Documents Reveal VA Hospital's Plan to Increase Sex-Reassignment Surgeries, Double Down on Gender Ideology

A Department of Veterans Affairs (VA) facility in Seattle, Washington, requested more than half a million dollars in fiscal year 2023 to build and staff a surgical facility to perform transitional surgeries of gender, although the VA has not yet approved those procedures, documents obtained by the Daily Caller News Foundation show.

The facility has offered hormone therapy, minor surgeries, hair removal and other treatments for decades as part of an effort to expand the procedures aimed at about 12,500 veterans nationwide who have been diagnosed as gender dysphoric, according to the documents obtained by the DCNF through the DCNF. public records requests. However, documents and emails show the VA medical center in Puget Sound also estimated to incur costs of $642,562 in 2023 and more than $1.5 million in 2027 in an initial proposal to the health system in VA to fund the establishment of a genital surgery center.

Veterans Affairs Puget Sound applied to the Veterans Health Administration's (VHA) National Office of Surgery (NSO) for funding to hire surgeons, purchase equipment and hire nurses and staff for the so-called Comprehensive Surgical Center of Gender Statement (CGASC), the documents show.

It was unclear from the documents whether the VA approved Puget Sound's application, and a VA spokesman said neither facility had built CGASC..

“No VA facility, including VA Puget Sound, has or is developing comprehensive gender-affirming care surgery centers,” VA spokesman Terrence Hayes told the DCNF. “While the rulemaking process on gender affirmation surgery at VA is still ongoing, VA continues to provide all other types of gender affirmation care to veterans.”

The VA has not yet implemented a proposal announced in 2021 to expand VA coverage of transgender procedures, including major surgeries. A defense group sued the VA on Thursday about the delay in implementing the rule, arguing that the withholding of services “saves lives” for about 4,000 veterans nationwide interested in a major sex change. procedures will aggravate his anxiety, Military Times reported.

But the VHA told VA Puget Sound that funding to specifically support existing transgender treatment programs was available in fiscal year 2023, which ended Sept. 30, the documents show.

“Seattle is a sanctuary city for LGBTQ+ refugees from across the United States,” the proposal said, referencing a 2022 study that found Washington state was home to the fourth-highest population of veterans diagnosed with gender dysphoria. genre. “Our facility is committed to continuing and expanding these medically necessary life-saving services,” the proposal said.

The two proposals seen by the DCNF, one of which appears to be a revision of the other, are undated, however emails beginning in April 2023, hospital and VA staff develop an updated proposal after the initial response from the National Surgeon General's Office.

The VA medical plan already covers a variety of transgender treatments, including gender transition hormones and prostheses such as breast implants, and will provide letters of support to surgeons and private insurance providers for reassignment surgeries of sex, an information sheet. shows. He may also perform surgeries to address complications from major sex reassignment operations. Undersecretary Denis McDonough, the VA has come out strongly in favor of implementing major sex reassignment surgeries, seconds on the website.

These surgeries include vaginoplasty, which is the construction of a fake vagina in men, and phalloplasty or metoidioplasty, two different procedures that involve the surgical construction of a fake penis in women.

In the first year, Puget Sound planned to hire two plastic surgeons, a urologist, nurses, social workers, psychiatrists and psychologists, a pelvic physical therapist and other staff to build the CGASC, the proposal shows.

The facility also requested $30,000 for specific hospital equipment to perform gender transition surgeries in the first year. In 2024, the installation expected pay $102,000 for a laser hair removal machine. Budget requests for immediate and future equipment totaled $159,000. A separate proposal among the documents obtained by the DCNF they ask for $149,000 in equipment.

Neither proposal had a specific date, but the latter appeared to be coming later, noting that “given the anticipated scope of the gender-affirming surgery program, we have decided to move forward with hiring a surgery NP/PA and wound care [nurse] a [fiscal year 2024,] which is a change from our initial proposal”.

Another budget item allocated $500 annually for a “Veterans Study to participate in monthly feedback meetings,” according to the proposal.

The main challenge in setting up a gender surgery clinic appeared to be providing hair removal services given an expected increase in demand.

Emails discussing the proposal show staff and professionals at Seattle Children's Hospital and the VA discussing ways to manage the expected complications that arise from major sex-change operations, which can occur up to 50 percent of the time of phalloplasty cases and less in other genital surgeries.

“This appears to be an opportunity for us to request additional resources (beyond those in the initial proposal) to strengthen our proposed program,” wrote Alexander Skokan, a trauma and reconstructive urologist and assistant professor of urology at the University of Washington. an email dated April 9, 2023 after describing the complications.

“They're probably not sure if our proposal is strong enough [of] the doors and so that's probably a critical piece to underpin our application,” he added, referring to the NSO.

At the time, veterans with complications were likely receiving community care referrals from the VA to the University of Washington College of Medicine, according to Skokan.

Although the facility was prepared to manage minor complications and some chronic problems such as post-vaginoplasty urethral stricture, the center lacked physicians with the appropriate expertise to treat more complex problems.

Puget Sound is “working closely” with surgeons at the University of Washington Medical. The doctors are “actively seeking the expansion of these surgeries at the VA Puget Sound HCS,” the proposal said.

The proposals include estimated annual salaries of $330,000 to $371,000 for professionals to perform major cosmetic procedures.

McDonough, the VA secretary, said in June 2023 that federal regulation to approve major sex-change surgeries across the VA was sitting on his desk, but he had not yet decided to authorize it, Military.com reported.

Then, he didn't explain why, other than that, he wanted time to study politics.

“As the person who asked for this and as the person who will defend the policy when we do it, when I'm ready to move forward, I will,” he said. he said Military weather in November.

Still, VA health centers, including the one in Puget Sound, have doubled down on care for transgender veterans.

According to a 2018 directive, last updated in June, the VA has been “injecting concepts of gender ideology” into “clinical work,” three VA professionals. he wrote in a Wednesday op-ed published in The Hill.

Transgender accommodations “effectively [extinguish] the entire class of women, undermining many physical and legal protections for female veterans,” they wrote.

Puget Sound launched a so-called Gender Diversity Clinic tailored to accommodate “gender diverse” veterans and train future transgender medical providers, which would be done through Puget Sound's partnership with the University of Washington, according to the proposal.

“A veteran's primary medical and mental health providers, as well as the gender affirming surgical team, will play a role in addressing any medical, mental, spiritual, or social barriers that prevent veterans from access gender affirmation surgery,” the proposal states.

The Puget Sound VA would host two LGBTQ+ support groups and an outreach coordinator to “promote self-healing and care” on a veteran's road to recovery, as the proposal authors stated. They also pledged to work together with the installation's DEI committee to improve perceived disparities in veterans' “gender diversity” experiences.

In support of its application, Puget Sound outlined plans to expand “LGBTQ+ education,” the application stated, with the goals of “ending invisibility,” improving “affirmative communication,” and creating a ” more affirmative environment in our facilities.”

Also as part of the program, Puget Sound Center's LGBTQ+ Veterans Care Coordinator (VCC) had already begun providing training to all staff, including those not at the proposed surgery center, to avoid dead names , using the old name of a transgender person, misgendered veterans. . Staff had already received 38 trainings on LGBTQ+ inclusion from the VCC, according to the proposal.

Additional efforts included renaming the women's clinic to include other self-described gender identities and making places like bathrooms and nursing pods more friendly to people who chose to live as the opposite sex.

The authors of the proposal said the Puget Sound VA Medical Center is creating fields in its electronic records for both sex and gender identity and plans to introduce transgender veteran communication media, such as signs and posters, throughout the medical center.

The center also hoped to recruit “gender-diverse staff,” while making a cursory glance at non-discrimination policies.

“Specifically for strategic hires in our gender diverse surgery program where we would/will intentionally hire staff who have lived experience/understanding of gender diversity,” the proposal said.

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