The Department of Veterans Affairs is moving to provide gender-confirmation surgery through its health care coverage, reversing a 2013 ban, VA Secretary Denis McDonough announced Saturday.

McDonough pledged to overcome a “dark history” of discrimination and take steps to expand access to care for transgender veterans at a Pride Month event in Orlando, which this month marked the fifth anniversary of a mass shooting at Pulse, a gay nightclub, that left 49 people dead. The VA plans to begin the two-year process this summer, a VA spokesman confirmed.

“This time will allow VA to develop capacity to meet the surgical needs that transgender veterans have called for and deserved for a long time,” McDonough said to a crowd gathered at the Orlando event, “and I am proud to begin the process of delivering it.”

The change marks a significant departure from VA under President Donald Trump, who limited transgender people from serving in the military, a prohibition reversed by President Biden soon after he took office. In 2013, while Biden was vice president, a department directive said VA “does not provide sex reassignment surgery,” effectively preventing transgender veterans from a surgery considered medically necessary by the World Professional Association for Transgender Health.

The federal rulemaking process, expected to begin this summer, will include a period for public comment, spokesman Terrence Hayes told The Washington Post on Saturday.

Although the cost to VA is unknown, it is estimated that fewer than 4,000 veterans would be interested in this surgery, Hayes wrote in an email. The National Center for Transgender Equality estimates that there are about 134,000 transgender veterans.

Some people treat gender dysphoria, a feeling that the body a person is born into does not conform to one’s gender identity, with medical treatments or transition-related surgeries.

Suicidal thoughts and mental illness are experienced at a far higher rate for LGBTQ veterans than those outside the community, McDonough noted. In addition to psychological distress, they also may experience prejudice and stigma. About 80 percent of LGBTQ veterans have encountered a hurtful or rejecting experience in the military because of their gender identity, McDonough said.

Transgender veterans have reported suicidal thoughts disproportionately compared with other veterans or the general population, recent studies have found.

“We’re making these changes not only because they are the right thing to do but because they can save lives,” McDonough said in prepared remarks.

He said VA would also change the name of the Veterans Health Administration’s LGBT health program to the LGBTQ+ Health Program to reflect inclusiveness.

McDonough praised the facility he spoke at, Orlando Vet Center, sharing a story about a transgender woman who struggled with depression and suicidal thoughts until she was able to seek care.

Since taking office, Biden has reoriented the federal government’s posture on transgender issues, expanding protections for transgender students and reviving anti-bias safeguards in health care for transgender people.

In Florida, where McDonough spoke, Gov. Ron DeSantis (R) signed a bill this month preventing transgender athletes from participating in school sports, a move critics described as an “attack” on the community.

Noting the law signed by DeSantis, Gina Duncan, director of transgender equality for the statewide LGBTQ civil rights organization Equality Florida, told the Orlando Sentinel that her agency was “thrilled to have allies at the highest level of government.”

“In a moment of fierce state and local backlash against the transgender community, this move by the Biden administration is a reminder that elections matter,” Duncan said. “Support for transgender veterans and the lifesaving health care they need to live authentically is a critical component to fulfilling our nation’s promise of caring for those who’ve served.”

The Department of Veterans Affairs headquarters in Washington, D.C.

The Department of Veterans Affairs headquarters in Washington, D.C. (Joe Gromelski/Stars and Stripes)

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