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Guest Post: Transgender Veterans and Their Gender Markers

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Editor's Note: This guest post from transgender veteran Autumn Sandeen, is part of a week-long series to celebrate the accomplishments and heroism of transgender Americans as part of Transgender Awareness Week. The final day of Transgender Awareness Week is the Transgender Day of Remembrance (TDOR), an annual observance on November 20 that honors the memory of those whose lives were lost in acts of anti-transgender violence.

By Autumn Sandeen

Up until October 16th, I was one of two transgender veterans who weren't able to change my gender marker in the Veterans Administration (VA) databases, to include my VA medical record. There's a story why other trans veterans were able to change their gender markers eight months earlier than I was able to change mine, and it has to do with a cost of community activism -- a cost of serving my trans community peer veterans in a manner similar to how I served my country in the U.S. Navy for 20-years between 1980 and 2000.

The story began with a white paper put forward by the Palm Center and the Transgender American Veterans Association. The paper spelled out the difficulties disabled trans veterans had accessing adequate and appropriate medical care from the veterans administration -- and that's not just transition related care, but even basic medical care. Eligible, disability rated veterans were even being turned away from some VA medical facilities just because they were trans -- it was horrible.

The National Center for Transgender Equality then approached the VA about the medical needs for disabled trans veterans, using the white paper to outline the difficulties trans veterans faced. Working with the VA, a new policy was adopted in June of 2011which NCTE described it this way:

"The Veterans Health Administration (VHA) has issued a Directive to all of its facilities establishing a policy of respectful delivery of healthcare to transgender and intersex veterans who are enrolled in the Department of Veterans Affairs (VA) healthcare system or are otherwise eligible for VA care. This Directive is an important first step in securing equal access for transgender veterans, and healthcare access for transgender people generally, by setting an example of how healthcare providers in both the public and private sector should be treating transgender patients."

NCTE described what the standard entailed for disabled trans veterans:

  • Indicates that all VA staff are to provide care to transgender patients “without discrimination in a manner consistent with care and management of all Veteran patients;”
  • Clearly states that all personal information about transgender status and medical care is kept confidential;
  • Reiterates that, under existing regulations, sex reassignment surgery cannot be performed or paid for by the VA;
  • Reiterates that all other medically necessary healthcare for transgender veterans is covered, including sex-specific care like mammograms and pap smears, as well as transition-related care such as hormones and mental health services.

In the FAQs for the new policy, there was a question about changing one's gender marker in the VA system:

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.

So, what was needed then was someone to test the new policy to change one's gender marker, so I stepped up to do it. I applied several times using several different forms of documentation only to be turned down each time I applied. Eventually, after I turned in the same documentation required to change one's gender marker with the State Department for a passport -- where one submits a letter from a medical doctor stating that one is receiving appropriate treatment for change of sex -- and was turned down again. The group that was in charge of changing gender markers at the VA stated that only documentation of sex reassignment surgery was acceptable to change one's gender marker.

I appealed. That was in October of 2011.

Four months later the VA changed their policy to embrace the State Department's standard specifically because I appealed and the system didn't work as the policy level leadership at the VA had planned. So since early in 2012, disabled, transgender veterans can change their gender marker within the VA, to include VA medical records.

But, I couldn't. My appeal wasn't resolved -- there apparently were internal documentation discussions going on between policy personnel and those who maintain the standards for how VA medical records are maintained regarding how one tracking treatment of transgender veterans. My appeal, as well as the appeal by another disabled trans veterans, apparently was what they were using as the impetus to find a solution to this issue.

So, by being the trailblazer, I couldn't take advantage of the new change of gender marker policy when my peer disabled trans veterans could. My emotional response was to weep and sob repeatedly over being not being able to take advantage of a new policy I played a significant role in helping to create.

As of October 15th, my appeal was resolved; as of October 16th, my gender marker was changed in the VA's electronic databases. I feel that I helped win a victory for myself, but a victory for my trans subcommunity of the LGBT community.

Looking ahead, the last federal system that lists me as male is the Department Of The Navy, which in turn means I'm listed as male by the Department of Defense. The next struggle in with gender markers involves working with the Servicemembers Legal Defense Network (SLDN) to change the gender marker policy of the Department of Defense regarding trans veterans.

And, of course, I'm looking forward to the day when transgender people can serve openly in the five military services just as now lesbian, gay, and bisexual servicemembers can now serve openly. I expect that day will come in my lifetime.

At a time of year when veterans are honored, we in LGBT community should we have many LGBT veterans we can thank for that service, and many trans veterans are among those who served our nation honorably.

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