Out-of-Control VA: Sex Changes Over Service Dogs

Transgender people cannot openly serve in the U.S. Armed Forces, but Department of Veterans Affairs has proposed paying for former military personnel to get sex-reassignment surgery.

At the same time, the VA will not pay for specially trained service dogs to aid veterans suffering from post-traumatic stress disorder.

“It underscores a confusion of priorities when we have 22 veterans per day committing suicide, and the number, tragically, is probably higher than that,” said Cole Thomas Lyle, a former Marine corporal and advocate of the use of dogs as an alternative to medication.

“It is really confusing when you see the VA amidst the wait-list scandal … to be doing something that affects an extremely small percentage of the U.S. military,” he said.

The VA currently pays for counseling, hormone treatments, and other services for veterans with gender dysphoria, a condition when a person feels trapped in the wrong gender. But the VA has a formal ban on taxpayer-funded gender-reassignment surgeries. The agency has submitted a proposed rule to the Office of Management and Budget to change that.

The agency said in its notice that previous knowledge about the condition was limited, and authorities deemed surgery to be medically unnecessary.

“However, increased understanding of both gender dysphoria and surgical techniques in this area have improved significantly, and surgical procedures are now widely accepted in the medical community as medically necessary treatment for gender dysphoria,” the notice states.

The VA stated that under the proposed rule, qualifying for surgery would be decided on a case-by-case basis.

Lyle said it is an odd priority for an agency that has been racked by scandal in recent years, including revelations that some veterans died waiting for treatment. He pointed to reports that the new rule has been in the works since 2014 and noted the continuing outrage over veteran wait times in the VA system. VA Secretary Robert McDonald recently revived controversy on the issue with comments comparing veteran wait-times to amusement park lines at Disney.

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“It is really confusing when you see the VA amidst the wait-list scandal … to be doing something that affects an extremely small percentage of the U.S. military,” he said.  “They’ve spent a significant amount of time formulating strategy.”

As for Lyle’s cause, trained service dogs to assist vets with PTSD, he said the VA has still not accepted the benefits. The agency’s position is that more research is needed to determine if the program works. Lyle said some members of Congress have also raised concerns about cost, although advocates have proposed paying for the service in a way that would not affect patient care elsewhere — by taking the money from the agency’s administrative and training budget.

Lyle pointed to a number of studies that have shown a correlation between the dogs and improved mental health. And he said he knows from personal experience. The veteran of 400 days in the Afghanistan war zone said he came home suffering the effects of PTSD. He said a private organization provided him with a German shepherd named Kaya, who has been trained to wake him when he is having nightmares and to recognize anxiety attacks.

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“They’re kind of dragging their feet on the issue,” he said. “I think there’s plenty of evidence.”

In the absence of movement by the VA, Rep. Ron DeSantis has sponsored legislation to direct the agency to carry out a pilot program to provide service dogs to some veterans struggling with the psychological toll of war.

But the Obama administration’s priorities are clear. The proposed sex-change rule comes on the heels of a directive from the Justice Department trying to compel every public school system in the country to allow transgender students to use the bathrooms of their choice, regardless of their biological sex.

The Pentagon in February proposed adding non-surgical hormone therapy for gender dysphoria to the military’s Tricare insurance coverage, according to Stars & Stripes. That followed a decision by Medicare in May 2014 to begin covering sex-change operations.

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The ban on transgender service members is also on its way out. Defense Secretary Ash Carter set a deadline earlier this year to study the issue, and although the military has not yet issued a final directive, most observers believe it is only a matter of time.

The VA has not offered any estimates of how many surgeries might be performed or what the cost to the taxpayers would be. Some LGBT advocates estimated that as many as 15,000 transgender peopled serve in the military. In 2013, according to USA Today, the VA treated 2,567 veterans diagnosed with gender dysphoria.

By contrast, DeSantis’ office cites statistics indicating that 29 percent of Operation Iraqi Freedom and Operation Enduring Freedom veterans suffer from PTSD.