Guest Blogger

Transgender veterans and navigating the VA system

Filed By Guest Blogger | February 26, 2009 1:00 PM | comments

Filed in: Living, Transgender & Intersex
Tags: Arizona, Arizona Daily Star, health care reform, military, Monica Helms, NCTE, tava, transgender veterans, VA, Veterans Administration

Editors' note: Monica Helms is the president of the Transgender American Veterans Association.

For the first time since the Transgender American Veterans Association existed, a mainstream print media has dedicated an extensive amount of space to present the stories of transgender veterans and the problems they face. In a two-part series, journalist Carol Ann Alaimo spent over three weeks of interviews, research and education to come up with this two-article, 3500-word essay on our veterans.

Alaimo, the military journalist for Tucson's Arizona Daily Star, told me that she got interested in transgender veterans when she discovered the TAVA web site and read the survey we did last year. From there, she found transgender veterans in Tucson and spoke with many of them.

I am absolutely impressed with all the work she put into the two articles. As Sunday came to a close, there were already over 150 comments on her first article. By the end of Monday, the second article had nearly 200 comments. Then we also found the articles appearing on Military.com, with equal number of comments.

Some veterans seem to think that if we transitioned after serving in the military that somehow gives the VA the right to deny us services. They brought up Don't Ask, Don't Tell and the Uniform Code of Military Justice (UCMJ) as a way to justify this. The UCMJ and DADT only apply to those people who currently serve in the military and have nothing to with veterans or the VA. Talk about grasping at straws to justify discrimination and hate.

Transgender vets: A hidden population

In this article, Alaimo focused on the people she interviewed, one of them being a friend or mine, Erin Russ. She pointed out all of the problems Erin has encountered, problems we all have faced at one time or another. Here is a quote from Erin that made a strong point.

"This is something I think nobody wants to talk about," said Russ, 52. "Transgender veterans basically make other people rethink their preconceived ideas of what a veteran is. We don't just push the envelope -- we crumple it up and throw it away."

Alaimo follows with:

Mocked by strangers and often shortchanged by the veteran's health-care system, these ex-troops say they get little of the respect accorded to those they served alongside.

She also sites a study titled "Transsexuals in the Military: Flight Into Hypermasculinity," (links to pdf) written in 1988 by Dr. George R. Brown, then an Air Force captain and psychiatrist at Wright-Patterson Air Force Base in Ohio. She also cites the Boston VA policy as being one of the most comprehensive documents from a VA facility in regards to transgender veterans.

One of the most compelling stories was that of Mick Andoso, a trans man who served 20 years and became a decorated Master Sgt. in the Air Force. In 1994, Master Sgt. Brenda Weichelt was named one of the service's top airmen for her work at the military's Defense Language Institute in California. Since then, Mick Andoso has had nothing but scorn and disrespect by many VA personnel. Transgender veterans see this as typical treatment in our VA system.

VA reviewing policy against transsexual surgery

The second article had some interesting information from Alaimo, some of which has already been disseminated to our veterans, such as the Boston VA policy. She interviewed Dr. Jillian Shipherd who actually created the policy in Boston.

Here is some of what Alaimo found in her research:

Officials at VA headquarters, given 10 business days to answer, said they couldn't determine how many transgender patients are in the VA system nationwide.
Officials at the Southern Arizona VA Health Care System -- Tucson's veterans hospital -- said 48 VA patients in Southern Arizona are transsexual or have been diagnosed at some point with "gender-identity disorder," the medical term that covers such cases.

A national advocacy group (TAVA) estimates that about 300,000 active or retired military personnel are transgender, though experts say an accurate count is impossible because many live under the radar to escape social stigma.

Alaimo then spoke with someone at the VA to ask them why the VA doesn't follow the American Medical Association's policy toward transsexual people.

"VA is in the process of rewriting its directive excluding gender-reassignment surgery and will be conducting a review of the evidence base on this issue," VA spokesman Terry Jemison said. "The current policy may continue or may change, but our decision will be based on the available evidence, not on the AMA's resolution."

The American Medical Association said many surgeries that help transgender patients -- such as removal of breasts, testicles or ovaries -- are routinely covered for other patients for various medical reasons.

Denying such coverage to transgender people "represents discrimination based solely on a patient's gender identity," the doctors group said.

What Jemison said hit us all like a rock. The VA is actually reviewing the policy on gender reconstruction surgery? This sounded like great news... until we realized that they have been reviewing the policy without contacting any transgender person or organization. Both TAVA and NCTE have not been made aware of this.

In order to find out who in the VA could be doing the review, I called the man whom Alaimo spoke with, Terry Jemison. To find him, I had to call the main VA number in DC and they gave me his number. I left him a voice message and the next day, Tuesday, 2/24/09, I got a call from him. Jemison works in the Office of Public Affairs.

The first subject I brought up had to do with the statement he made to Alaimo when she pointed out to him that according to the TAVA survey of 2008, 10% of the transgender veterans who used the VA have at one time been turned away for being trans and 25 % have experienced disrespect by VA people. Some of those stated that they had their medical records shown to people not involved in their case, a strict violation of The Health Insurance Portability and Accountability Act of 1996, (HIPAA) Privacy Rule. In the article, he stated:

Jemison, the national VA spokesman, said the VA "does not condone withholding delivery of routine medical care for transgender patients anywhere in our system."

At first, he said to me that those who have been turned away may not have been qualified for VA medical service. I quickly pointed out the case of a 100% disabled trans man who got out on a Medical Discharge, went to the DC facility and was turned away, only to drive 60 miles north to the Baltimore VA and received treatment. He couldn't respond to that. Then he gave me a toll-free number, 800-488-8244 for the Office of Patient Care Service, telling me that if anyone had a problem or were being disrespected, they needed to call that number. As far as TAVA is concerned, the VA needs to address the issue overall rather than addressing it one person at a time. It would make more sense to have a directive pertaining to our veterans. But, our government never makes much sense.

Then I brought up the policy review and he said that the people doing the review would be in the same Office of Patient Care Services. He stated that he would pass on my name and number to the people at that location and they will call me. The Office of Public Affairs did not have the authority to change policy.

To see what I would get by dialing the toll-free number, I called to hear a series of options. I could not determine what option our people had to use in order to file a complaint, but I could have missed it.

Not one to give up easily, I called Virginia Copland, the Secretary for the VA Secretary, Gen. Eric K. Shinseki. She and I had spoken before on other issues, before Obama took office, so she gave me a couple of other phone numbers to try. At one number the person worked in the VA Statistics Dept, which could not help me, but he gave me another number to try. I then asked him if he would do a study on how many transgender people use the VA, but he didn't seem interested.

I tried a number for the VA's General Council and left my name and concerns with the receptionist there. A few hours later, I received a call from Eric Raun, an attorney for the VA and we discussed the issues. Raun had also spoken with Terry Jemison about this and stated that the people who would be revising the transgender veterans health policy work for the Veterans Health Administration and Jemison will have someone from there give me a call. They happen to be the same people who can address the discrimination and disrespect problems facing transgender veterans.

As one can see, trying to narrow down the proper people who make decisions in the VA is an exercise in patients and futility. Even though I can call the Secretary for the VA Secretary, I hesitate to ask a favor of her to get the chance to meet with Gen. Shinseki or even present something to him. TAVA wants to work with the proper people making the decisions.

But, if I have learned anything in the Navy it would be to ensure you have a backup plan and that someone will watch your six ("watch your back" for the civilian types.) Right now, two of my friends will soon approach their friends in Congress who work in veteran issues to see if they can also set up a meeting with the VA officials involved in reviewing the transgender veterans' health care. The ball is rolling and is in the VA's court. The story doesn't end here, by all means.


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Thanks for sharing the articles. I read the first one just a second ago. It is cool that so far most of the comments are positive. Also interesting is that the negative remarks get high thumbs down votes while the positive comments get high thumbs up votes.

I saw the articles and, yes, they are very good and a welcome breath of fresh air. Its great that a newspaper covered this issue. It will be even better if more coverage is forthcoming.

But I didn't think about doing the sort of follow through that you have done. You're really on the ball! I'm impressed that you have been treated with respect, and given information by the folks at the VA. Bureaucracies have ways of shutting people out, but it doesn't seem to have happened with you. Good job!

I do have one question. You wrote:
The UCMJ and DADT only apply to those people who currently serve in the military and have nothing to with veterans or the VA.

Of course the Department of Veterans Affairs and the Department of Defense are completely separate. So the UCMJ is irrelevant with regard to the VA. However, I heard that the UCMJ still applies to anyone receiving a military pension. Maybe I was told wrong, but I am wondering if there could be problems leading to a military pension being cutoff?

Dale,
I don't think it affects pensions or benefits. I know many retired trans veterans and they are getting the money like clockwork. If the UCMJ did affect pensions or benefits, I would think it would have been used as a way to discriminate against us a few decades ago.

The hardest time I have is to convince vets that what they had on active duty is not the VA.

A plug for a veterans group that works hard for all vets, National Association of Black Veterans (NABVETS). I am proud to be a member of NABVETS. We are a service organization working hard to get vets in to the VA system and make sure they are treated well.

Monica, I'm always amazed at how much work you put into TAVA. You are an inspiration to org leaders around the country for your tenacity and dedication to the cause.

Bil,
I couldn't do it without the help and inspiration of the other board members and all transgender veterans. They are the true force behind TAVA. I'm just along for the ride, going where they take me. They deserve the credit.

Wendy R. Moore | July 23, 2009 12:46 PM

As a transwoman, I have nothing but praise for the treatment I have received at my local Veteran's Hospital. I have never been disrespected, mistreated or denigrated by staff.

I am intensely unhappy about the refusal of the VA to provide reassignment surgery is a holdover from past administrations.

I remain proudly a vet and proudly a transwoman. Monica, I wasn't aware of your organization until I googled VA policy. Thank you for your hard work.

Wendy - WIll you please clarify something for me? I served 12 years active duty in the Air Force. I am a MtF transsexual, but I did not disclose any of this to anybody while in the military. Now a 30% disabled veteran living in Florida, I am wondering if I am eligible for anything from HRT to SRS?