Doctors at the Department of Veterans Affairs (VA) have been instructed to stop providing forms and support letters that refer veterans to private medical providers for gender-affirming care.

Veterans were already unable to receive gender-affirming surgeries through the VA, and as such, VA doctors have referred trans patients to private practices for over a decade.

“There’s no rationale that I could point to other than it’s just simply an attack on transgender people for the sake of attacking,” one anonymous VA doctor told The Advocate. “Why else? Because it’s not costing you anything. It’s just getting in the way of their care.”

“There is no financial reason,” the doctor added. “There is no medical reason. It’s ideology, not medicine.” They also underscored that the letters they’re now forbidden from writing are an extremely minor task to complete. “It doesn’t require much extra time to write a simple letter. It’s not hard. It’s not costly. But now it’s prohibited.”

The VA officially stopped offering gender-affirming surgeries in 2013. In 2021, the Biden administration promised to change that, but despite lawsuits, it never came to pass. The current president then abandoned the effort when he took office in 2025.

This move ties in with the VA’s larger plans to phase out all forms of gender-affirming care for veterans. Plans to do so were finalized in July in response to the “two sexes” executive order. The new policies deny all gender-affirming care, including hormone treatments, to anyone who was not already receiving the treatment prior to the announcement.

The care provided through the VA is earned by retired members of the armed forces who have given years of service and risked their lives for the United States. With this new policy, veterans will either lose access to the care they need or will need to set up expensive primary care outside of the VA and start the whole process from scratch.

When The Advocate asked what trans veterans should do if they can’t obtain the necessary documents for a referral, VA press secretary, Pete Kasperowicz, pointed to a previous comment: “If Veterans want to attempt to change their sex, they can do so on their own dime.”

The move comes as the number of trans veterans rises dramatically, considering many trans service members are being forced out of the armed forces by the current administration.

The cost of this policy will be measured in human lives. “This isn’t policy nuance or administrative housekeeping; it is targeted discrimination, a calculated form of medical eugenics that uses denial of care as a weapon to decide which veterans are allowed to survive,” Lindsay Church, the executive director of Minority Veterans of America, told The Advocate.

Both veterans and trans people who can’t receive gender-affirming care are more likely to consider taking their own lives. Mental health issues can be (and has been) exacerbated by lack of care from VA medical services.

Out Rep. Mark Takano (D-CA) said he has joined others in introducing the “Veterans Healthcare Equality Act,” which will seek to “protect transgender veterans’ access to healthcare.”

“The Administration has remained set on targeting transgender veterans’ healthcare,” Takano said in a statement. “They have rescinded vital protections and are now attempting to obstruct veterans’ autonomy, cutting them off from care they’d pay for with their own dime. We can’t stand by as these attacks continue.”

“This measure protects transgender veterans’ access to healthcare, so all veterans can access medically necessary care from the Veterans Health Administration without discrimination. All veterans deserve access to comprehensive healthcare, regardless of the political whims of Republicans on their ‘anti-woke’ crusade.”

If this story affected you, just know you are not alone. The Trans Lifeline Hotline offers support to trans/nonbinary people struggling with mental health from 10 A.M. to 6 P.M. PST Monday-Friday. Call (877) 565-8860 to be connected to a trans/nonbinary peer operator and receive full anonymity and confidentiality. The Trevor Project Lifeline, for LGBTQ+ youth ages 24 and younger, can be reached at (866) 488-7386.