Late Breaking News
In February, the VA released a directive regarding “Providing Health Care for Transgender and Intersex Veterans.” The directive makes the medical facility director, chief of staff and associate director for patient care services or nurse executive responsible for ensuring that “transgender patients and intersex individuals are provided all care included in VA’s medical benefits package.” The covered services include hormonal therapy, mental health care, preoperative evaluation and medically necessary post-operative and long-term care following sex reassignment surgery.
In Dallas, the VA has proposed to establish a dedicated transgender clinic, following the model of clinics already operational in Minneapolis and Boston. Currently, behavioral health specialists coordinate care for the approximately 30 self-identified transgender or intersex patients who seek care through the Dallas VAMC, said Alan Bernstein, associate director for patient care services.
“Our goal is to provide services to this population in a sensitive manner and ensure that all their health care needs are met,” Gwen Robinson, RN, associate chief nursing service for perioperative care at the Dallas VAMC, told U.S. Medicine. “With a dedicated clinic, we would have providers that are more expert in the specific needs and we could provide more services, such as peer-to-peer counseling. There may be a population we do not get to see right now but may pull in, once we offer more services and reach out to the community.”
Dallas is not waiting to expand its services or train clinicians and staff, however. “We are training all healthcare providers about the specific care of transgender and intersex individuals and cultural sensitivity,” using the nationally developed tools, Bernstein said.
Transgender and intersex employees can already participate in peer-to-peer counseling. Patients, however, are still referred to behavioral health specialists for counseling.
The Dallas VA does not know how many veterans would use the dedicated clinic, but suspects it could have significant demand. A study in the International Journal of Sexual Health found that veterans comprise 30% of the transgender community, three times the rate seen in the general population and that transgender veterans used VA services at a higher rate than other veterans. The Transgender American Veterans Association estimates that about 300,000 transgender individuals currently serve or have served in the U.S. Armed Forces. 3
- Simpson TL, Balsam K, Cochran BN, Lehavot K, Gold SD. “Veterans administration health care utilization among sexual minority veterans.” Psychol Serv. 2013;10:223–232.
- Kristin M. Mattocks, Michael R. Kauth, Theo Sandfort, Alexis R. Matza, J. Cherry Sullivan, and Jillian C. Shipherd. “Understanding health-care needs of sexual and gender minority veterans: How targeted research and policy can improve health.” LGBT Health. June 2013. Ahead of print.
- Shipherd JC, Mizock L, Maguen S, Green KE. “Male-to-Female Transgender Veterans and VA Health Care Utilization.” International Journal of Sexual Health. January 2012.