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What good is improved VA gender policy if it’s inaccessible?

Commentary: Trans Progressive

In June of 2011 the Department of Veterans Affairs (VA) changed its policies for transgender veterans who access veterans’ services, especially the Veterans Healthcare Administration (VHA) portion of the VA system.

When the National Center for Transgender Equality (NCTE) announced the policy change, they stated that transgender veterans would be allowed to change their genders within the VA system to match their self-identified genders. NCTE published this question in their FAQ for the new federal policy:

“Does the new VA policy affect my medical records?

“Yes. The documented gender in the VA’s medical records will now reflect an individual’s self-identified gender. In order to change the name and gender in VA medical records, the individual must provide official documentation as per Veterans Health Administration policies.”

Here’s what VHA Directive 2011-024, the directive that announced the policy changes, stated:

“The documented sex in the Computerized Patient Record System (CPRS) should be consistent with the patient’s self-identified gender. In order to modify administrative data (e.g., name and sex) in CPRS, patients must provide official documentation as per current VHA policies on Identity Authentication for Health Care Services and Data Quality Requirements for Identity Management and Master Patient Index Functions.”

There weren’t any clearly enunciated policies in those two referenced documents.

Well, the clear intent of the VHA directive was to allow trans veterans to change their gender in the system to “consistent with the patient’s self-identified gender.” So, I tested the system for the NCTE and my peer trans veterans.

My gender in the VA was listed as male, so on three different occasions I provided documentation that indicated my self-identified gender was female. The last document I handed the VA was a letter from a medical doctor that was formatted exactly as required to change a sex marker with the State Department – the State Department being the government agency that issues passports.

And, it came back rejected. I filed an administrative appeal with the VA.

Because of that appeal, the VA clarified their policy. To quote the NCTE from their blog entry “Veterans Administration makes important clarification on records policy” (March 2):

“The VA has now clarified that this policy is intended to mirror the State Department passport policy. Effective immediately, to change the gender on VHA medical records, a vet must simply provide a letter from a physician certifying that the vet has changed genders and has had appropriate clinical treatment for gender transition. To be clear, the physician’s letter does not need to certify that some specific surgery or any particular medical procedure has been completed – only appropriate clinical care for the individual veteran as determined by the physician.”

With this clarification of VA policy I should have been able to easily change my gender with the VA. Yes, should have.

My appeal is the impetus the VA is using to hash out what their backend documentation policy regarding how many sex/gender markers there will be.

So, the VA changed their policy on gender markers to address the issue of people like me. But, I’m not allowed to avail myself of the relatively new policy because the VA is using my appeal to help clarify their backend documentation issues.

It all feels a bit bittersweet. It’ll work out in the long run, I’m sure, but in the short run … well, the VA misgenders me in a way my trans veteran peers don’t have to be misgendered.



Short URL: http://lgbtweekly.com/?p=29169

Posted by LGBT Weekly on Sep 20, 2012. Filed under Trans Progressive. You can follow any responses to this entry through the RSS 2.0. You can leave a response or trackback to this entry

13 Comments for “What good is improved VA gender policy if it’s inaccessible?”

  1. Maybe its that you got to have surgery or at least slme surgery before they change it. I know I had to prove Ive had some surgery to the mental health clinic here. And probably will have to do the same to my new GP’s office. As long as your pre op doctors staff will see you as and list you as a male. Just the way society works. GET THE SURGERIES!!!

    • I think you misunderstand. You can change your VA documentation/gender marker because of my efforts — I still can’t because of those efforts.

    • I would NEVER tell someone to “GET THE SURGERIES!!!”. In fact, my advice is, “if you can lI’ve without the surgery, do so!!!”. The last thing we need is yet another who made a mistake. At best , we get someone who tries to pressure people who need surgery to not have it. At worst someone commits suicide. And almost as bad, you have those who work to stop anyone from having surgery.

      No, surgery is not for everyone. That is what differentiates transsexuals from those who are transgender. If you don’t want to actually change your sex, you are not transsexual. And if you have. It actually changed your sex, it is fraudulent to claim you have. That seems pretty simple and reasonable.

  2. While the whole process does require one to have patience, it was rather simple for me, I went in with the documentation from my doctor, and accompanied it with my the Legal Name and Gender Change paperwork from the Courts. Had copies to have filed in the VA administration office, and all of my personal information was updated in less than 72 hours.
    However I have not had the same luck in obtaining my DD-215 to reflect my new name.
    If anyone is in need of help, if they contact the Women’s Clinic at their local Vaterans Hospital, there are individuals that are available at request to assist you in this process.

    Best of luck

  3. How does one change their gender? And if you can change your gender, why don’t you simply change it to match your sex? I cahanged my we, because my gender has always been female. I don’t. Elieve gender is mutable. That is why transsexuals correct our bodies. You can change your gender presentation in order to “transgress” gender, but that is something entirely different. I was able to change my medical records in spite of objections from hospital officials (not VA, at a university medical center) because my doctor, who believed my medical condition was real, went to bat for me. I was seeking SRS, not just the illusion of being female. Now I am female. I do not believe people who wish to remain physically male should have records changed.

    • Your opinion doesn’t reflect the VA policy. My column is based on VA policy, not on the beliefs of those who embrace your beliefs about the policy.

      • I’ve changed my genitalia as you’re quite aware I have. I apparently haven’t changed my body to your satisfaction.

        California and the VA don’t agree with your opinion — again,. one can change your VA documentation/gender marker/sex because of my efforts — I still can’t because of those efforts. Your opinion is totally irrelevant.

        • Actually, you have only had the equivalent of a oopherectomy for a female (removal of the ovaries). I’m sorry, but your genitalia remains male. My dog had been neutered. He is still classified as a male. And no, you managed to take advantage of a vaguely worded law to fo a judge. I seriously doubt you made it clear what was actually being claimed. In fact, in San Francisco the court makes it clear that actual SEX reassignment surgery is STILL required. So, you haven’t changed your body to the satisfaction of a court where such cases are regularly heard. You may be happy with a bit of legal fiction, but when it comes down to it, you will still be viewed as male by about 99% of society if the know all the facts. If you are happy with that, that is your right. But I honestly believe you are doing more harm than good. Such a case will ultimately lead to a legal decision that could hurt many.

        • Oh, and my opinion may be irrelevant to YOU, but it is more than a bit presumptive to suggest that it is totally irrelevant. Funny how that sounds so familiar. Now under what circumstances have I seen someone presume to tell another that her opinion is irrelevant? Hmmm…p

      • Oh, and you do realize that a more conservative president, and yes, there will be one sooner or later, will simply reverse the rules. And the more extreme changes will result in major backlash. Again, you are doing more harm than good. Right now, most accept transsexuals who have had surgery as legitimate. Asking society to accept “females with penises” is way too much. And it will almost certainly not end well. The only question is, how badly will it end?

  4. How is what’s in our pants anyone’s business? I thought they were called private parts for a reason.

  5. It’s been a while since this was posted, I thought I would anyone who comes across this what this woman’s efforts has done :) ; I am the wife of a war veteran transman. The VA is doing all they can to make things possible. We have been paying out of pocket for head doctors and hormones. With those two “outside providers” things are actually pushing forward. There is a flaw in the system now. There is a program called (or once called) Fee-basis. If the VA doctors are on board and you are classified in the computer system as transgender and have the Phyc evaluation from a VA phycologist. That program will pay for your surgery. It’s jus the VA must deem it so. The amended birth certificate, and letter of successful corrected surgery. The name will change in the system in a matter of hours. I praise and commend you Autumn! You are one hell of a fearless female. And thank you!!!

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