a 2020 document said that hair removal was cosmetic and could not be covered, a document from the Biden administration taught VA staff how to pay outside providers to laser-remove the hair on a transgender person&#8217;s &#8220;face/neck, back, chest, abdomen, or genitalia,&#8221; and to record it with a vague &#8220;unlisted procedure code for skin, mucous membrane, and subcutaneous tissue.&#8221;</p>
<p>The VA even gave a presentation to &#8220;parking attendants or valets, maintenance staff, [and] housekeepers,&#8221; forcing them to “Articulate the key elements of VHA’s Directive on Providing Health Care for Transgender and Intersex Veterans” and training them to &#8220;ask the Veteran what name, gender, and pronoun, the Veteran prefers&#8221; so they could place them in shared hospital rooms with a member of the gender with which they identified.</p>
<p>The Trump administration on Monday said that, in accordance with the president&#8217;s <a href="https://www.whitehouse.gov/presidential-actions/2025/01/defending-women-from-gender-ideology-extremism-and-restoring-biological-truth-to-the-federal-government/">executive order</a> on Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government, it would stop providing “medical treatments for gender dysphoria,” except for those who had already begun the treatments at the VA. In the years preceding, the Biden administration took extraordinary steps to expand the services it provided to those pursuing a gender transition.</p>
<p>Biden-era documents said that the department intended to change the regulations to also cover surgeries, but that the process could take years. A document called &#8220;Gender-Affirming Care at VA: Resources for Providers&#8221; said that &#8220;While VA cannot provide gender-affirming surgeries <i>at this time</i>,&#8221; it would diagnose them with gender dysphoria, put them on hormones, give them voice training, store their eggs or sperm, remove their body hair, and write letters convincing outside surgeons to perform the surgery.</p>
<p>An April 2024 presentation by an &#8220;LGBTQ+ Veterans Care Coordinator&#8221; added that the VA would also cover &#8220;medically necessary post-operative and long-term care following gender-affirming surgery.&#8221; It also construed that broadly, including revision surgeries and testicle removal if there were complications with prescription hormones.</p>
<p>There were trainings for VA providers on &#8220;diagnosing gender dysphoria&#8221; and &#8220;assessment of readiness and consent for hormone therapy,&#8221; including showing how staff could use the VA computer system to book a &#8220;transgender and gender diverse national e-consult” that would connect local medical staff to specialized transgender &#8220;expert hub teams” in Minneapolis and Tucson.</p>
<p>The e-consult screen triggered a warning that &#8220;for individuals still active in the military (e.g., Guard, Reserves, Active Duty) transgender identity can be grounds for discharge and their VA medical records are accessible by the military.&#8221;</p>
<p>The department — whose motto is the Abraham Lincoln quote, &#8220;To care for him who shall have borne the battle and for his widow, and his orphan” — offered classes on how men could make their voices higher, called the &#8220;Gender-Affirming Program with Speech (GAPS).&#8221; The program entailed &#8220;4-8 individual sessions with a speech-language pathologist&#8221; who not only helped men with &#8220;achieving your authentic and affirming voice,&#8221; but also taught tips to make sure that their laughs, coughs, and sneezes didn&#8217;t give them away as men.</p>
<p>The VA used a form letter to convince outside doctors to perform genital surgery on veterans, giving the impression that it was written specifically for one patient after close observation. It said &#8220;I support (honorific) XXXX&#8217;s decision to undergo genital surgery, and I am available for coordination of care,&#8221; and asked VA doctors to fill in the blanks and sign their name to it. Another version said “We are of the opinion that [veteran] meets all of the criteria for a vaginoplasty, as set forth in the WPATH Standards of Care, Version 7.&#8221;</p>
<p>The VA also allowed veterans to change the “birth sex” field on their medical records, saying “despite the medical implications…this is the Veteran’s right.”</p>
<div id="attachment_892645" style="width: 1034px" class="wp-caption alignnone"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-892645" class="size-large wp-image-892645" src="https://dw-wp-production.imgix.net/2025/03/form-letter-1024x171.jpg" alt="" width="1024" height="171" srcset="https://dw-wp-production.imgix.net/2025/03/form-letter-1024x171.jpg 1024w, https://dw-wp-production.imgix.net/2025/03/form-letter-300x50.jpg 300w, https://dw-wp-production.imgix.net/2025/03/form-letter-768x128.jpg 768w, https://dw-wp-production.imgix.net/2025/03/form-letter-1536x256.jpg 1536w, https://dw-wp-production.imgix.net/2025/03/form-letter.jpg 1680w" sizes=" (max-width: 1024px) 100vw, 1024px" /><p id="caption-attachment-892645" class="wp-caption-text">VA transgender surgery form letter</p></div>
<p>Veterans Affairs Secretary Doug Collins said on Monday, in connection with the announcement that all such services will come to an end, that he&#8217;s confident &#8220;this is the right decision.&#8221;</p>
<p>“I mean no disrespect to anyone, but VA should not be focused on helping Veterans attempt to change their sex,&#8221; Veterans Affairs Secretary Doug Collins said in the statement. &#8220;The vast majority of Veterans and Americans agree, and that is why this is the right decision.”</p>
<p>“All savings VA achieves by stopping specific medical treatments for gender dysphoria will be redirected to help severely injured VA beneficiaries — such as paralyzed Veterans and amputees — regain their independence,” the department said in a statement.</p>
<p>&#8220;All eligible Veterans — including trans-identified Veterans — will always be welcome at VA and will always receive the benefits and services they’ve earned under the law. But if Veterans want to attempt to change their sex, they can do so on their own dime.”</p>
<p>The VA &#8220;has not kept consistent and reliable records regarding the total number of Veterans who endured these procedures, the total amount of money spent on them or the total number of employees involved,&#8221; the department said in its statement. &#8220;Veterans Health Administration estimates indicate that less than one tenth of one percent of the 9.1 million Veterans enrolled in VA health care are trans-identified.”</p>
<p>The statement also noted that the “VA’s LGBTQ+ Veteran Care Coordinator (VCC) and VISN Lead roles are not affected by this policy change, as they ensure clinically competent, Veteran-centered, and effective care,&#8221; and that bathrooms and patient rooms across VA facilities are now segregated by birth sex. The statement also noted the VA had rescinded Veterans Health Administration Directive 1341(4), which provided for certain transgender services.</p>

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Biden Department Of Veterans Affairs Provided Transgender Procedures Despite Ban, Documents Show