A promise made at enlistment — that the nation will care for those who serve — has become increasingly uncertain for the nation’s LGBTQ+ veterans.
On Saturday, members of Common Defense, a veteran-led movement dedicated to upholding their oath long after active duty has ended, rallied outside the VA hospital in Pittsburgh’s Oakland neighborhood to voice their opposition to changes to treatment policies that have a significant impact on the care they currently receive.
“Today we are showing up to speak out against a June 12 memo that extends the rulings in the VA under two executive orders put under the Trump Administration that are cutting care for LGBTQIA+ veterans at the VA,” said Rayven Greer, Common Defense’s Veteran LGBT Caucus Co-Chair. She said that showing up sends a message to both veterans and VA staff that they will not let care for other veterans decline in quality.
The changes to treatment policies have raised serious doubts in the queer community regarding the continued care provided by the Department of Veterans Affairs. An internal memorandum issued on June 12, 2026, by the Under Secretary for Health John Bartram heavily weakens benefits that afforded LGBTQ+ veterans access to designated care coordinators, allowing them to access care for transgender-related diagnoses. The memo carried the subject line of “Reiterating Executive Order Compliance Responsibilities”.
The memorandum was issued, in part, to comply with Executive Order 14168 Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government, which prohibits government funds, time, facilities, or resources from being used to promote “gender-ideology or gender-identity.” The Order was issued by President Trump in January 2025.
While the VA policy does not eliminate transgender veterans’ general eligibility for disability compensation, pensions, education assistance or home loans, it can disrupt ongoing care for those already receiving medical and mental health benefits through the Veterans Administration, and act as a barrier to care for those seeking these benefits for the first time.
“Recently we just lost our LGBT Care Coordinators, so now we have no ‘GPS’ to go to care or doctors who understand our troubles, said Greer. “Every time I go in for my HRT, my doctor tells me ‘we might not be here for you tomorrow’.”
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In March 2025, the VA announced that it would phase out medical treatment for gender dysphoria. Under the policy, veterans already receiving hormone therapy through the VA could continue treatment, provided they were receiving that care on or before that date, and had a diagnosis of gender dysphoria. Veterans newly entering the system, however, could not begin such therapy unless they had received it while serving in the military.
VA Secretary Doug Collins maintained that transgender veterans remained welcome and would receive the services they had earned. “I mean no disrespect to anyone, but VA should not be focused on helping Veterans attempt to change their sex. The vast majority of Veterans and Americans agree, and that is why this is the right decision,” said Secretary Collins. “All eligible Veterans – including trans-identified Veterans – will always be welcome at VA and will always receive the benefits and services they’ve earned under the law. But if Veterans want to attempt to change their sex, they can do so on their own dime.” He argued that savings would be redirected toward veterans with paralysis and severe injuries.
Critics reject that framing. They argue that gender-affirming treatment is health care prescribed by clinicians — not an optional benefit competing with wheelchairs, prosthetics or rehabilitation. They also note that hormone medications remain available when prescribed for other conditions. The restriction therefore turns not only on the treatment itself, but on the identity and diagnosis of the patient receiving it.
The practical consequences extend beyond the cost of medication. Interrupting or denying medically indicated care can increase distress and discourage patients from seeking unrelated services. An empirical study by the American Psychological Association from 2014 shows that less than a third of LGBTQ+ veterans and providers viewed the VA as welcoming. Half of the providers surveyed indicated they do not assess sexual orientation with any of their patients, or alter their treatment plans even if they know the veteran is lesbian, gay, or bisexual. In a related study by the APA from 2014, nearly 54% of veterans who identified as a sexual and gender minority reported at least one suicide attempt as compared to 28% among those who identified as heterosexual non-transgender.
Female and younger LGBTQ+ veterans appear far less likely to access VHA benefits for health care compared to their cisgender, heterosexual peers. A study published by the National Institutes of Health (NIH) in the American Journal of Public Health noted that between 2006 and 2013, nearly 33,000 VHA users had a transgender-related diagnosis. The report also showed transgender veterans are seeing VA care at an increasing rate and showed that in the two years following the 2011 directive, there was a 40% increase in new diagnoses.
A transgender veteran who expects hostility at a VA facility may postpone a cancer screening, mental-health appointment, or routine physical. In a 2017 study titled “Transgender Veterans’ Satisfaction with Care and Unmet Health Needs”, the VA itself acknowledges that LGBTQ+ veterans face distinctive mental-health pressures and the most frequent barrier to seeking care is provider reactions to their gender identity or sexual orientation.
Military Times reported that critics expect the changes to cause some LGBTQ+ veterans to avoid treatment. In a now-removed resource on the VA’s website it had at least one LGBTQ+ care coordinator at each of its 142 facilities.
This retrenchment is especially significant because transgender people have served through repeated reversals in military policy. Some endured harassment or concealed their identities to remain in uniform. Others left service with discharge records connected to earlier anti-LGBTQ+ rules, creating additional obstacles to benefits. Lawmakers have proposed legislation to improve eligibility for people separated solely because of sexual orientation or gender identity, but those efforts underscore how past discrimination can follow veterans long after discharge.
Common Defense has been working with lawmakers defending against cuts to VHA benefits. Rep. Mark Takano (CA-39), Chair of the Congressional Equity Caucus and Ranking Member of the House Committee on Veterans’ Affairs, said that the decision to recind VHA Directive 1341(4) is “both shameful and cruel”. In a written statement in March, he said, “I wanted to make it clear to every trans, nonbinary and intersex veteran: my Democratic colleagues in Congress and I value your sacrifices and service to our nation. We are — and will keep — fighting for you, because you matter and deserve the same rights and treatment as every other veteran and American.”
Supporters of the VA’s approach say the government may define the scope of its medical package and prioritize treatments it considers most closely connected to military service. Yet the VA routinely treats conditions regardless of whether they began in uniform, and its health system is intended to provide comprehensive care to eligible veterans. Excluding one category of clinically prescribed treatment therefore raises serious questions about whether political definitions are replacing individualized medical judgment.
Transgender veterans have not, as a class, lost every VA benefit. A qualified veteran can still apply for disability compensation, use a VA-backed mortgage or receive treatment for many physical and psychological conditions. But access on paper is not the same as meaningful access. When specialized care is withdrawn, navigation support is diluted, and patients no longer trust the institution serving them, the value of the remaining benefits diminishes.
Military service is built on reciprocal obligation. Veterans accept extraordinary demands, and the country promises not to abandon them afterward. Whether that promise applies equally should not depend on a veteran’s gender identity or on which administration controls Washington.